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Standard N.Y.B.T.U. Form 8002. Bargain and Sale Deed, with Covenant against Grantor's Acts - Uniform Acknowledgment
Form 3290
CONSULT YOUR LAWYER BEFORE SIGNING THIS INSTRUMENT-THIS INSTRUMENT SHOULD BE USED BY LAWYERS ONLY
THIS INDENTURE, made the I ~day of January, 2002
BETWEEN
CATHERINE SIDOR, residing at 3980 Wickham Avenue, Mattituck, New York 11952, party of the
first part, and
l
JOHN E. CLAUSS AND JOANNA PAULSEN, residing at 6'~o Wickham Avenue, Mattituck,
New York 11952, party of the second part, as tenants by the entirety,
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WITNESSETH, that the party of the first part, in consideration of TEN and 00/100------------------------------_________
------------------------------------------------------------($1 0.00 )----------------------------dollars, and oth er 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 that certain plot, piece or parcel of land, situate, lying and being at Mattituck, in the Town of Southold,
County of Suffolk and State of New York, shown as Lot No.3 on a certain map entitled, "Map of Minor
Subdivision for Catherine Sidor", filed in the Office of the Clerk of the County of Suffolk on October 24, 2001
as Map No. 10701.
Being and intended to be part of the same premises conveyed to the party of the first part by deed dated
9/19/01, recorded 10/12/01 in Liber 12146 page 791.
Subject to the following covenant to run with the land: the property conveyed
herein shall merge with adjoining premises of the party of the second part to
the northeast, which merged parcel shall not be subdivided.
TOGETHER with all right, title and interest, if any, of the party of the first part in 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 premises 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 same
first to 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" when ever 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
written.
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Catherine Sidor
TO BE USED ONLY WHEN THE ACKNOWLEDGMENT IS MADE IN NEW YdRK STATE
State of New York, County of Suffolk, ss:
On the /S day of January, in the year 2002,
before me, the undersigned, personally appeared
CATHERINE SIDOR
personally known to me or proved to me on the basis of
satisfactory evidence to be the individuates) whose name(s) is
(are) subscribed to the within instrument and acknowledged to
me that he/she/they executed the same in his/her/their
capacity(ies), and that by his/her/their signature(s) on the
instrument, the indiy~ual(s), or the person upon behalf of which
the individual(s) acjed, executed the instru t.
:/
State of New York, County of Suffolk
55:
On the day of , in the year 2001,
before me, the undersigned, personally appeared
(signature and
Notary Public
personally known to me or proved to me on the basis of
satisfactory evidence to be the individual(s) whose name(s) is
(are) subscribed to the within instrument and acknowledged to
me that he/she/they executed the same in his/her/their
capacity(ies), and that by his/her/their signature(s) on the
instrument, the individual(s), or the person upon behalf of which
the individual(s) acted, executed the instrument.
ce of individ I taking acknowledgment)
DDNN~ '" CHITU~
N01~RY PUBLIC, Stale of Now York
No. 4,~51459, Suffol\\ County VfTb?--
1.1111 H~it" ~Ugust 18, If_
(signature and office of individual taking acknowledgment)
TO BE USED Ot>jLY WHEN THE ACKNOWLEDGMENT IS MADE OUTSIDE NEW YORK STATE
State (or District of Columbia, Territory, or Foreign Country) of ss:
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 satisfactory evidence to be the individual(s) whose name(s) is (are)
subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their capacity(ies), and
that by his/her/their signature(s) on the instrument, the individual(s), or the person upon behalf of which the individual(s) acted,
executed the instrument, and that such individual made such appearance before the undersigned in the
in
(and insert the State or Country or other place the acknowledgment was taken)
(insert the City or other political subdivision)
(signature and office of individual taking acknowledgement)
Notary Public
Title No.
SECTION
BLOCK
LOT
COUNTY OR TOWN
STREET ADDRESS
BARGAIN AND SALE DEED
WITH COVENANT AGAINST GRANTOR'S ACTS
CATHERINE SIDOR
TO
JOHN E. CLAUSS AND JOANNA PAULSEN
Recorded at Request of
COMMONWEALTH LAND TITLE INSURANCE COMPANY
STANDARD FORM OF NEW YORK BOARD OF TITLE UNDERWRITERS
Distributed by
. Common~~~'~~'~COM","
COMMONWEALTH LAND TITLE INSURANCE COMPANY
RETURN BY MAIL TO'
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TORRENS
Prior Ctf. #
RECORDE[,
2002 Feb 1508:41:08 m'1
Edward P.Romaine
CLERK OF
SUFFOLK COUI.ir.,'
L D000121E.9
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DT# 01-26843
Serial #
Certificate #
Deed / Mortgage Instrument
Deed / Mortgage Tax Stamp
Recording / Filing Stamps
4
FEES
Handling
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Mortgage Amt.
Page / Filing Fee
I. Basic Tax
TP-584
2. Additional Tax
Notation
R.P.T.S.A.
6~
QS -
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Sub Total
:;L{-
Sub Total
EA-52 17 (County)
Comm. of Ed.
50~
Spec.lAssit.
Or
Spec. / Add.
EA-52 17 (State)
Affidavit
TOT. MTG. TAX
Dual Town Dual County
Held for Apportionment
Transfer Tax ~ 00
Reg. Copy
Sub Total (d) /
- GRANDTOTAL~U
Mansion Tax
The property covered by this mortgage is or
will be improved by a one or two fam ily
dwelling only.
YES or NO
If NO, see appropriate tax clause on page #
of this instrument.
Certified Copy
Other
Real Property Tax Service Agency Verification
Dist. Section Block
Lot
6 Community Preservation Fund
Consideration Amount $ 7-> 7D
I~
Ii) 7. oV
010, .-v
Od3.o0.c}
CPF Tax Due
$ 0
Initials t-
7 Satisfactions/Discharges/Releases List Property Owners Mailing Address
RECORD & RETURN TO:
/'JBIC'AIL WICKJ!jVn, 1Z6Q..
WIO<HI/m, [U'U(l.11I1YI \I 13et;:SSL€/e-.
PO,BtJx' /'-1.2"-1
fY7/~ rnmcl(, AI 'I /I 'f.s-;L 8 Title Company Information
Co. Name&mMJ WE/lLT. LJ'J'</lJ 7/rL
Title # If: Hcfd7J},,2 'I 77
9 Suffolk Count Recordin & Endorsement Pa e
Improved
Vacant Lan~
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TO
TO
TO
1l1is page fonns part of the attached
Bf?/t.<;J'!jA/ .l}NJJ J4Lt:' /)CQ,
(SPECIFY TYPE OF INSlRUMENT )
made by:
(! Ih7/E.e1 JJ E J-/1\ o.e
The premises herein is situated in
SUFFOLK COUNTY, NEW YORK.
TO
,fiHN E. (!/...J'JU.5S )IN,/)
]O/tNIV,q P-'!-tILSE/I
In the T ownshi p of
In the VILLAGE
or HAMLET of
S"Unf"J..Lj
IhR77TTZtC.K.
BOXES 5 TIlRU 9 MUST BE TYPED OR PRINTED IN BLACK INK ONLY PRIOR TO RECORDING OR FILING.
(OVER)
1111111111111111111111111111111111111111111111111111111
1111111111111111111111111
SUFFOLK COUNTY CLERK
RECORDS OFFICE
RECORDING PAGE
Type of Instrument: DEEDS/DDD
Number of Pages: 3
TRANSFER TAX NUMBER: 01-26843
Recorded:
At:
LIBER:
PAGE:
02/15/2002
08:41:08 AM
000012169
412
District:
1000
Deed Amount:
Section:
107.00
EXAMINED AND
$35,000.00
Block:
01. 00
CHARGED AS
Lot:
003.004
FOLLOWS
Received the Following Fees For Above Instrument
Exempt Exempt
Page/Filing $9.00 NO Handling $5.00 NO
COE $5.00 NO EA-CTY $5.00 NO
EA-STATE $25.00 NO TP-584 $5.00 NO
Cert.Copies $0.00 NO RPT $30.00 NO
SCTM $0.00 NO Transfer tax $140.00 NO
Comm.Pres $0.00 NO
Fees Paid $224.00
TRANSFER TAX NUMBER: 01-26843
THIS PAGE IS A PART OF THE INSTRUMENT
Edward 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) 4Y3-722t
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FOR COUNTY USE ONLY
Cl. SWIS Code
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REAL PROPERTY TRAN~FER REPORT
......... JC:
C2. Date Deed Recorded I d / 1--'
} / ~.nth Day
C3.-Book I I "d II t::fl 'I C4. Page I
PROPERTY INFORMATION
/ G dT
Year
Lf. /, d,-
STATE OF NEW YORK
STATE BOARD OF REAL PROPERTY SERVICES
RP - 5217
RP.5217 Rev 3/97
1. Property!
Location
STREET NUMBER
Hickham Avenue -.....
STREET NAME
Southold
CITY OR TOWN
112 t tituck
VILLAGE
11952
ZIP CODE
2. Buyer
Name
Clauss
LAST NAME I COMPANY
John E.
FIRST NAME
Paulr.en
LAST NAME / COMPANY
Joanna
FIRST NAME
3. Tax Indicate where future Tax Bills are to be sent
Billing if other than buyer address (at bottom of form)
Address
LAST NAME I COMPANY
FIRST NAME
STREET NUMBER AND STREET NAME
CITY OR TOWN
STATE
ZIP CODE
4. Indicate the number of Assessment
Roll parcels transferred on the deed
FRONT FEET
I X I
'ACRES'
. !~
(Only if Part of a Parcell Check as they apply:
4A. Planning Board with Subdivision Authority Exists
48. Subdivision Approval was Required for Transfer
4C. Parcel Approved for Subdivision with Map Provided
D
D
D
11 # of Parcels
OR D Part of a Parcel
5. Deed
Property
Size
OEPTH
lOR I
6
6. Seller
Name
Sidor
LAST NAME I COMPANY
Catherine
FIRST NAME
LAST NAME I COMPANY
FIRST NAME
7. Check the box below which most accurately describes the use of the property at the time of sale:
A~ One Family Residential
B 2 or 3 Family Residential
C X Residential Vacant Land
o Non-Residential Vacant Land
E ~ Agdcultucal I ~
F Commercial J
G Apartment K
H Entertainment / Amusement L
Community Service
Industrial
Public Service
Forest
Check the boxes below as they apply:
8. Ownership Type is Condominium
9. New Construction on Vacant Land
lOA. Property Located within an Agricultural District
lOB. Buyer received a disclosure notice indicating
that the property is in an Agricultural District
D
D
D
D
SALE INFORMATION
15. Check one or more of these conditions as applicable to transfer:
11. Sale Contract Date
,/ / /
Month D., Year
').1 / /,' , / Oi-
Month D., Year
A
B
C
D
E
F
G
H
I
J
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' is Government Agency or Lending Institution
Deed Type not Warranty or Bargain and Sale (Specify Below)
Sale of Fractional or Less than Fee Interest (Specify Below)
Significant Change in Property Between Taxable Status and Sale Dates
Sale of Business is Included in Sale Price
Other .~~~actors Affecting Sale Price (Specify Below)
12. Date of Sale I Transfer
13. Full Sale Price 1 3 1 5 I 0 I 0 1 0 I 0 1 0 I
, , .
(Full Sale Price 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.) Please round to the nearest whole dollar amount.
~
14. Indicate the value of personal 1 I 1 ,-' ), 0 I 0 I
property included in the sale, , .
ASSESSMENT INFORMATION - Data should reflect the latest Final Assessment Roll and Tax Bill
16. Year of Assessment Roll from IUOI.O 1.
which information taken
17. Total Assessed Value (of all parcels in transfer) I
/o7-~ /0 -J'r
, ,
]
,
o 0
,
18. Property Class
./
I..
\."j.LLJ
Hattituck
19. School District Name I
20. Tax Map Identifier(s) / Rollldentifierls) (If more than four, attach sheet with additional identifierls))
1000-107..]0-3.4
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I
I CERTIFICATION
J certify that aD.of-the items of infonnation entered on this fonn are true and correct (to the best of my knowledge and belief) and J understand that the making
of any willfuf fiaIse sta~ment of material fact herein wiD subject me to the provisions of the penal law relative to the making and filing of false instruments.
/
BUYER
BUYER.S ATTORNEY
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- 'LAST NAME
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FIRST NAMf '\
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BUYER SIGNATURE
John E. Clauss
DATE
JoanJli'l Paulsen
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STREET NUMBER
STREET NAME IAFTER SALE)
AREA COD
TELEPHONE NUMBER
."
CITY OR TOWN
1\'
STATE
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SELLER
CITyrrOWN ASSESSOR
COPY
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ZIP CODE
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SELLER S'G~~",..Gc:therine
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Sidor
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