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THIS INI>ENTURE._1luI! .....","" <lay.., MlltI:tI 2OIIZ_
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_ipted.lot No. I aubo_ ClUeed_nup mditI..... ......, of~c:I!ab
FI'-\1.- filc=dJin the SuffoIkColllllyClerk:" OftiiccoaOcronr17. 197'.'" No.
6736 - - puficubll'ly ..........w ad cbc:ri1Ied u raDowI:
BEGINNING at tho alnlme W....sy CDCl of1be arc of a__ CI)..,!f!I ~h18 ".11111 "'of
Coumry Club Drive vri1b 1bI W..-..ty liDe 011':"_ AWIIIIII tItIa MDoro'd...
RUNNING THENCENorU:lD dI&~41 m......l01lllCll ~ W...._~1,ylilleol
'Coul1by Club Drive.171.2S _
l'HENC.E Nonh 6.... 33 D'llnuIeIIO ItCI".... W.. 201M..
THENCE South 84 __ 34 millUlllIO IIIlXlIm .... 'US.U rect to.. W.....,.. of
Liadeo Avenue; ,
THENCE South J ~_ 2S mimlrrlISO -.ada w-. 15'.83 feet to tJae ...1.....
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2S.ClO feet a -..'"': of37.47 lileUo ilia ...,;b....... Waterlycnd or.w..._poialorplaae
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'1'IU\.NSFBR TAX RUKll'BR: 02-0382'
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011:1"'2002
0811.:1152 ..
000012205
4.12
Deed Aa:nmt I
Bact1cm; BJ.oc]u
109.00 03.00
D"KIRIIiD AIm ........--.. AS J'Ottl: 0"'IlI
$&05,000.00
LOt: 1
002.022
Diat.:dctl
1000
Received 'thto FOllowing P_a I'Or ~ ~t,
Pap/PilinG'
COIl:
BA-CTY
'l'i'-584
RM'
'l'rllDafer t_
$U.OO
$5.00
$5.00
$5.00
$30.00
$1.,6:it0.00
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IiIO 1fY8 ImRCBQ
lIIO ....-8'J.'&ftI
lIIO CIlrt.COpie.
IiIO sew
110 C_.~.
..... >>&14
'5.00
'15.00
'25.00
$0.00
$0.00
$5,100.00
$1,.:aa.OO
811 _'"
110
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110
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110
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'1'IC:S P.... :l:S .. I'II.Jt'l' CD' ''l:'JDj DIIIS'1'!IWDIIf
I4wer'd. .,... 4....
c-tl' CJ.erk, 8v.t!foU: C>>lmt.y
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PLEASE TYPE OR PRESS FIf!MLY WHEN WRITING ON FORM
INSTRUCTIONS:'http:// www.orps.state.ny.us or PHONE (518) 473-7222 ::),.. - '6661
REAL PROPERTY TRANSFER REPORT
1. Property I
Location
1
Country Club Drive
STREET NAME
STREET NUMBER
-"
Cuthogue
CIlY OR TOWN
New York
VIUAGE
11l93S
ZIP CODE
2. Buyer
Name
Coia
LAST NAME I COMPANY
Giacinta J.
FIRST NAME
Mea
Josephine
FIRST NAME
LAST NAME f COMPANY
3. Tax Indicate where future Tax Bills are to be sent
Billing if other than buyer address (at bottom of form) I
Address
STATE OF NEW YORK
STATE BOARD OF REAL PROPERTY SERVICES
RP - 5217
RP.S217 Rev 3197
LAST NAME {COMPANY
FIRST NAME
STREET NUMBER ANO STREET NAME
CIlYORTOWN
/ # of Parcels OR D Part of a Parcel
4. Indicate the number of Assessment
Roll parcels transferred on the deed
5. Deed
Property
Size
.'.. ?;/
. ,(; . ,-' I
ACRES
Ixl
lOR I
FRONT FEET
DEPTH
6. Seller
Name
I Mattituck Fann Holdilll!s. LLC
LAST NAME I COMPANY
FIRST NAME
STATE
ZIP CODE
(Only if Part of a Parcell Check as they apply:
4A. Planning Board with Subdivision Authority Exists 0
48. Subdivision Approval was Required for Transfer 0
4C. Parcel Approved for Subdivision with Map Provided 0
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 Residential Vacant Land
D. Non.Residential Vacant Land
---
.11 I 14 I 20021
Month Day Va"
13 I 4 ! 20021
Month Day Year
15. Check one or more of these conditions as applicable to transfer:
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
her Unusual Factors Affecting Sale Price (Specify Below)
None
Block:
1
'....
I certify that aD of the items of infonnation entered on Ibis fonn are true and comet (to the best of my knowledge and belie!) and I understand that the making
of any wlIJfuI false t"""""t of material fact herein will subject me to the ProvlsiollS of the penal law relative to the making and filing of false instruments.
~(\ . \ BU\~R BUYER'S ATTORNEY .
'I ~ l""'''* \" ~\) Y
\ '
~j
-
E ~ Agricultural I ~ Community Service
F Commercial hI Industrial
G Apartment ' ~ Public Service
H Entertainment I Amusem~t t Forest
\ '- ,
11. Sale Contract Date
12. Date of Sale' Transfer
13. Full Sala P,I.a ,4 , 0,5 ,0 ,0 ,0 ,0,0 1
, , .
(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 0 0 1
18. Vear o~ Assess~ent Roll from I 0 I / I 17. Total Assessed Value (of all parcels in transfer) I
which Information taken
18. Property Class
'j
I" ,I ,0 I-U 19. School District Nama 1
~/^
"'---
20. Tax Map Identifier(s) I Rollldentifier(sl (If more than four. attach sheet with ackfrtionalldentlfier(s))
Dist:
1000 Section 109.00
03.00
Lot:
002.022
'-I..
1 3/4/02
DAT<
LAST NAME
Rubel
BUYER SIGNATURE
1
/ (: ;;:,0
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Country Club Drive
STREET NAME (AfTER SALE)
516
STREET NUMBER
AREA CODE
Cuthogue
ClTYOR~.
INY
STATE
11935
ZIP CODE
'"
\;\
SELLER
~ -
~~-iJ-~~A
"'LLEIH.IGNATURE v' , . ,.
"'11'
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....
Check the boxes below as they apply:
8. Ownership Type is Condominium
9. New Construction on Vacant Land
10A. Property Located within an Agricuttural District
108. Buyer received a disclosure notice indicating
that the property is in an Agricultural District
o
o
o
o
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169 - ~- :(. L '--
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Steve
........1
FIRST NAME
678-1800
TELEPHONE NUMBER
.-
.