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HomeMy WebLinkAboutL 12385 P 128 ,ce.. 2341./3 li ,/-- 3is ( t;Lg i' 'v SEC~~ON 104 BLOCK 2 LOT 23 {(I LJ-1-2) CONSULT YOUR LAWYER BEFORE SIGNING THIS INSTRUMENT .THIS INSTRUMENT SHOULD BE USED BY LAWYERS ONLY THIS INDENTURE, made the I 'i day of A r ~ (' ( , BETWEEN 2 DOS- , JOSEPH M. MELLY, residing at 2390 Pine Tree Road, Cutchogue, New York 11935 and JOSEPH J, MELLY. JR. AS LIFE TENANT. residing at 1475 Sterling Road, Cutchogue, New York party of the first part, and JOSEPH J. MELLY. JR.residing at 1475 Sterling Road. Cutchogue, New York 11935 e;wN~~~~lffi~panyfOfiile;iifS[part!%"conSliieratiori~DfmU~mNT "l;()\lI.D E1F.llS~!J Iil~ L.W;,YimS Of'lL Y -'."'-----.--..--.--'"'..--.-----.---...-.-.-- dollars paid by the party of the second part, does hereby grant and release unlo the party of the second pan, the heirs or ~~f~~~,:P8~f\~.~~gt;~~e party ~~m,eC1~nd part forever, ALL that certain plot, piece or parcel of land, with the buildings and improvemenls thereon erected, situate, iYihg'l'~li(nleing in the ~/:tld SO near Nassau Point, in the Town o~ Southold, County of Suffolk and State of New York, described as follows; part of;fLots Sl and 52 as shown on a map entitled, I.Map p~ptCNass~utrarms?~and filed in the Suffolk County Clerk's Office on March 28, 1935, as Map No. 1179; bounded and described as follows: BEGINNING at a concrete monument set on the northerly side of Sterling Road, distant 70 feet easterly from the corner formed by the intersection of the said northerly side of Sterling Road with the easterly si~e of Norton Road, being the southeasterly corner of the land of Carlson; , RUNNING THENCB North 4 degrees 14 minutes 00 seconds West, 150 feet to land os ~'Ster:rinb?':.cr.d .P.~rt ;-.r)l'~"'" - "~;?''-'1 ".lll"Hl,., -?.:~:.,..}'. ,~..~~"..,.. - ",t, ,".~ ",,',.','~r,"". "'~I" . '1~.""'I~\tIr.M'" f.:'!.-"", '; n.::l::: lm"~i) :t!',' ~"'JI;"",::~:~ t'll\;' Y 1I'i";THBNCB~ ~a.1!.ongl.'saia~t..land'":..of~,:S~er;bl,n9;rNortliJCa5:>idegrees" '4'6" mJ:nutes '00 seconds 'Eas t , 116.16 feet to'aJi..tfoii'pipe.;'''-'.__h __,_,_,___u"'___ ..,--...-.--. dollars oslG '. THENCB South.,4.degrees..14,. minutes..,OO .seconds.East i'~.;].50"feethto, -the.nor,ther1wlr'side !,.;y".~ .,,,,,...J .~; .......n...l-....\; ......... "Iv....., ......-".., r;'~lll........#...,...._..,..... ....... ""'~"""J ..... \.,..t'~.......l.i ,.._.~: ....... ..~; .,... ff"of......SterIJ.ng.~oad;" IkO .,-,4,. ,~.;~,., 0"'" .,.,.., ,..~..: '"'~.-. I~.- '.Mr-~.;';E''''': i'!1.i"J "~'''':~t''Ii''.'1 ,,-.eh... ,11'1' . ...~.d.,....l~.f St'l a'l't;".c., R d S th 85 d 46' 00 .i...._~~_:.;~~9ng iL__'it;) n..qr er Y.a~!. eo' er ~ng oa o~ egrees m~nutes seconds West, 116.16 feet to the point or Blace of BBGINNING. ',' B' E'I""G' CAND~ "-ir:INT-I-~';;":ED- .'-...t..... ',::'I."t-h' ,.,'r 1-""'''1 .-- ".~ '~"'~ ;""j'l"""''''~ ..l".~~d'r....I"I't','Jj'.~,.'!o.,..., t~!oo,t,:<r."f'ntr.li't"r1"""f....1 .,;IU'';ll-~ t j.' fIr .....' . D.n.l.l . 0 'ue-- e. same prem~'seB conveye . t'o'" e ~-par y' 0 e'" '1:rst'par ~~fiy~~~~~rQatea~12/27/00 recorded 2/13/01 in Liber 12102 page 173. par-;.~ ')f ti'i~ ~itst riar~, t\-:; "-::.. :'11 ;!:.~srlj!!-R,,:,"t~!,'1I!&g.~t, title and interest, if any, of the party of the first part in and 10 any streets and roads .!I~~g;tt'.!i~'~9~:Crllll!m!8I!!,l9",ttt';';~II!l!~.lt~,,!!1e~f; TOGETHER with the appurtenances'and all the estate an~ righls'of.the-party of the first Ili!rl'in and~Io'sald' premises;' TO' HAVE AND TOJ:!:I.9.~D,)l!11j1 Ilrem~!!~~l:!!i~lg!~I!~IH~~:V,1I!.'P.!!1Y.I~,t,h,e~lI!lil?l!!!;'-~;h!lj~, 9Mj'l-~f!l:~n.tt~!9\!li"C?f m~ P.!.r:tY.9t the second ~rt forever. .., r.... ~~l.'. ".r' 1"- s-'-- ,..I . J~ ""'0"'" ............'....~....'-'1 .. c;y," ;~~....~".- .... '.~' ~.., L' ..... '.. -. ........ ...... ,\'"....~Ci, .., ~ :~r~ ~r.;....,:,;" . ...~f'lb r lc:!:":~ U~C . ':If.j ",~ :. . , ,~ . AtlP. ,\h,e:P.lI.rtx.,~f ,!':1~,fi!)1t:~~, i!),.~!1)PJ!a!).~wjl!1, ~C?JlI~~, ~f3~l~t~i!l.1I~4vo;,c;o)!!!II!~!1l1.\!1Btl~)I!l!~i;pj,!!t.!! fi':St\~:W1,~i~il(!!!\he consideration for this conveyance and will hold the right 10 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 same first 10 the payment of the cost of the improvement before using any part of the total 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,wrrNESS'WHEREOF, the party of the first part has duly executed this d written. IN PRESENCE OF: 1"0_-:'" ," ."k "0,,,,, . -,' -"'" 'f""' ..-j"" ' .,. _ l; ," MIl:,. 4 t~Hj:. ~II:;" ~ ,Ie If ,tt..;, r. . ~,,\, .:\ .1.... p~.! "..... f,~.', .. I -, _ _ ',',. __ ". . . _.. . , ... _ . ~*!. }.~....;...~~.' ,:~. ;.:\;~.J~~~ f.t:",~ I~~,. .:~~p~~lli~lJ:1!~1t;!J1tH! J.~ ":J ,.:t ")1::;\ ".\ot~l1 \t,,:.~pp~:-ij"ia(t~6n~ at! ~-w.,~..~...t '. ,...- T' .' '~"'V- H C. -0 '.IL" ... '" Ulr ....,:te~\1~~ml 1 ; ...~ '.II llll::., .;i~' !-Ic-lH .ol '1'J'oJ .:, .IU . ..~. , .. r..., .... , . tot , J':!':-:~':.'-^'.Ai~~ P.r.j' L."',1IP'~ltlr<_.raihTlC'J,HE.C 'a~~n..\i....IE '~'-,~ !:;~~lhe,:;:~'~t...L~'i. Oif,:'f" 't.~~.~. ,. ,;:: '! ..\ H ~:(.d.td~r"l"'j\lil:af i~ aart\: .~," t:-l..~. i/;:J. \. .~SWli'_Ol'NeW'yat~, ..#'_,!"l.~_. ...~. .; -;:1 . .., c '. .'. - . " '. . '" _.. ....~ ~1lI.r.;' _. iT... ll'l'....I,I_ ti 11'..~~~ ' r;;;.. l.No"411706 ~.. .......... ,,;. ,. ,n' .." ." ... I ,< .:".,Q.'?"l'~f""~"'''''~~':'''.'' ,.0,-.,.,1, 0.". ,.' JOSE H ME Y JR LIFE "'ENAN'T. ':-;t.:..~ '':'~Expira'~~_~ .'.... . ,., .1,;, ~M~~ f:8,~ ~"t};~~~f~a.~~ ji;p! :w)~t;.lfI~:.:~~i1tp'!i<"!~'W:C~ "f~:1f: !:'i~~n,'1..l;~~ ~.:~ipJh~W~lt'f;~gMt~~1{;\l!f.~~l1'~1J~tp.~~tZ:i?!J~~~ 7"::mtrJ.1#~f.:-.6!lI~~.Qj"!5'.~F! (""r.:"F.~dP~~!,,'l f,'11!1!{~ c'rr.J~";'jn~ ~j'l-.., -".1'1 '.(;!d thlS rioht Ie !e{",eivt! .'vc~ (OOI'i,!ccrat!on Stal!Cl8td N.Y.B; "U:F.orm.BOO1-. Borglln,liId sale OMi:t"wilhoul c.winlnt!lllllnsl ~nto~.ACla -UnIfOrm ~nt ~om;13284iTllJ. \.) uc: .:,~(.I'1€.'"" III.:.: ~I." tHo: [.l:J~ ~,:~~~rVI. pS-idr~\ ~!:t'; .,v"ST. (.01 .11,,; l;qJIVJf";III:.::it:. c'lV di!1 C...'!;l! i.1e same t 'f!~t 1\) Uitl payroe:1t of the cost r,)i t!"'\:"' ifr'1c-rr;',tt~rr:FIJj( ~biJ :Jting ::!!1Y pa:1: of ,:h~-i yotai of th$ $aJ'"i'S fl)( at:y ot1ef U purp?ss. The \~."rd "p~rt{ ~Jt~il{ be \,".Ctlsm~i?L':~ i?~: if !, r'~:":itl "!i:a!rtl?<<. wheOOVF.lr t:ltll St:..nSB of thiz; indentur~ ao ~,- - .. .. OSEPH i'9~ : f .~ . ,. . TO BE USED ONL V WHEN THE ACKNOWLEDGMENT IS MADE IN NEW VORKSTATE - . State of ~ew York, County of 5j pIC I:.,~ as:./ State of New York, County of Onthe :llf day of Afy-t\.-- " In'theyesr ~l)~< - On the dayO!' . "-".InthilYaar before me, the undersigned, personally apJlllllred before me, tha undersigned, personalty appeared M. MELLY & JOSEPH J. MELLY, JR; -. 7f pensonally known to me or proved to me on the basis of personally known to me or proved to me on the basis of' satisfacloty evidence to ba the indlvldual(s) whose name(s) is satisfactory' evidence to} ba the indlvldusl(s) whose name(s) is' (are) subscribed to the within Instrument and acknowledged to (are) subscribed' to the within instrument and acknowledged to me that helsheN1ey' executed the-saine In' hlslherllhelr . me thet helshe/lhay execuied the saine In hisiherllhelr cepacily(ies), and that by hisiherllheir Signature(s) on the cepecltyOes). end that by 'hlslherllheir Signature(s) on the . Instrument, the indMdual(s), or the person upon behelf of which . instrument, the indlvldual(s), 'or the person upon bahalf of which the indlvldual(s) aded, ellllQJled the instrument. . . - the indMduaJ(S) aded, exacutad the instrument. (Si9~Q ~l~ing ack_nowtedgmfl (slgnatlire and Offt~ of ~ndlvldual ta~lJ'1g acknowledgment) . -,~ClC!Ilt c!e,,"t otee e.. I :r'.J~- ......., ,l, ..-, :~.,. ~""i.4fJW= tJqfA~r /,,1;1;(.., '$p..f< vrAkw ~~_~_.:L,_~.__,~.. :..... .. ~I>qths-JO.~~'-. . NO, 4..~II70ro :' - u," . . ..'..:-..'..'-lh'''hllech", S'...~I( WVfA.1y . . . UJ""""'~SIfl/l 'Gte/"esl 3- JO- 04:> TO BE USED ONL V WHEN THE ACKNOWLEDGMENT IS MADE OUTSIDE NEW YORK STATE os: State (or OlslJfcl of Columbia, Territory, or Foreign Country) Of , as; , ! On the . day of .', .. '.. . U" . in theysar j before me, the undersigned, personally appeared ; ...... _ =C''::;':'' ..::=~ -.:.... l_ _ __ __ personally. known to me or proved to me on the basis of satisfadory evidence to ba the Indlvldual(s) whose name(s) Is (are) subscribed to the within instrument and acknowledged to me that helshelthey executed the same In hislherllhelr cepacltyOes), and -that by hislherllhelr slgnature(s) on the Inshument, the IndMdual(s), or the pel'89" upon behalf of which the IndMdual(s) aded, executed the instrument, and that such Individual made such appearance before the undersigned in the -in (Insert the City or other political subdivision) (and insert the State or Country or other plsos the acknowledgment was taken) . ':". _ . ~ : '.'*'..U'~.:I .' C :;.:: ':"'L'. i~ U'.:':U II' L:: ;,~~L;::tt.il:C:= l:U:,:P,,:. (slgnotuIll and of!l9".qfJ~~IvIJl'!!lItaki!19.acknowledgment) ,-_. - - .. ..........- ...-....:....z..:._.-I....__ _ __ __." I ' I I. I !: i ~~ - ~~I~:r.:::.~I~T-:~-;-~!~u;.l;.. OT.ti\t.cdb-1 c~ .....HOlUl ~ ,I ~ ~ ~ ; I ! SECTION 104 -BlOCK-2--- LOT 23 COUNTY OR TOWN STREET ADDRESS suffolk :::'.Jg-I~~\~... _:-.:~:~~{!l ......, :.z...,~'i:)',! .:r \'..!.r~_~~ ,;, .':"'"\. '.J' ~'. -, tlH~ :",' "";,\".1.1 r.a)~.' h." _ BARGAlN:ANOSALE:DEED )'VlTHOUT COVENANT AGAINST GRANTOR'S ACTS i '; ~.,...=-.;. : TItle No. t-'-'--- ---- --, 1 I L MELLY TO MELLY I ,. I s I Ii to' U <i: .'- I VI '.' " .. " lii UI ~ -~ ... ... 0 I u W IE ... 0 !l ~ ... w li . ~ .~ ~ ~ Recorded at Request of COMMONWEALTH LAND TITLE INSURANCE COMPANY -~ ,_.. --, ..." Tn. ~ STANDARD FORM OF NEW YORK IlOARO OFlTTU! U~S .. DIsIrlbu18d by ~ O' Commonwealth .:; A~~J\NY TERENCE M. QUINN, ESQ. 275 LAKE AVENUE ST. JAMES, NEW YORK 11780 COMMoNWIW.DI lAND 1'rI1.81NSURAN'CB COMPANY ~ '-. Nurllb'er of;pages , TORRENS 3 Serial # Certificate # Prior Clf. # Deed I Mortgage Insbumenl Deed I Mortgage Tax Slamp FEES 3 Page I Filing Fee Handling TP-584 5. 00 {= Nolalion { Sub Tola! ;yj EA-52 17 (Counry) EA-5217 (Slale) R.P.T.S.A. ?i5- Comm. of Ed. 5. 00 Affidavil Certified Copy NYS Surcharge Other 15, 00 Sub Tola! Grand Tola! _ Q?3.,._OOo 023000 ' 4 O(s{X>O ;- " I Real Property I Tax Service I: Agency' Verification 11 L ___w , . '/ 6 SatisfactionslDischargeslReleases Lisl Property Owners Mailing, Address , 'RECORD & ,RETuRN TO: I,' ]ele,'!( e 11. z?> tale 0<,('>1"'" J G5f. $el'1ue ' I I , I , TitleCom an Information ,~/.!:"q~ (~/ .9>/V(i~ .' ',__ Ct< - ?~q't_-3, & Endorsement Pa e Recordin Deed (SPECIFY TYPE OF INSTRUMENT) ,The premises herein is silualed in SUFFOLK COUNTY. NEW YORK. ,In the Township of So \ )'\~ 0 l d In the VILLAGE or HAMLET of sl. - .)~e5 -' tJy' /11F"d 7 8 "Suffolk Count .' f sms page forms part of the attached JO~~fh /1" ./fe/lv ~/ld :t JfIse/h ~,I1'&'#1 "5(, , ' ~~fh TO ""J. fJ,elt'l -Sf. , ' RECORDED 2005 May 02 04,13.58 PM Edward P.Romaine CLERK OF SUFFOlK COUNTY- L DOOOI2385 P 128 DTi 04-39176 , Recording I Filing Stamps Mortgage AmL 1. Ilasic Tax 2. Additional Tax Sub TOlal SpeclAssil. or Spec. I Add. TOT. MTG. TAX Dual Town _ Dual Counry _ Held for AppointmCW,,, , Transfer Tax 0 Mansion Tax The property covered by this mortgage is or will be improved by a one or two family dwelling only. YES or NO If NO. see appropriate lax clause on page # of this' bu)DenL ...- - '1-cJ) 5 Community Preservation Fund C , sideration Amount $ -e- $ Improv Vacant Land TO TO TO ID made by: BOxEs 6 TIIRU 8 MUST BE TYPED OR PRINTED IN BLACK INK ONLY PRIOR TO RECORDING OR FILING. (over) 111111I111111111I1111111111111111111I1111111111111I1111 1111111111111111111111111 SUFFOLK COUNTY CLERK RECORDS OFFICE RECORDING PAGE Type of Instrument: DEEDS/DDD Number of Pages: 3 Receipt Number : 05-0047017 TRANSFER TAX NUMBER: 04-39176 Recorded: At: 05/02/2005 04:13:58 PM LIBER: PAGE: D00012385 128 District: 1000 Section: 104.00 EXAMINED AND $0.00 Block: 02.00 CHARGED AS Lot: 023.000 FOLLOWS Deed Amoun t : Received the Following Fees For Above Instrument Exempt Exempt page/Filing $9.00 NO Handling $5.00 NO COE $5.00 NO NYS SRCHG $15.00 NO EA- CTY $5.00 NO EA-STATE $75.00 NO TP-584 $5.00 NO Cert.Copies $0.00 NO RPT $30.00 NO SCTM $0.00 NO Transfer tax $0.00 NO COXl1I1I.Pres $0.00 NO Fees Paid $149.00 TRANSFER TAX NUMBER: 04-39176 THIS PAGE IS A PART OF THE INSTRUMENT THIS IS NOT A BILL Edward P.Romaine County Clerk, Suffolk County PLEASE TYPE OR PRESS FIRMLY WHEN WRmNG ON FORM INSTRUCTIONS: http://www.orps.$le.ny.us or PHONE (5181 473-7222 ~OR COUNTY USE ONL V C1. SWIS CoM 1''-1, 1. ~ ~ g,11 cz. Dote Deod __ I -5 I 5( It)..s I ManIII Dew' . y..,. C3. _ I /, ~ 3. g ,.51;;-; ;';'01 I .01, j?, PROPERTY INFORMATION lit ' . " . -'I REAL PROPERTY TRANSFER REPORT STAU OF NEW YORK &rATE IIOARD Of REAL I'NWERJY SERVICES RP - 5217 1. "-"y ......- krc.I'~ p~ (" ,../-c. L.. ap.,:n ... JNI Z.8uyor Homo "e ~. -- 3. T.. IndIClUt whn fut1n Tu BiIIInlD bI .... 1 ..... H _ l1li. buvIr lIdd_lII_ ai_, - LAlT NAIl! , CCWMNY ..,...... .....:_ MJIIII'fIINGIJMlT.... Cln'ClIITOlMlI . 1-1 . of "-all OR 0 P.1t of . P.n:al . SIAU """"" 1.:::""'1 SIzo , I (. IORI <lI>U . lOnIv' POll clo P_ a.m _ thoy_ 4A. """""" IoIrd wiIh Subdivillan A&ahodly ElOIII 0 .. SubdIvIsIon AppnwoI_ RocProd far T_ 0 4C._~""_"''''MIp_1dod 0 4. Indlclte the numa..r aI & -.... _....-__ on...._ Ixl lru P1lONTI'RT IIlP'nt ...,lk!.J ~ 'IJ!) (~ ...,- -t~lP.ph c~J?,"~e ph (Y) 3'" Z)"- ..- Homo ~ lYle.\'1 1. Check ,he.. b.Iow which moat --ateIr deIaIIn the...... the prapMy . tile din. of AIr. II.FuII__ , ,.g-,O,OI , , 0 lFolII Solo Prlco 10.... _ ......, PIlei lor \he pr...... .......... ........ _. ThIs..,....,. ruy be In the form at CIIb. ather property or 000dL or Ihe ..umptJan 01 ~ or othlIr obIlpt1ona.J ".... round ro rhI.........."., amount. CI-*"'__ _ thoy_ .. 0wMtshIp Typo II Condominium F. ~ AQricuh..ol I ~ CommuniI\' So~ I. _ eo.......... on V..... Lond f' Com.,.rc:lII J ~rial 1M. Property L.ol:atId within.. AgrIcu/Iurll DiIutcI o ......- K Publoc_ ''''IIuyor""""o___U.. H EntIl'tIIlnment I AmUlel'Mm L foreII lhalhllRPldY illn In AgricuIuIII DiIIrIa: /.-). Ctl"..~ ,&'" c..., Cc.... 1I.QId_.......fIf~_ -1.-..........<<0.....-: 1 I I I ^ SlIo__..F......_ MlaMh DIy v.. R Silo Between Related Campen_ or P.rtntfl In Bu.... of rho Buvart I. .r.a . Seller '"-'" _._Agoncy",LoncIlng_1ion DeId Type .. W..,_lY or &.gain end SIlo ISpeGify BlkMI Solo of __I '" Laoo tho. Foo 1_ 1SpacI/y IIoIowI S1G- Q1o...I. I'Iupor\y _n T_ S..... and So.. D.- So" 01-10-",....- 0Iher Un.... F-. AII_ SIlo _ ISpod/y _I o o o o ~F.mllv_.. B 2 or 3 FIII'IiIW' RaicUlill C Raidlnlill VlClrd LnI D Non._ioI V_LoncI I SALE INFORMATION I II. _ Canoroot lIDto - v_ 12. Dale GI ....., Tr.n* 4 1/fJ. r.r lof, '" ......... ... ..... cI ........ I , , 0 , U 1 pnIp.-ty IncIudId III ..... ... , . ASSESSMENT INFORMATION. 0011 ohould _ tho Iotlll Finol _mont Rail ond To. Bill ,.. V__II A__ .l;:o".,l RoI ".. 0 --..... 17.T...._VoIuolololl_In.......,1 Cvkl.1u(; , ; .2.e.~ol , ,1. .......... a.. I'Z I,OI-LJ 11.___1 .."Tu..... .........111 RoM.........c.I (I more than......n.h IhMI: wllb ~ ..........001 <; l(j<j l 1.'" I CERTIFICATION I I ftI1II) ...... cI u.. _ cI_ _ ..lIdIlllom... ........ ...- lID u.. .... cI., _....... "'1Joiofl_ I _ ..... IIw ....... or...,___or_fiocI.....ln...ouI\I<<1....1bo 1ow_1u.............lIIIoilor__ BUYER BUVER'S ATTORIlEV .g 0"L /000- jtYI-OJ- 0;1.3 e \\'1 '3 i: ~~~ fri. WIUlIAL!I AJy ..., - .....-- -.... -- r / NEW YORK STATE COpy -..-- ---;: -~:.- .~ ~ PLEAse TYPE OR PRESS FIRML VW\iEN WtllTING ON FORM. - IN,t>I.Rue;flqNS: http://www.orps.state.ny.usor PHONE (518) 473-7222 . "'~~<>'j,:400J"" ; ~j-' ~_ ;l'.l;~j' ~!~;'H'0 REAL PROP6RTY:rRAN$flEffh~PORT . 0 ~. "~A:1I~;,~i"llRK STATE 80Al!l18~ flA~f.f'!ITY SERVICES RP'j>"SF17 RP.~;17iJ.~:3m ,1,. 1. Prope.rty LJJ:J, l;5 I, <Sir'" ( II /)(1 Location ST ET uM STREET NAME cCJ.4i;~ 11(J{1 {Af"~ rnr:;.kl \4 LAST NAM I MP f2 () (Hi VILLAGE I W1351 ZIP CODE 2. Buyer Nlf."e ", , li";ic{Jli s j~ E (y) VI lAST NA.ME I COMPANY , 3. .Tax Indicate where future Tax Bills are to be sent Billing if other than buyer address (at bottom of fbrm) I Address FIRST NAME LAST NAME f COMPANY FIRST NAME CITY OR TOWN f I # of Percels OR 0 Part 01 a Parcel STATE ZlPCOOE STREET NUMBER AND STREET NAME 4. Indicate the number of Assessment Roll parcels transferred on the deed (Only if Part of a Parcel) Check as they apply: 5.0..d Property Size I X I I FRONT FEET (\\ 11/ W~N'fMp~YJ I 4A. Planning Board with Subdivision AUthority Exists 48. Subdivision Approval was Required for Transfer D D D f)EPTH lOR I 4C. Parcel Approved for Subdivision with Map Provided 6. Setler Name -r: -- .Ji, "",~,-~~- ~ ~~ lAST NAME I COMPANY FIRST NAME :0.-- 7~ Check the.box below which most accurately describes 1:he use Of the property at the time. sale: Momh ~ I Check the boxes below as they apply: 8. Ownership Type is Condominium I~' . c.omm un.i.tv.S erv ice 9, New Construction on Vacant Land J Industrial... 1OA. Property Located within an Agricultural Oistrict K Public tJr!!iCJ.... 108. Buyer received a disclosure notice indicating L . Forest ~' that the property:is in an Agrycpltural District '~' 15. Ct\eck one or mOre of these Conditions llis 8pp6cable to transfer:' D D D D A~ One Family'Residential B. . 2 or 3 Family Residential C Residential Vacant Land D ~on-Residential Vacant Land ~~~ 1,1. Sa,,"Contract Date E ~. Agricultural F Commercial' G _ Apartment H Entertainment I Amusement Day I Vear A B C D E F G H I J Sal~ Between Relatives. or Former Relatives Sale Between Related Companies 'or Partners in Business One of theSuyers fs also a Seller Buyer.or Seller is Government Agency or Lending Institution Deed Type not Warranty or Bargain and Sale (Specrty Below) Sate of Fractional or Less than Fee In~~rest (SpeCify ~elow) Significant Change in ProlJerty Betwjen Taxable Status {lnd Sale Dates - Sate of Business is Included in Sal,'Price Other Unusuai Factors Affecting ~~Ie Price (Specify Below) None Mo,,", I~ I ~ 7 I O() Day Year 12. Date of Sale I Transfer tfl: rt ' . 13.F~IISaleP~ce I""", ,(),O,OI . .; "'.. e (Full SJiB"rice is the total amount 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.l Please round to the nearest whole doffar amount. - 14. Indicate t~e value ~ personal I,' I I I I I I () I 0 I 0 I propertylndUded,nthu.e_ . I^~-~~ ...... '. .... .. ..... 16. Vear of Assees..... RoM from . (J (J . .' 1/01- which Inform";on taken ~ 17. T_ _ Value lof .1 parcala m tra......' .' , ., , ;2 .-c?2.3i,3.0.01 , , 18. Property ct.ass 1;:2, I ,U I-U 19. School DIstrict Nome 1 M11Jh +11 r: k:. ., 20. Tax Map ldentifier(sll RoH ldentifier(s) (N more1than four, attach shut with addltlonalldentifier(sJ) ~e~ h(dl JOL} I. -Blo/' f 2- 1 lo-r 23 ~ .... . ..... \ I certify that ell or the items or infonnatioo entered on this Iono .... ..... end eorrect (fIlthe _ or mr knowledge and belieIjllllll I lIIIlIerstanit'that the maIdng " or anr wiIifoI IJ'ise statement or materiaI fact herein fi subject me fIlthe oro........or '!'" oenai law _ve 10 the lDJIkIog llIIlIllIing or false ~. E / { . BU~R'~ ATTORN~Y t..l );;;~ ,;A) Mias LAST NAME j.rloward FIRST NAME :r b3J AREA CODE 4- :xJ - /J-) d- TELEPHONE NUMBER (14+r:J}Of11 J e CITY OR TOWN NY STA lJ~o? C) SELLER .' :f:/ '"". ( I) /} ) / u-... DATE SELLER SIGNATUR~ _-,---.;.~,~._~:':"',,:..' .'" ',s';.~' - -.:...... -'~.