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. CONSULT YOUR LAWYER BEFORE SIGNING TKIS INSTRUMENT-THIS INSTRUMENT SHOULD BE USED BY LAWYERS ONLY
CVP"~"/IiP /lJ- O~ /-;p.o Ii"
THIS INDENTURE, made the / I"" day of January, two thousand eight.
BETWEEN
PORTER J. GOSS and MARY R. GOSS. now residing at 1822 Woodring Road, P.O. Box 248. Sanibel. Florida
33957,
party of the first part, and
C. HIRAM UPSON III, Trustee of the C. Hiram Upson III Qualified Personal Residence Trust dated May 14, 1996,
141 Shearer Road, Washington. Connectlcul 06793-1012,
party of the second part,
WITNESSETH, that the party of the first part, In consideration of One Hundred Twenty-Five Thousand and
OCl/100-----($125,OOO.00)----do1lars paid by the party of the second part, does hereby grant and release
unto the party of the second part, the heirs or successors and assigns of the party of the second part forever.
All that certain plot, piece or parcel of land, with the buildings and improvements thereon erected. s~uate, lying
and being at Fishers Island, Town of Soulhold, County of Suffolk and State of New York, being more particulariy
bounded and described as set forth on Schedule A hereto.
BEING AND INTENDED TO BE a portion of the same premises conveyed to the party of the first part by deed
recorded in the Office of the Suffolk County Clerk on January 16, 1979 in Liber 8567 page 522.
The party of the second part acknowledges that the parcel described on Schedule A hereto does not constitute
a separate building site under the Town of Southold Zoning Code and that, upon the recording of this deed In the
Office oflhe Suffolk County Clerk, such parcel will merge with and become a part of other premises of the party
of the second part adjoining said parcel on the north and east, said adjoining premises being known. shown and
designated as Block 30 - Lot 3 on the Map of Fishers Island Development Corporation, whlch said Map was filed
in the Office of the Suffolk County Clerk on September 25, 1991 as Map No. A421, said Block 30 - Lot 3 also
being designated on the Suffolk County Tax Map as'Dlstrict 1000, Sectlon 003.00, Block 06.00, Lot 002.000.
TOGETHER with all right, title and Interest, If any, of the party of the first partin and to any streets and roads
abutting the above described premises to the center lines thereof; TOGETHER with the appurtenances and all
the estate and rights of the party of the first part In and to said premises; TO HAVE AND TO HOLD the premises
herein granted unto the party of the second part, the heirs or successors and assigns of the party of the second
part forever.
AND the party of the first part covenants that the party of the first part has not done or suffered anything whereby
the said prerrises have been encumbered In any way whatever, except as aforesaid,
AND the party of the first part, in compliance with Section 13 of the Lien Law. covenants that the party of the first
part will receive the consideration for this conveyance and will hold the right to receive such consideration as a
trust fund to be applied first for the purpose of paying the cost of the Improvement and will apply the sarne first
to the payment of the cost of the Improvement before using any part of the tolal of the same for any other
purpose. The word "party" shall be construed as if it read "parties" whenever the sense of this indenture so
requires.
IN WITNESS WHEREOF, the party of the first part has duly executed this deed the day and year first above
wrillen.
IN PRESENCE OF:
. Standord N. Y.B.T.U, Form 8002 - Borgoln IO'ld Solo 0Md, wtth Covenont ogaInsl Gronlor'. Acll- UnIform Acknowledgment
SCHEDULE A
TO DEED
Party of the First Part:
Porter J. Goss and Mary R. Goss
Deed Dated:
C. Hiram Upson III, Trustee
January / I ,2008
Party of the Second Part:
ALL that certain plot, piece or parcel of land situate, lying and being at Fishers Island,
Town of Southold, County of Suffolk and State of New York, more particularly bounded and
described as follows:
BEGINNING at a point on the southeasterly line of a road, said point being located
4789.22 feet North of a point which is 764.61 feet East of a monument marking the United
States Coast and Geodetic Survey Triangulation Station "NIN"; and
RUNNING THENCE South 40 degrees 19 minutes 30 seconds East, 307.78 feet to an iron
pipe;
THENCE South 39 degrees 43 minutes 02 seconds West, 105.98 feet to a point;
THENCE North 42 degrees 24 minutes 10 seconds West, 318.31 feet to a point on the
southeasterly line of said road, said point being located 4704.28 feet North of a point
which is 684.65 feet East of said "NIN" monument and also being at a point of curve to the
right having a radius of910.27feetand the direction of whose radius at that point is South
47 degrees 55 minutes 54 seconds East;
THENCE northeastwardly along said road line and following the arc of said curve, 116.28
feet to the point of BEGINNING.
TO BE USED ONLY WHEN THE ACKNOWLEDGMENT IS MADE IN NEW YORK STATE
State of New York. County of ss:
stale of New York. County of ss.
On lhe day of In the yew
before me. the undersigned, personally appeMld
On the day of In the year
before me, the undersigned. personally appeared
personally known to me or proved to me on the basis of
satisfectory evidence to be the individusl(s) whose name(s) are
subscribed to the wlthin instrument end acknowledged to me that
heJsheJ1hey executed the same In hlslherlthelr capacity(les). and
that by hislherlthelr signature(s) on the instrument. the
individual(s). or the person upon behalf of which the individuel(s)
ected, executed the Instrument.
personally known to me or proved to me on the basis of
satisfectory evidence to be the Individuals whose names we
subscribed to lhewlthin Instrument and acknowledged to me that
helshelthey executed the same in hlslherlthelr capacities, and
that by their signatures on the instrument, the individual., or the
person upon behalf of which the Indlvidue/8 ected, executed the
instrument
Notary Public
(signature end office of individual taking acknowledgment)
Notary Public
(signature and office of Individual taking ecknowledgment)
TO BE USED ONLY WHEN THE ACKNOWLEDGMENT IS MADE OUTSIDE NEW YORK STATE
state of Florida; Countyof Lee .s:
On the 1,I'oday of January in the year 2008, before me, the undersigned, personally appeared
Porter J. Go.. and Mary R Goss
personally known to me or proved 10 me on the basis of satisfactory evidence to be the individual whose neme is subscribed to the
within instrument end acknowledged to me thlt he executed the same in hi. capaclly, and that by hi. slgnlture on the Instrument,
the individual. or the pernon upon behalf of which the individual acled, executed the Instrument, and that such individual made such
eppewence before the undersigned In thecit-f ~ f' So.V\; bc.\ In the Slate of Rcrldl.
(insert the.Cny or other political subdivision)
~ office of indlvldulllaklng ICknowledgmenl)
ilii.~ lIY==~:fD
f ~ 1bQdn.u....,,..UI*IrIIr:I
'" .
Title No
RH07301718
DISTRICT 1000
SECTION 003.00
BLOCK 06.00
LOT plo 003.006
COUNTY OR TOWN SUFFOLK - SOUTHOLD
STREET ADDRESS (no #) PRIVATE ROAD
FISHERS ISLAND, NY 06390
BARGAIN AND SALE DEED
WITH COVENANT AGAINST GRANTOR'S ACTS
PORTER J. GOSS ond MARY R. GOSS
TO
C. HIRAM UPSON W. TRUSTa:
RETURN BY MAIL TO:
STANDARD FOIlII OF NEW YORK BOAAO OF TITLE lNlERWRI1BllI
lliI1l't>Jtodby
RESERVE nus SPACE FOR USE OF RECORDING OFACE
Number of pages
RECORDED
2008 J<I"I 23 11: 09: 54 ilM
Judith ~. P~c~le
ClERK OF
SLHOlJ( COLm\'
L 000012538
P 155
D1# 07-16966
This document will be public
record. Please remove all
Social. Security Numbers
prior to recording.
Deed I Mortgage Instrument
Deed I Mortgage Tax Stamp
Recording I Filing Stamp'
3
FEES
Comm. of Ed.
5. 00
Mortgage Amt
1. Basic Tax
2. Additional Tax
Sub Total
SpecJAssil
or
Spec./Add.
TOT. MTG. TAX
Dual Town _ Dual County _
Held for Appointment
TramferTax (>.;5"00, --- .
Mansion Tax
Page I Filing Fee
Handling
TP-584
5. 00
--;;:r-
0_
Notation
6;-
/bS
3D
Sub Total
EA-52 17 (County)
EA-S217 (State)
RPT.SA.
Affidavit
t:..s.e.r:tIfle<i'~ppi@
NYS Surcharge
Other
--
~
15. ()()
Sub Total
01(7
The property covered by this mortgage is
or will be improved by a one or two
family dwelling only.
YES or NO
Grand Total
If NO, see appropriate tax clause on
page' oflhls Instrument.
4 Dist
~~
~
1000 00300 0600 003015
. , ....
5 Convnunlty Preservation Fund
Real Prop'
Tax Servic
Agency
Verincati,
Cdnsideration Amount $ 125.000
CPF Tax Due
s
1. 000
6 Satis actions/Discharges/Releases Ust Property Owners Mai ing
RECORD & RETURN TO:
Improved
Vacant Land
STEPHEN L. HAM, III, ESQ.
MATTHEWS & HAM
38 NUGENT STREET
SOUTHAMPTON, NY 11968
TO
TO
TO
Mail to: Judith A. Pascale, Suffolk County Clerk
310 Center Drive, Riverhead, NY 11901
www.suffolkcountyny.gov/derk
7 Title Company Information
Co. Name Commonwealth Land Title Ins. Co.
Titie' RH0730171B
8 Suffolk County Recording & Endorsement Page
This page forms part of the attached DEED
by:
PORTER J GOSS and MARY R GOSS
made
(SPECIFY TYPE OF INSTRUMENT)
The premises herein Is situated In
SUFFOlk COUNTY, NEW YORK
TO
C HIRAM UPSON III TRUSTEE
In the TOWN of SOlJTHOI.D
In the VILLAGE
or HAMlET of FISHERS ISLAND
BOXES 6 THRU 8 MUST 8E TYPED OR PRINTED IN BLACK INK ONLY PRIOR TO RECORDING OR FILING.
lover)
1111111111111111111111111111111111111111111111111111111
1I11III11111111111111111I
SUFFOLK COUNTY CLERK
RECORDS OFFICE
RECORDING PAGE
Type o~ Instrument: DEEDS/DDD
Number o~ Pages: 4
Receipt Number : 08-0006533
TRANSFER TAX NUMBER: 07-16966
Recorded:
At:
01/23/2008
11:09:54 AM
LIBER:
PAGE:
000012538
155
District:
1000
Section:
003.00
1l'Y"MINED AND
$125,000.00
Block:
06.00
CHARGED AS
Lot:
003.015
FOLLOWS
Deed Amount:
Received the Following FeliS For Above Instrument
Exempt Exemp
paqe/Filinq $12.00 NO Handling $5.00 NO
COB $5.00 NO NYS SRCHG $15.00 NO
EA-CTY $5.00 NO EA-STA'l'E $165.00 NO
TP-584 $5.00 NO Notation $0.00 NO
Cert.Copies $5.00 NO RPT $30.00 NO
Transfer tax $500.00 NO Comm.Pres $1,000.00 NO
Fees Paid $1,747.00
TRANSFER TAX NUMBER : 07-16966
THIS PAGE IS A PART OF THE INSTRUMENT
THIS IS NOT A BILL
Judith A. Pascale
County Clerk, Su~folk County
PLEASE TYPE OR PRESS FIRMLY WHEN WRITING ON FORM
INSTRUCTIONS: http:// www.orps.state.ny.us or PHONE (518) 473-7222
FOR COUNTY USE ONLY
CI. SWIS Code
11.\-,1,3,6 ,5 ~..J
,it
REAL PROPERTY TRANSFER REPORT
C2. Doto Doed Recordod I 0 \ I a3 I ~ 3 I
Monlh Day _
c3.II_1 \,a,S.3,61C4.POUOI ,\ 55
PROPERTY INFORMATION
STATE Of NEW YORK
STATE BOARD OF REAl PROPERTY SERVICES
RP - 5217
RP-!lJI1 b\ :wr
I. Proporty I ~o') Private Road off Eaat End Road
LocotIon 5 T NUMIII'l '''''Ir.tN.I..WI
Southold Fishers Island I 06390
cmOllTOW\l ,...... ;'CClCli
2._ C. Hiram Upson III Qualified Peraonal lesidence Trust
Homo LAJTI6MIl.I~ ,.,.......,.
1.AST"IAM!/COoIUAhV
""'..-.
11... lndic.IIe'tlil'her"e Mute Ta Bills ale to be MRt
11Ilinu if othSl thin buyer Iddrna (It bottom of form) I
~
LAlTNAlIIIf.tCOlM'AHY
""T""'"
STllhTNLW....lWCJlll'arNAMk
01'1' [)lII fD'WN
il~l(
lII'toCIi
"""
I OR I
',1,(""'
. 8 ,0
10nly H Port '" . .....u a..dr .. ..... opply:
.... 1'1_ Boanl with Subdivision ~ &.loti ~
48. Subdivision Approv.1 was ReQu.Irod lor Tr.nvfor ~
4C. PIIrtel Approved tor Subdl...Jtion with Map Provided 0
... 1ndic.a1. th. number of AaMUllMnt
Roll perceh tr.nsMn-ed on the dud
, 0' P,rceb OR 0 Part of . P.r~1
S. Ilood
Proporty
$Iu
~'m
I xl
6._,
H_
u.sr Ggy, COfII'N{'I
Porter J.
--........
Goee
Mary R.
LAlINANliI~
f'N"[........
1. CMdI ttw ba. be60w which moat accurattty duc:rtbM the UN of thtl property at the tirN of ....:
A~ OIM F.mlly Ruidenti.a
B 2 Dr :3 FomCty Raadl:nWlI
C RMJdential V.CIInl Ulnd
D. Non--Ret;idc:mtl4l Vacant Lind
I SAlE I NFORMA TlON I
11. ~ ContI'8Ct Date
F.~"'ricu",,'al
F Com~1
(i ApartmenI
H Encertairwnenll Amu.emenc
I ~ CommunllV Sorvlco
J Indu:t1rial
K PubUe Se1v1C*
L Forest
CIo... tho ...... _ .. thoy _
.. Ownerwhlp Type is CondomInium
i. New ConRruction on Vacant IIrx1'
1OA.. Propeny lOClted wirhln an AQri(:uJwraJ Ois.tricl
laB. BLJ'fIlf' fecotvad , ditdoI1JO notJco Inditatlng
lhel the proporty Is In an Agricutlural Oistrict
o
o
o
o
15. 0-* one or ....... of thne ~ .-., 4 as -wn-....... to trander:
u....
I!!
108
Vw
A
Il
C
o
E
r
G
H
I
J
Sale Between AoIatI.... Of' Fomwr RoJ..t:iws
SaJe e.twMn ReI,tee! COl'1'"IpaI1Ies or Pert,..... in Bualnns
One 01 the 8uyeq it also II Soller
Buyar or SoIor iI Gowrl"ll'Mnt Agency or Lcndlng In.tilutJon
Dood Typo not Warr.-rty or BargaIn end Snit! ISpocify &row)
Sale of Fracl:lonIJ or leJa than Fee 11ll8f'at (SpecJfy B8Iow)
SignJflClnl Chango It'I Property Bttwocn Taxe~ Status 8nd 51110 De
SMt 01 Bul:lneu IS Ir1c:ruded In S81e Price
Othor- Unuaual Fectorl Aft'ectlng Solo Price (Spocify s.&ow)
No..
12. Dat, of s... J nlnsf4r
01
-
I I r I 08
Coy YIA<
13. Fu! s.Ie Price
, 1 , 2 . 5 , 0 , 0 , 0 , U , U I
, , .
lFull s.r. Pritt i. tM leal amount pold fOf tho plopertv IncludIng personal property.
TtUa payment may b& In the form of cash. ~ pl'optrty or goods, Of the llaUfnPIlon Gf
mort~M or ather abI~ItIons..1 PIaMe rolllld to th. ~.G whoI. do&r MnOCJnf.
,..---..........."'........ I 0 0 U I
_Indudodln...... - . ~ .
ASSESSMENT INFORMATION. DaUl snould reflect the latmlt Final Assaumont Roll and Tax Bill
t6. V... "'_... ""'" 07 081 17. T.... _ V_lot oil_in b__' I
_In__ .
;
,
,
*entire
3 4
;
parcel
o
or
18. Property au.
I 3. 1, 1 I-U 19. School Diotrirn....... I Fiahers Island
20. rlX MIp 1den1illel1l1 I AoIldlntifierfsl (II mon than fOW', ,tuch shMt with ~ IdenttfI.-(,JI
100o-003.00-06.~~03.006
I
I CERTIFICATION
I anti')' lIuat all oIlbr ilnm of Infmmlllton I!IItfftd oa Ihb ronn al'\" Ink' .IUld ("()fTf'l1 tlo thr baa of my klll)'WlcdJ:I: UDd _olin) aD:I I ~ Lbat l.br mak~
of 11II" ,,1l1fullnht ~C'IOC1JI 01 matcriul fac1 herrin ",01 subjH111U' 10 lbe DrmfoJrms 01 'hI:' ~ tow rt!bdk~ to Ihl' IDDIdn<< r.md ftI.InR oIl'alw lrIiIl'UIllftll'\o
~ BUYER'S ATTORNEY
C. HIRAM UPSON III QUALIFIED PERSONAL RESIDENC
, TRUST
Bv C. ~~\)~~~I 01/ Jl /08 Ham Stephen L.. III
kJ't('! IG.'UT\.ItI! r:::-- Do\T! LUf NAMI '1IIllT H.AW
C. Hiram Upson III, Trustee
141 Shearer Road (631) 283-2400
.,.,.crrM*!II!fII I1'NlrNAlA/Nlll'ISAI,tt MUoCODl "LPHQrd~
06793
""cOO<
NEW YORK STATE
COPY
/08
./
Porter
DOn:
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