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CONSIDERATIO
'I1US INDIlN'I'UIIEo mode Ille
BETWEEN
26 th
day 01
January
, in lhe YCDr
2004
Concetta Beta. presently residing at 55 Hanrahan Avenue. Farmingville. NY 11738
party 01 the lint put, aod
"RJ::SI!KVING TO THE GRA"''TOR HEREIN A LIFE ESTATE INTEREST III THI! PREMISE"
__ _~''?i?~~ :~9well. presently residing at 101 Winge. Avenue. Patchogue. NY 11772
D:I...t
1000
party olllle -"" put, .
wrnrESlIE'I'H. dW Ille party 0I1lle lint part, in coonoidention 01 Ten Dollan and other w1uab1e amaid~
J!IIid by Ille party 0I1lle Iicand put, _ hereby grant and re_ unto the party 01 tbe -.d pan. the hcin
or 1.-..... aaiI ....... 01 tbO party 01 tbe I8Coad part forever,
AU. IhII cerlaiu pIoI, pi-. or panlII 0I1aad, with tbe IIuiIdinp aod impro_ta tiler.- IlrcCIed, aituaee,
Iyi.. aod beiac in. near Nassau Point, in the Town of Southold. County of Suffolk and
Seat!e of New York.. known and designated as LotNNo. 39 on a c.ertaJ.n Hap eneit.led ~I:.,
"Hap of Nassau Farman. situated ac Peconi.c. Suffolk County. New York. OCto W. Van '!,
Tuyl. "L:l.censed Surveyor. Greenport. New York" and filed in the Suffolk Cauney
Clerk's Office as and by the Map lIo. 1179. on March 28. 1935.
Sect
104.00
Block
02.00
Be1.ng and lntended to be the same premises as conveyed to Grantor by deed.:dated
December 4th. 1978. recorded in the office of the Suffolk County Clerk in liber
8551. page 49. on December 18. 1978.
Lot
014.00
"RESERVING TO THE GRAI\."TOR HEREIN A LiFE J!STATIi INTEREST IN THE PREXISE. '.'
TOGETHER wilh ell riJhI. litle and inle....1, il any, 01 the pany 01 the firsl pan in and 10 ..t)' slrccu aod
"laCll abollin.. Ih. above deocribed pren.i...1o Ille cenler linu lhereol: TOGETHER with the appu_
"nd "l1lh. .....Ie and riellll 01 the pan)' 01 tbe lint part In and 10 _id promiIBI; TO HAVE AND TO
HOLO lhe pren.iIBI herein granted unto the party olllle -.I pari. the hein or s....,....,.. and uslcns 01
the pany of lhe I8COnd pan fore".r.
AND the party oIth. lirll pan co.......nll lhalthe party 01 the lir. pari bas not clone or IUff.reel anytmng
whereby the uid rremises have been encumbered in any way whale\.-er, e~ .. afonaid. .
AND the flIlrty 0 the lira pan, in compliance with Sec:tion 13 of lhe LIen Law, COYenants lhat the pany of
the linl pan will receive lhe conlidentlOD lor Iml COftYC)'...... and will hold th. ripl to recei". lueh conold-
.ration al a Il'UIt fund to be applied lint {or the pu~ 01 payi.. the COIl ollhe Impronmenl and will appl)'
lhe sam. linl to the flIl)'1I..nl 01 the COlI of the Improvement before uling any pan 0I1lle IOla1 oIlhe same lor
an)' oth.r pu~.
The ,,-ore' .'party" shall be conllrued .. if it read .'partics" whenever 1M lCDie' 01 thi. indenture 10 reqwrea.
Dl' 'WrI1fES5 WHEREOF, lhe pari)' 01 the lint pan bas duly ........ted this deed the day and year lira above
wriuen..
hr .aaEIICS w:
[1&-R~~~ ~&~
Concetta Bets
IIII~IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII
IIIIIIIIIIIIIIIIII~ IIII
SUPFOLK COUNTY CLERK
RECORDS OFFICI
RECORDING PAGE
Type of Instrumentl DEEDS/DDD
Number of Pagesl 3
Receipt Number I 04-0036741
TRANS PER TAX HUMBER: 03-36547
Recordedl
Atl
03/31/2004
04127.14 PM
LIBER:
PAGE:
D00012310
999
COHCE'lTA BBTZ
JOYCI POWILL
District 1
1000
Section. Block.
104.00 02.00
IP.UMINBD AND CHARGID AS rOLLOWS
$0.00
Lot.
014.000
Deed AmoWlt 1
Received the rollowing rees For Above Instrument
Exempt
NO
HO
HO
NO
NO
NO
Page/Filing
COB
EA-CTY
TP-584
RPT
Transfer tax
$9.00
$5.00
$5.00
$5.00
$30.00
$0.00
Handling
NYS SRCBG
lA-STATE
Cert.Copie.
SCTM
CClIIIIII.Pres
re.s paid
$5.00
$15.00
$50.00
$0.00
$0.00
$0.00
$124.00
Exempt
NO
NO
NO
HO
NO
HO
TRAHSPBR TAX HUMBERI 03-36547
THIS PAGI IS A PART or THB IHSTRUIIBN'l'
THIS IS HOT A BILL
Edward P.Romaine
COWlty Clerk, Suffolk COWlty
Num....r of pug"s
TORRHNS
RECORDED
2004 Mar JI 04.27.14 PM
Edward P.Roa.oI""
CLERK OF
SUFFOlK COUIITV
L DOOOI2J1D
pm
DT. 03-36547
Scriallt
c..niliealc It
Prior Of. "
o.....J / Mangage In.lrumenl
Deed / Monguge Tu Stamp
FEES
Rccording / Filing Stamp"
J
Cenilied Copy
NYS Surchl1ll!e
Other
IS. 00
Suh TUlal
/#/ - rJ
Monllage Amt.
I. Basic Thx
2. Additional TIlX
Sub Totul
SpccJAssit.
or
Spcc./A<kI.
TOT. MTO. TAX
Dual Town _ Dual Coun
Held for Appoinlment 7
TlUIIsfer Thx
Munsiun Tux
'The propeny Loovered by this mongagc i.
or will be improved by II one 01' two
family dwcllill& only.
YES or NO
If NO. _ appropriale tllX elllulle on
pag" It of this il1$lJ'U n..
P-"!:" / Filing Fcc
Handling
TP-S84
.5. 00
NOClIlion
EA-S2 17 <<County)
EA-S217 (Slale)
R.P.T.S.A.
Sub 1"tul
30QU
Comm. of Ed.
Affiduvit
.5. ...!!Q....
Grund Thlul
4 Dist.
Section
Block
Lot
5 CommUDltJ' PNnrvatloa Jl'uad
Rcul Propcny
Thx Service
All!"ncy
Verification
~12063 1000 10400 0200 014000
0::.-p~
RKWOA~
MAR~
--
6 SatisfllCtions/Dischl1ll!esIRele..."". List Propcny Owners Muiling A<kIre..
'RECORD & RETURN TO: '
~
Consideration Amount $
CPF Tax Due S
Improved
Vac..... Land
Ci:?na.-Z:Z~ &~
0~#;:u?r;A~g-- 4~_
. 7f~
F/<,-ytn//fytl t, f)V //"J ;'~;::amc
Suffolk Count Recordi
1'1>
TO
TO
Title Com
Information
Thi. pugc forms pan of the ullucho:d
C tQ7 a ~../h J ~; ~-62 The premi.... herein is situated in
Y SUFFOLK COUNTY. NI,W YORK. .v
4 ./.tJ In lhc~ownshipof '... b/~a
!t In the VILI.AGE
.
01' HAMU!T of
BOXES 6 THRU 8 MUST BE TYPED OR PRINTED IN BLACK INK ONI.Y PRIOR TO RECORDING OR FILING.
dorsement Pa e
8
made by:
j -?~ f";~'rO..
COV"I"
.
FOR COUNTY USE ONLY
Cl. SWIS Code
PLEASE TYPE OR PRESS FIRMLY WHEN WRITING ON FORM
INSTRUCTIONS: http://www.orps.state.ny.us or PHONE (518) 473-7222
REA~ PROPERTY TRANSFER REPORT
<;i, '7. ?, >;" ~ 9'1
,
*.....1,.
_ ~ . 't
_.tt.ti
C2. Date Deed Recorded
0-::(/
MunUI
leVI
Yli/ill
it
C3. Book 1 /':.;(. _ s / , 01 C4. Page 1
PROPERTY INFORMATION
,7',9,'(1
1. Property I
Location
2650
STFlEETNlJMSfFl
I Pine Tree Road
$TAEETNA.Me
5&',~
~''''Gf!vr?;.k1 d~
. \o';/.C_-e.
FIRS NAME
11935
21PCODE
2. Buyer
Name
C~JFlTO~N 0 -
~A~~MLL
STATE OF NEW YORK
STATE BOARD OF REAL PROPERTY SERVICES
RP - 5217
KP.5.217 K,.~ M<n
LAST NAME f COMPANY
FfftSTNAME
3. Tax Indicate where future Tax Bills are to be sent
Billing jf other than buyer address (at bottom of formi 1
Addren
lAST NAME I COMPANV
f1RSTNAMAi
ST~eeT NlJMaeFl AND STRe~ NAME
CI1'YOATOW"-i
Z1PCOCE
4, Indicate the number of Mseument
Roll percels transferred on the deed
1/
I # of Parcels OR 0 Part of 8 Parcel
5. Deed
Property
SIze
.-.---_.
I.a I qr;,1 ., /'. il
I.CL Ixl-\t::>,3IoRI
HIDNfFi:ET uH'TIi
ACRE.!":
.
ST....TE
COnly if Part of . Parcel) Check as. they apply:
<4A. Planning Board with Subdivision Authority Exists
46. Subdivi1lion ApprOVlll was Required for Transfer
4C. Parcel Approved for Subdivision with Map Provided
D
o
D
6. Seller
Name
~etz-
l NAME I COMPANV
~ f.) nCe::\\-cc..
FIRST NAME
lAST NA~c ICOMP'ANV
FIRST NAME
15. Checlc 0 or more of 111eM conditionll as .ppllcabl. to transfer:
A Sale Between Relatives or Former Relatives
B S81e Between Related Companies or Partners in Business
C One of the Buyers is also a Seller
D Buyer or Seller is Government Agency or Lending Institution
E Deed Tvpe not Warranty or Bargain and Sale {Specify Below)
F Sale of Fmct.ional Of l.es& than Fee Interh\ \Speclfv Belowl
G Significant Change in Property Belween Taxable Status and Sate Dates
H Sele of 8I.JsineS5 is Included in Sale Price
J Other Unusuel Fectors Affecting Sale Price (Specify Below'
J None
7. Check the box below which most accurately describMI the use of the prop.nV .t the time of 5&1.:
Amne Family Rllsidential E~ Agricultural I ~ Community Service
B 2 or 3 Family Residential F Commercial J Industrial
C Residential Vacant Land G Apartment K PubUc Service
D Non-Residential Vollc8nt lend H Enterteinment I Amusement L Forest
SALE INFORMATION
11. Sale Contract Date I I
Monll'1 Do, Year
12. Date of Sale I Transfer 1/ 6i' Co I tJ'-it
Month D., YN'
,~
, , .
(Full Sale Price is the total amOlJnt paid for the property including personal property.
This payment may be in the form of cash, other property or goods, or the assumption of
mortgages or other obligations.) PI9llse round to the nearest wholiJ dollar amount.
13. Full Sale Price
,0,01
Check the box.. below as they apply.
8. OWnel&hip Type is Condominium
9. New ConstructIon on Vacant land
10A. Property located within an Agricultural District
108. Buyer received a disclosure notice indicating
that the property is in an A.gricultural District
D
D
D
o
14. Indicate the value of pefsonal I , 0 , n I
property included In the RIll; , e
ASSESSMENT INFORMATION. Data should reflect the latest Fin81 Assessment RoJl and Tax Bill
18. Property Class
I J... !. D-LJ
17. Total Au_d Value lot aU parcels in tnlnsfer) I ~ c.J71o... ~
- - , ,
--'- 11 l I. I, .,...., --++- .
19. School Diiltrict Name I l - {I -,{f1..fl.Jiq uJL ,. t f Ici 1 I d u. (' K~
16. Ve~r o~ Assessment Roll from 1 (/, .:71
\Alh",h 1l..lnrnu,t1nn till.km.._
--
20. Tax Map Identlfler<<s)I Rollldentifier(slllf more than four. attach shMt with additional idantifier(sll
loaf.)
JOt/. DO
oP ,lOll/.. 00
0.;2.
CERTIFICATION t
J certify that aU of UN: items of information enten:d on lhiIJ form ar-e trut! and COITCrt (10 the best of my knowlede,e and belief) and I understand that the makilJ~
of any willful false !lutement of material fact herein will subject me to the nrovi'iicms of the ocoal htw relative lo the making and filing of fai'le instromcnbi.
BUYER
~':O'~W~I~ I
\0\ LA..\,,("~<.., k
STREET NUMBER STREET NAME FlCIl SALEi
~o.:h.\,= U ,
CITYORroWN l
Q
I ~:,t -;;1\.0 \, o..}
./
;/tH,,, it
~"'ST NAME
lo~'
,o.~1\ OOE
---."
IY\~I
STA-TE
/>~ &z:-'
vL. C7J/ i . ....
~,~'''''~,/. .~
\ 111)..-
ZlPOOOE
Il~c<{
BUYER'S ATTORNEY
--
IJh/Utc
flRSTNA E
fJh' 5"'<:'-
.
lSlf - I <.f I q
TEL.EPHONE NUMen
.-.--------..
/"
NEW YORK STATE
COPY