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Form 8002 ("1199) . 20M - .&.Ipin IIftd $:ale Deed, with c~ .piMl QIan"':'. Aa.-'nclhrkhE or~. (..... .....1)
OONeULT YOU" LA.,... ~........ Tlll8ll1aT11UMmIT - THI.laTlIU~ _MOULD .. __.Y LAWY.IIS ONLY.
THIS INDENTURE. 1I)I!iI. I~ 28th day of December. 2003 and
BETWEEN . ....
. Jonathan B1oom.resld~ng at 473 West End Ave. New York City. K.Y.i0024
as owner of a nlnety-f~ve (95%) par cent interest as a tenant~in-common of the
proper~y:de8cr~~ed ~~~~ln
pan)' oflhc firs. pan. and Matth~w BloOl1l r-eaiding at 31-23 32nd Street. Ascoria. Queens.H. Y.
11106
pany of the second part.
WITNESSETH, thai: rile party ofllle first pan. in consideration of len dollars and Giber wluable consideration paid by
the pan)' of .he &eCOnd pan. does hereby grant and release unto the pan)' of the second pan, the heirs or sUCCCS$Ors and
...i""softheMltvoflhe"""""dpartfon:vcr.. twelve & one half (12 1/2 %) per cent intereat
a8.tenari~'-1n-common
ALL thai certain pial. piece .DC parcel of land. with .he buildings and improvemen~ lhen:on erecled. situalc. lying and
b( _. ., See descr:lpt.ion annexed aK Schedule A and made a part hereof
TOGETHER Wilh all righl. lille and lmcren. if any, of Ihe pany of the linn pan. in and to any "trecl" und rOOlds
abullins the above.d~scribcd prcmbicl'llo Ihe cenlcr lines rhereof; TOOETHER wirh Ihe appunenances Bnd Blllh..:
Clllltale and righls of Ihe pany of Ihe finl pari in and 10 said premi~: TO HAVE AND TO HOLD Ihe premiscllo herEin
grOIn led unlo Ihe pany oflhe ~cond pun. the heil'" or ~ucce!l:~rl' and IIssi,n" of the pany of Ihe .econd pan forever.
ANDlhe purly of Ihe firl'll pan coyenllnt~ that the purly of Ihe fir!41 pan hu~ nCtI oune or ~urrcrcd anything whC'rcl'\y
lhl: "aid premil'lc,,; have been encumb~rcd in uny way whatever. ellccpl u" uforclloaid.
AND Ih~ p.lrl)' nt"lhe Iir,,1 pari. in compliance wilh Seelion I).orthe Lien Law. c,'C'lvenunllli Ihullhe purl)' nr~hc:
fir,;,1 pari will receive Ihe cunsidcro.lion for (hilli convcyance and will hold Ihe righltn receive such consider-
Illion as a trUSI fund 10 be applied firsl fnr Che purpofic of paying rhe COsl or Ihe improvemenl and will uppl)'
Ihe !tume fir51lo Ihe payment of (he emit of !he improvement before u:-in& an)' pan of lhc Inial of Ihe !loame for
any IIlher purpClfie.
The word "pany" shall be cuntolrued Ul'l if il reud "par!ie,," whenever the !'enlCe of thi,.; indenlure I'll requires.
IN WITNESS WHEREOF. Ihe PUrl)' of Ihe finot pari has duly ex.ecuted [hili derd Ihc day and year lirsl .dxwe
~".. ~ /e:~~ o.
......
Acknowrod~!!,..nt ta~n; In NewYorIc 8tatl!l
Slatl!!-~I!!.wVorJt.l..~.c.:!!!.'!!YE~~~_t:rolk_. .
On Ihe 28th day 01 DecembCjt1n the year 20.03, belore me,
the undor.igned. personally. appeared-
Jonathan Bloom
personally known to me or proved to me on the ba,ls 01
satisfactory evidence to be the Indlvldual(s) whOle name(s) Is
(are) subscribed to the within. Instrument and acknowledged to
me that he'shel1hey executed the aame In hl8lherlthelr
CBpaclty(ie.). and that by hlslher/thelr algnature(s) on the
Instrument, the indivlduales) or the behall of which
the Individual(s) acted. execUl
No711fJ..-t P~('Lil YlAp";
N f' "v. ':1 e? h.
('I D- O'J. !5l,) ~ ~ 5"lRD
n'-i?.i~':";-F""j) -'"";',..1. K.;;;..:t~lr {ty(lH-(
C.DI1l,. 0'1-1\11..., (,-.~.. -95"'
Acknowledgement by Subscribing Witness taken In New
Vork S..t.
Slare 01 New York, County of
On lhe day 01 . in the year
the undersigned, personally appeared
. belore me.
the subscribing witness to the foregoing Instrument. wilh whom
I am personally acqua!nted. who being by me duty sworn, did
Clopose and say. Ihol he/.heIIhey _cIe(o) In
Ihal helshellhey know(s)
to be the individual described In and who executed the
foregoing instrumenl; that said subscribing witness was
present and saw said
execute the aame: and that .ald wltne.. at the s.me time
. subscribed hislherlthelr name(l) 88 a wltnells.lhereto.
TrtleNo.: ~ r O,? --poi I)...
Jonathan Bloom
TO
Matthew Bloom.
I
!
Distributed by
Chicago l1t1e Insurance Company
.
Acknowledgement "ken In New Vork State
. ss:
Stale ot New York. County of
. S8:
On the day of . In the year
the unCSers;lgnild. perlSOnalty appeared
personally known to me or proved to me on the basis of
satlolaC1ory _neo to be the Indlvldual(a) whose name(s) I.
(are) subscribed to the wtlI1In Instrument and acknowledged 10
me that he/.helthey executed the same In hlslher/thelr
capaclty(les). and that by hlslherlthelr slgnature(s) on the
InolrurMnl. lhe lndivldullJlo) at the ponsan upon behalf at which
the Indlvldual(s) acted. executed the Instrums!"'_
. before me.
Acknowledgement taken outalde New York Slllte
. IS:
- Stale 01 . County of . ss:
. (or Insert District 01 Columbia. Territory, Possession or
Foreign Country)
On the day of . In the year
the underalgned. personally appeared
. before me,
peraonally known to me or proved to me on the basis of
satisfactory B"tl'idence to be the Indlvldual(s) whose name(s) is
(are) aubacrlbed to lhe within instrument and acknowledged to
me thai he/ahelthey executed the same in hislherllholr
capaclty(le.), that by hlsth.rltheir .Ignature(s) on the
instrument. the Individual(s) or the person upon behalf of which
the Indlvidual(s) acted. executed the Instrument. and Ihat such
individual made such appe.rence before the undersigned In the
(add the cfty or poIittcal subdMslon and the state or country or
other pface the acknowledgement was taken).
SI;CTION 107.00
BLOCK 05.00
LOT 006.004
COUNTY OR TOWN
"ETURN BY MAIL TO;
Robert A. Bloom.esq
430 West 23rd. Street.
N. Y .10011
Zip No.
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ALL THAT CER1'AIN PLOT, PIECE. OR PARCEL OF LAND. SITUATIl:, LYING, AND BEING AT
MAT'XITUCK IN THE TOliN OF SOllTllOLD, COUNTY OF SUFFOLK AND STATE OF NEll YORK,
BEING BOUNDBtI AND DBSCRIBED AS FOLLOlIS:
BEGINNING A'~ A POINT ON THE NORTHERLY SIDE OF WIClOIl\M AVENUE (MIDDLE ROAD, OLD
MIDDLE ROAI:i) AT 1017.78 FEET EASTERLY FROM THE CORNER PO'RMEO BY 'I1IE INrERSBCTION
OF THE EAST~:LY SIDE OF MILL Ll\IlE WITH THE NORTHERLY SIDE OF WICKHAM AVENUE;
RllN!iING THENCE NORTH 18 D1lGRIlES 19 MINUTBS 20 SECOlIDS WIl:ST ALONG LAND NOlI OR
FORMERLY BUR1' 270.71 FEET TO LAND NOW OR FORMERLY B"H F.!lllMS LLC AND TOlIN OF
SOllTllOLD;
THBNCE NORTH 71 DEGREES 40 MIIllJTES 40 SECONDS EAST ALONG LAST MENTIONED Ll\IlDS
300.56 FEET 1'0 LAND NOW OR FORMERLY B&H FARMS LLC;
THBNCE SOlJTH 22 DEGREES 21 MINUTES 30 SKCONDS EAST ALONG, LAST MENTIONED LANDS
43.77 FEET;
TH8NCE NORTH 71 D1lGRIlES 40 MINUTES 40 SECONDS EAST STILL, ALONG LAST MENTIONED
LANDS 38. o. E'EST TO LAND NOli' OR FORMERLY SIDOR;
TH8NCE SOOTH 22 DEGREES. 21 MDlll'l'ES 30 SECONDS EAST ALONG: LAND NOW OR FORMERLY
srDOR 22.19 E'EST;
THBN:CE SOlJTH 21 DEGREES 54 MINUTES 50 SECONDS EAST ALONG: LAST MENTIONED Ll\IlDS
234.59 FEET 1'0 THE NORTHERLY SIDE OF IIIcnIAM AVENUE;
TH8NCE SOlJTH 76 DEGREES 20 MINUTES 40 SECONDS lIEST ALONG: THE NORTHERLY SIDE OF
WICKIIAM AVI!IltIl! 359.10 FEET TO THE POINT OR PLACE OF BEGINNING.
FOR INFORMATION ONLY: DISTRICT 1000 SECTION 107.00 BLOCK 05.00 LOT 006.0(14
Being and !.ntended to be the Balle premises as conve,ed to tlie party of the first
part and Robe:rr A. Bloom and Joan E. Bloom by deed dated,November 25. 200:3 from
James Georg.. and Linda Schaffer
-.
SCHEDULE A
Nunlber of pages
...1ORRENS
RECORDED
2004 Fob 04 D5.22. 3:5 PII
Edward P.Raaai".
CLERIC OF
Sl.f'FlLK COUHTY
L DOOOl~
P4JO
DTI 03-~79
Serial II
Cenific:llc #I
Prior Clr. /I
Deed / Mongago In0l111menl
Deed / Mongage Tux Slump
FEES
Rec:ording / Filing Slolllp'
3
Gr-dnll To",1
/017
Mb
MOrl!.l3go AmI.
I. Ba.ol. TlIX
2. Addilional Tux
Sub Tnlal
Spec J A..iL
nr
Spec./Add.
roT. MTG. TAX
Duul Town _ Dual Counly _
H"ld ror APPOinlmen~
Tron.rer"Jbx ~
Munsion Thx
The pmpeny ","'CR.... by Ihis n",nga!!" is
or will be improved hy a onC' ,'r two
ramily dwelling only.
YES or NO
If NO. ... appn.pria", lOX clau"" on
paac II of this instrument.
PallO / Filln. F.."
Handling
S. -ll!!...
TP-~1l4
S'ot:lli,'m
EA-~2 17 (County)
EA-S217 (Slalc)
Sub Toml
Comlll. (If Ed.
~. ...QQ...
R.P.T.S.A.
;Jc-
Affidavit
Cenilk-d Copy
Rog. COP)'
Olher
Suh Tht.1
4
'Go.()
Dhuncl
Lot vol, .00,-#
5 CoaaDluDity PreHIV.UOD Fund
Consideration Aml)Unt $ t{ (}t-/ .e...
Real
Pnlpeny
Tax Service
,\gcflC'~'
VerificAtion
04004597
~:p-
6 Sali.raclionsIDischaIgcsIReleascs Li.t Propeny Owne,.. Muiling Add......
RECORD &/ RETURN TO.
p'oge~'T A.. \3LOfl'1' .e5 4
'+70 w. d-S~ S"T.
/'l.-I. r-l........[. (0011
-
1000 10700 0500 006004
CPF Tax Due $
Improwd
""..cunl LaIRd _
TD/OOO
TD
TO
Suffolk Count Recordin
7
Cv.NuIIIC
TItle /I
This p3!;e fnnns p:aft of the ullachcd made hy:
-:It) r-r f\"T H A rl
/5Loo}-1
"'
The premises herein is 5iiuAb..-d in
SUFFOLK COUNTY. NEW YORK.
III the Town.hip or ..:... <''; ':f2.H . b L. ()
In the VILLAGE
or HAMLET or -/7 1't-r'1I'1 ~ ( h
BOXES 6 THRU 8 MUST Bfi TYPED OR PRINTED IN BLACK INK ONLY PRIOR 10 RECORDlNQ OR riLING.
10
H Prr'THe IN'
&LOOh
(o\'cr)
IIIIIIIIIIIIIIIII~IIIIIIIIIIIIIIIIIIIII~IIIIIIII
1111111111111111111111111
SUFFOLK COONTY CLIRlt
RlCORDS OPPICI
RlCORDING PMB
Type of Instrument: DEEDS/DDD
HUmber of Pages: 4
TRAHSPIR ~AX RUMBBR: 03-27579
Recorded:
At:
LIBIR:
PMI:
02/04/2004
05:22:35 PM
D00012299
430
JONATHAN BLOOM
MAn_w BLOOM
District:
1000
Section: Block:
107.00 05.00
II!'lI'lUIIlIID AND CHARGED AS FOLLOWS
$0.00
Lot:
006.004
Deed AmoUl1t:
Received the ro11owing rees ror Above Instrument
Exempt
NO
NO
NO
110
110
NO
Page/riling
COB
IA- C'1'Y
TP-5B4
RPT
Transfer tax
$12.00
$5.00
$5.00
$5.00
$30.00
$0.00
Handling
NYS SRCKG
lA-STATE
Cert.Copies
SC'l'II
COIIIa.Pres
rees Paid
$5.00
$15.00
$50.00
$0.00
$0.00
$0.00
$127.00
Bxempt
NO
NO
110
110
110
110
TRAlIBPlR TAX 1IUIIBER: 03-27579
THIS PAGE IS A PART or TBI IRSTRUIIIIIT
THIS IS !lOT A BILL
Bdward P.Romaine
COUI1ty Clerk, SUffolk cOUI1ty
PLEASE TYPE OR PRESS FIRMLY WHEN WRITING ON FORM
INSTRUCTIONS: http://www.orps.state.ny.us or PHONE (5'8) 473-7222
FOR CO'UNTY USE ONL V
C1. SWIS Code ~?,~ ,f?, 9.1'1 *
C2. Date Deed Recorded eil / ~y9f I ~y I
~_I ,<,,,,>,,9', >l~_, , ><:.',,," ", ,
PROPERTY INFORMATION
1'r:::1
) 'j (So
STfIIEETNUMBER
:~ ;t
j,~~~ I~E f " {-I F\ y'j
2. Buyer
Name
~" .'
, .... I..~ ( t I lO,
(:1 OR TOWN
.')
bL l'(',H
"MTNAW/CO"'''A.NY
H:\
VIllAGE
':"'v
111\
FlflS'TNAME
LAST NAME I COMF"A.NV
fll\STNAME
3. Tax Indicate where future 18ll Bills are to be sent I
Billing If other than buyer addl'85$ l~ bottom or form)
A""'...
\.;. ') 3> 'v' /C;~ .,
S,",[l'TNU""llIell"'NDSTAnT~E
JL,.,.;'--j
LAST~ICOMPANY
,. .
__ '-'I) .-\p...., I
-/ ("~ h-
;"'-,,2 \....v
CITY OR; TOWN
4. k'ldlute the numtMtr of AaMsunent I I
Roll pIIrce1s transferred on the deed . _
# of Parcels OR 0 Part of a Parcel
6. Deed
p-
Size
lOR I
ACRES
.- :<
...:)..,. .;
Ixl
DEP'TH
FIIONTFEET
'-:-.
'C'"
;,IlSTNAME
8, S.....
Nom.
.~:.:. , rJ) f. I r 1;
lAST NAME I COMPANY
c I,.~ 1-1.
LAST NAME I COMPANY
FIltSTNAME
7. Check the ~x IMlow wNch most accur8tely dHCrfbel tMo use of the property 111: the time of ..Ie;
A~" One Femlty Relldentiel E~ Agricultural
B 2 or 3 Family Reslciential F Commercial
C Residential Vecanl Land G Apartmant
D Non-Resldentlal Vecent lend H Entertainment I Amusemant
I ~ Community Service
J Industrial
K PuollcS&tvlce
L Forest
REAL PROPERTY TRANSFER REPORT
STATE OF NEW YORK
STATE BOARD OF REAL PROPERTY SERVICES
RP - 5217
RP-51171lc:,,3/f7
_< ( t,:
,. OO~
He ,.V
,I ,p., ,,'
FIRST NAME
\ /, j i
SALE INFORMATION i;,.
11. 611.. Contrlct Dd. .. ": , I I
Month "" Year
, ' I :i.~...; I r.'>
12. Dete of 511. I Trenater I ~,.J...
MOnlh "''I' v~
15. Chedl: on. or more of these conditions es eppliclbta to transfer:
"Sale Between Rel8l:ivel or Former Relativea
Sale Between Related Com~nie$ or Partntlr& in Business
One of the Buyers ia elso a Seller
Buyer or Seller la Government Agency or lending Institution
DeEld" TVpe not Warranty or Bargain and Sale (Specify Belowl
"'Sale of Fractional or less than Fee Intereat (Specify Belowl
Significant Change in Property Between Taeble Status and Sal8 Dates
Sale of Business is Included in Sale Price
Other Unusual Factora Affecltng Sale Price (Specify Below)
, \';l r 1;'1 t:' , 0 , 0 I
, , .
(full Sale Priee Is the total amount paid for the property including personal property.
This peyment may be in the form of cesh. other property or goods, or the sl8Umptlon of
mortgages or other obIlgatlon8.1 PfHSB round fO ths nHrsst whof. doll.r .mount.
14.lndlcmttheveluaofpersonal I, t--lq/-lt~ ,0,0 I
property Included In thl ..I., , e
I ASSESSMENT INfORMATION - Data should reflect the latest Final Assessment Roll and Tax Bill I
16. Ve., of Aasesement Roll from IC).-! ~ ?I 17. Totel ~ Velu. (of all pII'CII"ln trlMl.rl I. ... I. )-
whlctllnforrnation hlken , , J
,...........C,... ~-U '.."'_1 Dl...IctN.mo I -ff(:;y ~e,,,,,U\ LR,,,v
VI<;'IQ I L I
\".> .
(~i. I~C fT
I CERTIFICATION I
J certify tluIf. all of the IIemII ollnfnrmBdon entered on lb. form are tnJe and corred (to th... bllSt of my knowledge _d beliei') Bnd I ulJderstllnd that the maklnJl:
of BIIY willful rake ltaternent of mlteriBl fRet bercln will mbJed IIlI!i to the 1X'O"lsions of the DenBi law J1!Ialive to the making BOd fDinR 01 &be Imrtrummts.
BUYER BUYER'S ATTORNEY
13. Full Sa" Price
20. Tlx Map kilnt:lfierllll Ron Identlfl.r(slllf more than four, IttHh sheet with .ddltionalldentifler(lll
(I)'.,;.t:.
',ec I (J). C.
Lc:.'J nA.. f.[,'t I
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BUveRSIGN..,l\IIl(
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.... LASTNAMt:
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STIlEETNUM8lYl
7-, ~ t:f) ":7.
S NAMfIAFU"SAl!)
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.....",'"
i\ ..,....
"\\(";;),'1'
, aTY 0" TOWN
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SELLER
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M"
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J,"2-,-/,~ . : ,,(..\ ,.-'(
BE RBlGMTURE
1'- L-i I I " ,,~<,t I
STATE ZlPCOD~
COnly if hrt of a Percell Check ..thev .pply:
4A Planning Board with Subdlvlslon AlJlhorily Exists D
48. Subdivision Approval was Required for Transfer D
4C. Pan::el App~d for Suodlvlllion with Map Provided 0
(
'-, ..
,p\~~'. H A r"-\
Check the bo_ IMlow as they epply:
8. Ownership Type Is Condominium
9. New Construction on Vacant Land
1OA. Property l.oca1ed within an Agricultural Dlstrlct
10B. Buyer received a disclosure notice Indicating
that tne property il in an Agrieultural Olstrict
o
o
o
o
None
I j.'~')"
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-),:.., t.fi }'i'1" 1f-1 [' i.,~1Id./"-1
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FIItST_
/. '11 Li:l '1-'-1
TELEPHONENUMaat
NEW YORK STATE
COPY