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Standllrd N.Y.B.T.U. Form 8002 - &.rg8ln end Sale Deed. with eoven.nt agIIinIl Gr.nlor"a Acts - Uniform Acknowleclmment
Fonn3280 .
C0H8UL T VOUR LAWVER BEFORE SIG~G ~~-1HIS INSTRUIIENT SHOULD BE USEO SV LAWYERS ONLV
THIS INDENTURE, made the / ~ day "I B.scen.lIe.. 200/1
BETWEEN
JOAN JACOBS, residing ..ik~ros Road, New Suffolk, New York 11956.
PETER GRABOWSKI, re;kling at 35B Washington Avenue, Apt. 17, Pleasantville, New York 10570;
and CAROL GIACONE, residing at 5431 Delaware Avenue, Apt. 3, Delmar, New York 12054, the
party of the first part, and
"
:G
JON . JACOBS AND CANDACE ~ JACOBS, hi. wife, residing at 1BB75 Main Road,
Mattituck, New York 11952, the party of the second part,
WITNESSETH, that the party of the first part, in consideration of TEN and 001100
($10.00) dollars, and other good and
valuable consideration 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 their right. tiUe
and intareat in and to:
All that cert:lIln plot:. piece or parcel of lend, situate, lying, and being at Mattftuck, In the Town Southold,
COunty 01 Suffolk 8nd state of New York, bounded and described as follows:
BEGINNING at a point on the northwesterly side of Main Road where the same Is Intersected by the westerly
boundary line of land now or fonnerty of Charles B. Gardner, said point or place 01 beginning being distant
1046 feet more or less southwesterty as IIH!IISUred along the northwesterty side of Main Road from the corner
formed by the Intersection of the southwesterty side 01 Elgah's Lane with the norIhweslErty side 01 Main Road;
RUNNING lliENCE from said point or pIeao 01 beginning along the nartII\. !city side 01 Main Road, South 79
degrees 00 minutes West, 100.00 feet to lends 01 the State 01 New Vork (recharge basin);
RUNNING lliENCE along said lands the following two (2) courses and distances:
1. North 35 degrees 29 minutes 00 seconds West, 120.72 feet;
2. North 53 degrees 04 minutes 30 seconds East, 91.04 feet to land now or formerly 01 Gardner first
above mentioned; and
lliENCE along said land South 35 degrees 29 minutes 00 seconds East, 164.45 feet to the northwesterty side
01 Main Road, the point or pIeao 01 BEGINNING.
BEING AND INTENDED TO BE the same premises conveyed to the party 01 the first part by deed dated
6/12/00, recorded 7/28/00 in Uber 12059 page 092.
TOGElliER with all righllitle and Inleresl. if any, of tha party of tha first part in and to any s~ts and roads
abutting the above described premises to the osnler lines thereof; TOGETHER with the appurtenances and all
the aslete end rights of the party of the first part in and 10 said premises: TO HAVE AND TO HOLD the
premises herein granted unto the party of the second part. the heirs or SL'<lOS'''''''' end 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
_y the said premises ha". bean ancumbered in any way whatever. except as aforesaid.
AND the party of the first part, In compliance with Section 13 of tha 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 same
first to the payment of the cost of the improvement before using any part of the tolel of the sama for any other
purpose. The word "party" shall be construed as if it read -parties" when ever the sensa of this indenture so
requires.
IN WITNESS WHEREOF, the party of the first part has duly execuled this deed the day and year first above
written. -
IN PRESENCE OF:
~
J it.. ~
Pe\e/J.Grabowsk~
A 1IA1A.. .'
Carol Gia\""('n~
fJn'rJ::~
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TO BE USED ONLY WHEN THE ACKNOWLEDGMENT IS MADE IN NEW YORK STATE
'-
Sl8le Or New York. County of w.utt}.r..~ sa:
Onlhe 11- dayof btct~ , Intheyesr 2003.
-'!;!i before me, the und....igneg.,penoonelly appeared
I~" GRABOWSKI fl:!)
penoonelly Iu10wn 10 me or proved 10 me on the bIIolo of
..Uof8clory evidence 10 be the Individuallo) whose name(o) 10
(are) suMcrlbed to the within lnatrument .nd acknowledged to
me that heIsheIlhey executed the ..me in hllllherllhelr
capecity[...o), and that by hilllllarllhelr olgnelure(o) on the
instrument. the Indlvldual(I), or the penlOn upon beI1elf of which
the incf d (a acted. executed the instrument.
(I a 0IIice of individual laking 8Cknow\8dgment)
Notery Public
..:::.'a\mll....
".~ClllIlI1'I
~=~~""..."
Sl8te of New York, County of n:
On the 84"day of /J::..:.c.ft1J.,( ,In tha yesr 2003
before me, the underolgned. per1IOI1allyappeared
CAROL GIACONE
personally known to me or proved to me on the _ of
l8liof8clory evidence 10 be the individual(l) whose name(l) il
Care) subscribed to the within instrument and acknowledged to
me thel ""'"heIIhey executed the ..me in hI_lIhair
capacIty(I..), and that by hi_llhelr IIIgnelure(l) on the
Inlbument, the individua~I), or the person u crI which
the Indlvldual(l) 1ICl8d, axecuted the
JeIfery Jordan
NoIary PubHc Slate of New York
ResIdfng in Saratagll ~
My lXllllIIiSSIOI. exp~ -If -(j 5
Nl:~
Sl8te of New York, County of II:
On the /'91'1.day of ~c.uJl, In Ihe yesr 2000/ before me, the unde,.;gned, penoonellyappeared
JOAN JACOBS -
""",,,",,11y Iu10wn 10 me or proved 10 me on !he _ of uUofaclory evidence 10 be the indivldUlol(o) whose name(o) is (are)
subllCribed to the within ina1rUment and acknowledged to me that helshelthey executed the same In hlslherllheir capacity(ies), and
that by hiolharllhair Ilgnalure(o) on the inobumenl. the individual(o). or the person upon beI1elf of which the individual(o) acted,
executed the Instrument. .
BARGAIN AND SALE DEED
WITH COVENANT AGAINST GRANTOR'S ACTS
Tille No.
JOAN JACOBS, PETER GRABOWSKI AND
CAROL GIACONE
TO
JOtJ.lri:l'liIl!i1~ JACOBS AND
CAN[!ACE MIE JACOBS. HIS WIFE
STANDARD R)IIIIIOf NEWYORKIIOARDOF nn.E ~....I_
~--by
'0 Common~~~!~~,__~..__,_
("Ct\I'\k.I"'IO'A".AI.llll.A~UnTIr.I"""",,.IlA.,"~I.CI)M".\"ll'.
_. --- .-- .-.. .. -.-..
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ABiCAI:"'A. WICKHAM
MClar/ Pubiic. Stale at New \'.:u1::
No. 52.4fi.\2~71
C u ~'lfie~ 'I" S\.:lft~:k CU"!"'Y_ ~ ,
r.l"'TI~'I:!:'!ilu'i E=:r.ires S.."!pt. SO~
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A-b\jCt;\ A .lM~hatY'l
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SECTION
BLOCK
LOT
COUNTY OR TOWN
STREET ADDRESS
Recorded at Request of
COMMONWEALTH LAND TITLE INSURANCE COMPANY
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l';umhtar III" pag....s 3
TOIUlENS
Cenificate #
?ECORDEu
2004 Rpr 23 02: 4'): 2S PI'I
Ea-.rd P.Roaaine
CLERK OF
SUFFOLK CQI..tlTV
L 000012315
P 3'90
DTlI 03-39829
Scrial #
Prior Clf. #
Del:~d I Mnn1!agc Tax S13mp .1_ _ __.. R~nrding I Filing St:lm~
D..'C<! / !\Ion!!a!;e Instrument
31
I'EF_~
Handling
5. ..!1!!..-
Mong..lgc Anu.
I. Bask- Tax
2. Additiunal Tax
Suh T".al
SpccJAssil.
P-..ag.."/ Filing Fcc
TI'-5H-J
N,'tulilm
,.r
EA-51 J 7 (ellUnt)'.
Suh Tutal
S"",../A<I,J.
TOT. MTG. TAX
EA-5:!17 (Stale)
CI"Imm. uf r"od.
5. IN'
R.P.T.S.A.
3lJ=
Dual Town Dual Cuunly
Hel<l for Appointm<nt
Trunsf<rTax J'~-
~1ansil)n Tax
Aniduvil
~4 D' I DO()
1St.
Tt~ pro~ny co\'cl'c\l by this mnn~al!e is
nr will he improved by a one llr Iw,)
fmnily dwcllinp: unly.
YES "r NO
. . Gran<l T"lal \ rl If ~O. see a""Rlpriat" UL' clause "~n
. page # nf this inslrunJi~
1Oi'".oOI 04.1:0- -OA1.oor-I". I - "2/11
I Section Block I 1.01 5 Community PreaervatioD Fuad
-C~~Si~~-:tion Amount S c:ISll Iro'"D
.m
15. IN)
Suh T"lal
Ccnilinr Cnpy
NYS Surchurgc
Olher
RL-ul Pn)~rly
T~I." Service
Af:!e'D\."Y
VcriliL"ulitln
04013204
(iK~'~~
\~9"'AR;;
"-"
1000 10800 0400 002001
CP~' Tax Due
$
6 Sali~ractium;JDischaIbTCJRclC'uses List Pnlpcny ()" ncrs :\1uiling r'\c.ldrc~~
RECORD &: RETl;JUI; TO:
Vn.:unl Lmd __
TO __. IQ_
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g~&- (("1m+- st. -" 0 DDlC ..2Db~
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Title Com an Information
c.. 111- l.t.. InSUAQ.hlU-
~.Ko_:s- 0 I 09.8.:
Suffolk. County Record.ing & Endorsement Page
j)C;:,
n ..!...ll..D ..
rSPECIFY TYI'E OF INSTRt:MENT)
7
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Thi.... paige rtlrms pOln uf the allm,:hcd
mad... hy:
_"'}_o~ClCOks I tllltc..6crW:l.wsk..i t
_" 0vtaR_Gj'~.rmJR..."_.
TO
-Son ::ra..c.o rs_Ml4. C~ ~
The premises h~n.'in i~ Nilu:nN in
SlIFFOLK COUNTY. NIiW YORK"
In Ihe TtlWnl'Ohip uf ~o~d_
In .he VILLAGE \ I ,. aJ.. L" . r.
"r HAMLI;T "f _~!LY"IJJ.LU\.-.
flOXES 6 THIW 8 Ml:ST HI:: TYPED OR PRINTED IN liLACK IXK ONLY PRIOR TO Rt:CORDlNG OR HUNG.
(elver)
1111111111111111111111111111111111111111111111111111111
1111111111111111111111111
SUFFOLK COUNTY CLBRK
RECORDS OFFICB
RECORDING PAGE
Type of InstrwDentl DBBDS/DDD
Number of Pagesl 3
Receipt Number 1 04-0047188
TRANSFER TAX NUMBBR: 03-39829
Recorded 1
Atl
04/23/2004
02140128 PM
LIBER:
PAGE;
D00012315
390
CAROL GIACONB
JON JACOBS
Districtr
1000
Deed Amount.
Section: Block 1
108.00 04.00
1!Ya.IIINBD AND CHARGIm AS JOLLOWS
$250,000.00
LotI
002.001
Received the pollowing Pees Por Above Instrument
Exempt
NO
NO
NO
NO
NO
NO
Page/Piling
COE
EA-CTY
TP-584
RPT
Transfer tax
$9.00
$5.00
$5.00
$5.00
$30.00
$1,000.00
Handling
RYS SRCHG
BA-STATB
Cert.Copies
SCTM
Comm.Pres
Pees Paid
$5.00
$15.00
$50.00
$0.00
$0.00
$2,000.00
$3,124.00
Exempt
NO
NO
NO
NO
NO
NO
TRANS PER TAX NOKBKRI 03-39829
THIS PAGE IS A PART or TJDI: INSTRUMENT
THIS IS NOT A BILL
Bdward P.Romaine
County Clerk, Suffolk county
PLEASE TYPE OR PRESS FIRMLY WHEN WRITING ON FORM
INSTRUCTIONS: http:// www.orps.state.ny.us or PHONE (518) 473-7222
FORpOUN~USE ONLY
C1. SWIS Code
~<73, g''<;?,/I
00
MDnth
REAL PROPERTY TRANSFER REPORT
-*
RP.5117RevJlfn
STATE OF NEW YORK
STATE BOARD OF REAL PROPERTY SERVICES
C2. Date Deed Recorded
a. 3/ OYI
Yo"
0.,
RP - 5217
-::'-?,9,DI
C3. Book
C4. Page I
PROPERTY INFORMATION
,. Propllriy I 18875
loeatlon STR.EHNUM8ER
Southold
CITY OA TOWN
2. Buyer Jacobs
Nama LAST NAME I COMPANY
Jacobs
LAST NAME/COMPANY
Main Road
STIIEETNAME
Mattituck
11952
VllLAG(
ZlPCOllE
Jo~
FIRSTNAIolE
Candace .a.e-.
FIFlSTNAME
3. Taa
Billing
Addren
Indicate where future Tax Bills are to be sent
if other than buyer address lat bottom of form)
LAST NAME' COMPANY
FlflSTNAME
STIlEn NUMBER ANQ STRHT NAME
CITY OR TOwn
STATE
ZIPCOOE
4. Indicate the number of Assessment
Roll p4IIrcefa transferred on the deed
1 I # of Parcels OR D Part 01 a Parcel
(Only if Part of 8 Parcell Check as tney apply:
4A. Planning Board with Subdivision Authority ExiSU 0
4B. Subdivision Approval was Required for Transfer 0
4C. Parcel Approved for Subdivision with Map Provided 0
5. OMd I X I lOR I 3 0
Property .
Size FAOHTFEET llEf'TH ACRES
6. Seller Jacobs Joan
Name Grari6~~ltr vl~Sf~~E
Giacone Carol
lAST NAME {COMPANY FIRsrNAME
7. Chec:k the box below which most accurately describes the use of the property at the time of sale:
Check the boxes below all they apply:
8. OWnership Type is Condominium
9. N8W Construction on Vacant Land
lOA. Property located within an Agricultural District
108. Buyer received a disclosure notice indicating
thetthe propertyi, inan Agricultural Di5trict
o
o
o
o
A~ One Family Residential
B 20r 3F<lmily Residential
C Residential Vacant land
D Non.Residential Vacant land
E8Agricultural
F Commercial
G Apartment
H Entertainment! Amusemenl
I 8 CommunIty Service
J Industrial
K Public Service
L Forest
SALE INFORMATION
15. Check one or more 01 these conditions as applicuble to transfer:
11. Sale Contract Date
10
Moo~
Sale Between Relatives or Former Relatives
Sale Between Related Companies or Partners in Business
One of the Buyers is also a Seller
Buyer or Seller i8 GOvernment Agency or lending Institution
Deed Type not Warranty or Bargain and Sale {Specify Below'
Sale of Fral;:tional or Less than Fee Interest {Specify Below)
Significant Change in Property Between Taxable Statu8 and Sale Dates
5&1& of Business is Included in Sale Price
Other Unusual Factors Affecting Sale Price !Specify Below}
None
10 /
Ooy
03
Yn,
I
A
B
C
D
E
F
G
H
I
J
12. Dilte of Sale I Transf&r
~
/
17> /
0",
~~....J
Moo~
13. Full S.le Price , 2 [ 5 I 0 , 0 , 0 I 0 I 0 ,OJ
, , .
(FuJI Sale Price is the lotal amount paid for the property including personal property
This payment may be in the form of eesh, other property or goods, or the a"umption of
mortgllges or other obligations.l PllIase round to the neafltst whole dOl/Sf amount.
14. lftdlcllte the value 01 ptIIr80nal I () 0 0 I
property included in the sale " , . ~ I
ASSESSMENT INFORMATION. Data should reflect the latest Final Assessment Roll and Tax Bill
16. Year of Aasesamant Roll from I 02/031 1
which Information taken 17. Total Assesud ValulIl (of all parcels in transfer)
3
7
o 01
,
18. PrOptllrtyClass
12.1 .0 I-LJ 19. School Dbtrict Name I Mattituck-Cutchogue
20. Tall Map ldentifler!s)! Rollldentifiarlsl III more than lour. attach sheet with additional identffiarbll
1000-108-4-2.1
I CERTIFICATION
] certify Iha1 all of the Items of Infonnation entered on this fonn are troe and correct (10 the best of my knowledge and beflef) and I understand Ibat the IDBking
of any willful false statement of material fact herein will subject me to the provisions or the oenallaw relative to the making and filing of fal!le Instrument&.
BUYER BUYER'S ATTORNEY
Price
William H. J Jr.
F1RSl"NA"'~
LAST NAME
631
1477-1016
TElEPHONE NUMBEIl
AIlEAOOOt:
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Clrv6"Il'rOWN
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NEW YORK STATE
COPY