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'5.IHld..d ~" Y B.T Lj, Fo.m 1002.
-B~,.~;" ~ad S..k DlI'lI'd. .'-11" ClJVlI!nllll ~a~;"~l G'~nlof's ^~.._ lr.Ji...du,d;,,, Corpou.;on (..nlk shR'l)
CONIULT YOW LAWYD .U4:)_ SlaNING THIS ....TItUM~T_T"n INSTaUMBn SHOULD" USID .Y LAWftIlS O_Y.
(II 01..?io ~1.3
'lH1S INDENnJRE, made .he 11 t.h
BE1lWEEN
day 01
Ilugu./>t.
. in the YI~:J.r 200~.
~ce.e.nl...lI_.ia~ /lo.ed, Inc.
S- 9 llaw.Jt.'hu#l.At Roa.d
CoLd S,"'lObog NalOfolO. Nlf 1172~
./.
-, 1li~ ;j"J
V2'no'
~77'"
ptlrlt.y of the tint part. and
~~LL~a. A4an~o and Ra.yLou
~60 V.i.l'Lage Lane
~at.t..i.t.uek, Nlf 11V52
AlOaneo,"~ ~.~
party of the second put.
WfilIiF..SSETH. that the pal"ty of the lint part, in consideration of Ten DoIUIir5 and oth~:r valuable considcrati~
paid by the party of the scce,nd part. does hereby grant and release unto the party of the second part. the heus
or !iUCCC".sson and a55ips of the party of the &ccond put forever,
ALL that certain plot. pieo~ or parcel of land, with the bu~lding5 and improvements thereon erected, situate.
lyinC and bel.......,. aL Cut.chogue, 70wn o~ S.ouLhoLd, Count.1I o~ Su~~oLk
and St.at.e o~ New lfolOk...... ...SEE SCHEDULE A. A771lCHED HERE70
IlNll ~IlDE Il PAR7 II.EREOT.
Be.-4:n.g and i.lILe.n.ded Lo I..e. the ...a.e. pc.e..-i.6e.... a.6 conveye.d t.o t.he.
g.,..,nt.olO he..e.i.n (y deed dat.ed AplO.i.L 1, 200J, a,..d ..eco..ded IIp...il
, 1 ~. ZOOJ" -.in L.i.(elO '122~5 Page VOO .i.n t.Ae Su~~,~Lk Cou.nt.y CLelOlr.'./>
o,l,~~i..c~.
S,tl.~je.cL 1:.0 Couc.nanL.6, Re..6Lc..i..eL.i.on..6. l:.a...e..e.lI.t.4 and Ag...e.e.e.II.t....
0;( cf!coc.d.
7.h,,":... conve.yance. had '-eell .ade IIJ.i..Lh t.he. unan...i..':1u.6 con,.6c.n.t 4-n
w.,,-.it..i.ng o~ aLL ./>LoekhoLdelO./> o~ t.h"e palOLy o~ t..~o:. ~.i."At. palOL.
Sl~,.id ,pC.e...i....e.A I..e..i.n.g knoldll ad 1545 Count.c.g CLUll DII.-Lue ~
C.".t:chogue, New lfo<< 11VJ5.
TOGETHER with all right, title and interc3t. if any. of the party of the fint part in and to any streets and
roads auuuing the above deseribed premi3cs to the c:enter lines thereof: TOGETHER with the appurtcnnncu
alld all the estate and righu of the party of the first part in and to mid premi5Cs; TO HAVE AND TO
HOLD lhe premises here-in l!C:ral1tcd unto the party of the second part. the hciu OT successors and assigns of
the part)' of the second part forever. .
A ND the part>: of the _first part covenants that th~ party of the first part 11a.s not dom~ or suffered anything
wh~reby the said premises hi~\.c hero ~ncumbcrcd In any way whate\'cr. exc:cpt as aforesaid.
A.N[? the party. of the. first part. i!, c:om.pliance w~th Section J3 of the. Lien Law, covenants that the party of
the hrst 113.rt Will rec:lClve the conslder.atlon for thiS conveyanc:e and will hold: the right to rcceive such con&id-
er;ltil)n as a"-trust fund to be Ilpplied first for "the purpose of paying the cost (l,r the improvement and wi1l apply
Ihl!: !ioame first to the lX1}"I11t"'nt of the cost of the improvement before using any part of the total of the same for
a"yother purpose.
The word "party" shall be construed as if it read "parties" whenever the Slmse of this indenture so requires.
IN'.WITNESS WHEREOF, the party of the fint part b. duly executed this deed the dil,y and year first above
wnlten.
11'i' ;PaESENCE OF;
!ic.<<e.n.I..c.:a/N.o.e.~!Io' Inc.
8y: ~~-'2- (~~~
6Je..fLn<<c. AdeL, P'<<.e.;",
'..
"lIlt\.....,.............,
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,...~-..~,..,.,.~,_. __._ ,..~._,.Ul,>-.~.~~ll.nl.,
11'1:.1111 No: RH043C1243
SCHEDULE A - DESCRIPTION
ALL that certain plot, piece or parcel of land. slltuate. lying and being at Cutchogue, Town of SOuthold, County
of Suffolk and State of New York, known and dl~signated as Lot No. 12 on 8 certain map entijtled, -Map of
Country Club Estates", and filed in the Office of the Clerk of the County of Suffolk on October 17, 1978 as Map
No. 6736, bounded and described as follows:
BEGINNING at a point on the easterly side of Country Club Drive the following two courses ;;md distanc:es:
1. North 13 degrees 04 minutes 10 seconds West. 144.93 feet to a point;
2. Northerly alonl1 the arc of a curve to the left having a radius of 600.00 feet a distance of 30.02
feet to a point;
THENCE North 74 degrel~s 03 minutes SO seconds East along the division line between Lots Nos. 11 and 12,
247.19 feet to a point;
THENCE South 05 degrees 2S minutes 50 seconds West along the division line between Lots Nos. 3 and 12,
59.79 feet to Cl point;
THENCE South 06 dcgrE:es 33 minutes 10 seconds East along the division line between Lots nos. 2 and 12,
131.45 feet to iI point;
THENCE South 76 degrees 55 minutes 50 sccc~nds West along the division line between Lots Nos. 12 and 13,
212.25 feet to the eastt~rly side of Country Clulb Drive, the point or place of BEGINNING.
"j
.
!
.... ..
_.
--\--.
I I.
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r
STATE OF "'IEW YOR)KJ
) n.:
COUNTY OF SIlTTOOO
'* STATE OF NEW YORK)
) !is.:
COUNTY 010' )
On the 11- day of ILl"."", In the year 2004- befon: me. the
undersigned. personally Ilppearcd 1J~..n_A. Ad.d
penonally known to me or provrd to me on the basis ':If AlisfactDry
evidence tD be the indiviclual{s) whose name(s) is (are) subscribed. 10
the within 1Q!;trumcnl iU'ldlacknowlcdgcd to me that he/shelthey
cxecUted the same in hislherlthcir capacily(ic!Ii). and that by
hislhrr/their !;ignat~,s) lJn the instrument, the indiyiclual{s). or the
person upon behalf of which the individual(s) acted, executed Ihe
'nstrumenf
SHEFIRY A A8, ~
Notary Pubilc State of New Yo _ '
No 4906686 SlgDatu and mec or
f" . Qualified IrI Nassau County ladl!!!!Jlal tak nlacltDOwledgmeot
...ommlsSlon Exolres Se;::ltember 2 I. 20 ~
On the _ day of in (he year before me. the
undersigned, personally appeared ___~_..
penona.lly known 10 me or proved 1:0 me on the 'basis of satisfactory
evidence 10 be the individual{s) whlCJsc name(s) is (arc) subscribed to
the within inSDUment and acknowledged lo me that helshellhey
executed the same in hislherhheir cllpllCity(ies), Ind lhat by
hi&lhrrlthc:ir signlture(s) on the instrumcnl. .he individual(s). Or the
person upon behalfofwhieh the individual(s) 3Cled. executed the
instrument.
SlgDaturt' aad Office' of
ladlvldual taking uktlOwlnlgment
. For ac:knowlftlgmttDII ftllkeD In Nrw York State.
..o Statr. ntstMd or Calunlbl.. Territory. Pouesslon, or Foreign Countl")'
) '1.:
On the ___ day of _____ in the year _ before me, Ihe undersigned. personally appeared _____..
personally bown 10 me or prov~ tD me on the basis ohltisfactory evidence to be Ihe individu:sl(s) whose mune(s) is larc)1 subscribed to Ihe
wilhin instrumenl :and acknowledged to me thlt he'sl1e1thcy executed Ihe same in hislher/tbeir capacily(ies), thai by l1islherllhc;r sign:sturc{s)
on the instrument, the individual(s), or the person upon behalf of which the individunl(s) acted. executed the instrument, and 1hO:I such
individual made such aP1~ce before the undersig-l1cd in the . (Inscn the C'1i:[y or other political
subdivision and thr.- state or CI)Untry or other place th~' acknowledgment was taken)_
SlgD.lure add Omec of
Individual .aklDI ackaowlftlgme'Dt
.... Fol'" ackno,,"lrdCI'l1le'nts fakelll ou.side of Nnt" York :!!Itatc.
l"qpIln anll "'Ie .cell
Vv'n H CoVENANT AGAINSI" GR^N10R-S ^CTS
T'TLII No. ..f1IO'f~/.:2 ~.3
}~'-'>.A.~ ~(r,......,-jC
TO
I"'~"'\.
I_'~~
SECTION
BLOCK
LOT
COUNTY 0.. TOWN
Reanded At Request of
Fint Arnerican nde I...rance Company or Ne.v YOI'II.
.BTIJ.N BY IlIAI:L TO:
SU,NDAID IlCMIM or NIW TOIl: .cuD Of nnl 1INDf"111l11S
,Dulribt"'nlb,,
First A merican Tille Insurance Compa~y
of New York
~
Dan.U.L C. No..._, Uiq.
J15 1tI~, 1Iv~
P. O. BoJC 146
I'fntUt"eIt, NY 11'J52-0146
Zip -
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Number of pages \
TORRENS
RECORe'Eli
2004 SeD 08 03:48:06 PM
Edw.ard P. ~~om.aine
CLERK OF
SUFFOLK COUNTY
l D00012342
P 1":6
Nt 04-(16091
Serial #
Certificate #
Prior CI f. #
Deed I Monga!~c Instrument
2J
Deed I Mortgage 1'"" Stamp
FEES
Recording I Filing Stamps
Page I Filing I:ee
Handling
5. 00
------------
Mortgage ArnL
1. Basic: Tax
2. Additional Tax
Sub Totnt
Spec.lAssit
or
TP-584
Nutation
EA-52 17 (COlmly)
Sub Tolal
Comm. of Ed.
5 00
-- -----------
Spec. I Add.
TOT. MTG. TAX
Dual Town __.... Dual County _
Held for Appointment
Trdnsfer Tax.~ y<:, 0, - _
EA-52 I7 (Stale)
R.P.TS A.
___,30__
Affidavlt
Mansion Tnx
NYS Surcharge
Other.
_.J2,..QQ._
Sub Total
Grond Total -.J ';) d. --
The property covered by this mongage is
or will be improvc:d by a one or two
fnmity dwelling only_
YES ___ or NO
If NO, SIX appropri.ate tax clause on
page # ____ of Ithis instrument.
Certifieu Cop~'
d
~_~~~on _
r----
I 04037406
/P~'-T-~j
(R ~m A
\!l.l-SEP~
-~----....'
I Block
Lot
5 Community Preservation Fund
Consideration Amount $ 'OL\O,QO::)
--
CPF Tax Due $ ..13 'rlOO
Improved X
Real Property
T:u: Service
Agency
Verification
1000 109(10 0300 002033
.J
'Vacant Land
~ Sa(isfactions/DjschargcsIReleas~s List Property Owners Mailing AdtJn:Sfi
RECORD & R)';TlIRN TO:
TD
\(J
DAeJI~_ C k.. &1
'3 I S- G.)e~ill'~ l'~"c-
'(<0. -4~; ,~
'i1t"fTl?T.<<:.-~ I "''1 'rr:.~
TD
TD
~
Title Com I~ny Information
""- 0 ~ c:.J9A<.:rl-t
::l "-13. .
Suffolk County Recordine & Endorsement Page
DE..n
(SPECIFY TYPE OF INSTRUMENT)
7
This page fonns parr of the attached
made by:
__m____~~IU.dP ~'" ~~
The premises herein is situated :in
SUFFOLK COUNTY, NEW YORK.
TO In the T~wn.hip of
___.......:~""'kM 4J1.&-d(!ZS In the VILLAGE
.----.-~~L~4~,hI"""" or HAMLET of V(I-n-Ml..v::.ILS:
BOXES 6 THRU 8 MlUST BE TYPED OR PRINTED IN BLACK INK ONLY PRIOR TO RECORDING OR FILING.
-SalL-a..l<:>'- "b..__
(over)
1111111111111111111111111111111111111111111111111111111
1111111111111111111111111
StllFFOLK COUNTY CLERK
RECORDS OFFICE
RECORDING PAGE
Type of InstruInent: DEEDS/OO!:'
Number o:E PagelJ: 4
Receipt l!lumber : 04 - 0099054
TRANSFER TAX NUMBER: 04-(116091
Recol~ded:
At:
09/08/2004
03:48:06 PM
LIBE:R:
PAGE:
District:
1000
Section: Block:
109.00 03.00
EXAMINED AND CHARGED AS FOLLOWS
$840,000.00
Deed Amolmt:
D00012342
186
Lot:
002.033
Received the Following Fees For Above Instrument
Exempt Exempt
Page/FiHnH $12.00 NO Handling $!i.00 NO
COE $5.00 NO NYS SRCXG $l!i.OO NO
EA-CTY $5.00 NO EA-STATE $7S.00 NO
TP-584 $5.00 NO Cert.Copies $0.00 NO
RPT $30.00 NO SCTM $(1.00 NO
Transfer tm< $3.360.00 NO COJIDI\.Pres $13,800.00 NO
Fees Paid $17.3121.00
TRANSFER TAX :m~ER: 04-06091
THIS PAGE IS A PART OF THE INSTRUMENT
THIS IS NOT A BILL
Edward P.Romaine
County Clerk, Suffolk Cotmty
FOR COUNTY USE ONLY
C1. SWIS Code
PLEASE TYPE OR PRESS FIRMLY WHEN WRITING ON FORM
INSTRUCTIONS: http:// www.orps.state.ny.us or PHONE 15181 473.7222
I Y'7 ' s ,g' &..e:J
8:
C2. Date Deed Recorded I 09' I 0 ~ 10 Y I
Mnn\h Day Year
C3. Book I /(~,0, $<;' ;<tC4. p,.. L ,/,1 ?: I
.
PROPERTY INFORMATION
1. PrOIl,erty L-l...2 4. "j
locE,tion 5TREnNUMBE~
iJJlilJ~
1 CounL~u C;'uA
STR~~T NAIVE
REAL PROPERTY TRANSFER REPORT
STATE OF NEW YORK
STATE BOARD OF REAL PROPERTY SERVICES
RP - 5217
RP_52HRe~3/'"
2. BUY'lr L Ananp...o
Name LAST~"'M~ICOMPA:'V
lJitli..am
FI~ST NAME
Cut.cho gUJl.
VlLLAGE
I
1119~
ZIP CODE
SouthoLri.
CITYO~ TOWN
AJlaneo
LAST "'AME ICOMPANV
l'1aJlyLou
FllISTNAME
3. Tax
Billing
Address
:,ndicate where 'uture Tax Bi'ls ilreto be sent
.1 other than buveraddress (atbctlorr: oflorml L.
LAST NAME I COMPA,NV
L-
S-:-REETNUMIlloHAN)STRHT NAME
C<TY OR TOWN
4. Indi.:ete the numbllr of AS&8ssment
Roll parcels transferred on the dMld
L~_~J # of Parcels OR 0 Pan of a Parcel
5 Deed
Prollerty
SizB
lOR I
'ACRES
. 9 J
L ---.J X I
fAONTFEU
OFPTH
6. Sell.iIl"
Name
q~~~nK~~aR HomLA. Inc.
IAS-IlAMEICOMPA,NV
FIRST "A~'E
~...
LASl r~A""E I COMPANY
fIASTNA,ME
Check the box below which most accurately describes the use of the property at the time of sale:
A~~ One Family Residential
A 2or3Family-Residenlial
c: Residential Ifacant land
o NOJ1-ReSldental Vacant land
I SALE INFORMATION I
11_ SeleC<Jntract Date
E ~ Agricultur~1 I ~ Ccmmunity Service
F CommerCial J Industrial
G Apartment K PUbliC Service
H Entertain;",ent! Amusement L Forest
-
...--J
FIASTNAME
STAn
lIPCOl.l(
(Only if Part of a Parcel) Check as they apply;
4A. Pla~ning Board with Subdivision Authority Exists 0
4B. Subdivision Approval was Required for Transfer 0
4C. Parcel Approved for Subdivision with Map Provided 0
Check the boxes billow IS they apply;
8. Ownership Type is Condominium
9. New Construction on Vacant land
10A. Prooerty located within an Agrjcultu-al District
10B. Buyer received a disclosure notice indicarng
that the property is in an Agricultural District
D
D
D
D
15. Check one or more of these eondition'll as applicable to transfer
12, Date of Sale' Tntnsfer
5 5 04
Month D" Year
L ...JL...l 11 O~ .J
MonU-, D., V"a.
A
B
C
D
E
F
G
H
I
J
13. Fun Sale Price ~._. ' , 8 ,4 0 , 0 , 0 , 0 , 0 , 0 I
, , .
(Ful Sale Price is the total amount paid for the property ;ncluding personal property
This payme'lt may be In the form of cash, other property or goods, or the a~~umption 0'
mOr:gages or othel obligations,) Please ro~'nd to the n8ilresf whole dollar amount.
14, Indicate the value of personal
pr<Jpertyincluded inthe sale
I ASSESSMENT INFORMATION
o 0 I
, , .
- Data should reflect the latest Final Assessment Roll and Tax Bill
16. Year of Assessment Roll from
which informatioo taken
lllUlMJ
17 Total Assessed Value lof all parcels in transferl 1
18 Pr,)pettv Class
l.L_i1~-LJ 19. ScholJI District Name I Sf) 473812 SouthaM.
20, Tall: Mep Identifierlsl , Rollldentlfillrls) (If more "than four. attach sheet with addItional identifier(sll
~rooo .
109.00
OJ.oo - 002.0]]
Sale Between Relat;ves or Former Relatives
Sale Between Related Comp<l1ies or Partner!! i'l Business
One of the Buyers i5 alsc, a Seller
Buyer ur Seller is Government Agency or lending Institution
Deed Type not Warranty or Bargain and Sale (Speclf'( Belowl
Sale of Fractional or less than Fee Interest (Specify Below)
Significant Change in Property Between Taxable Status end Sale Dates
Sale of Business is Included in Sale Price
Other Unusual Factors Affecting Sale Pric!;' (Specify Below)
Nnne
-------,----
1
,
00 I
~
L
I CERTIFICATION
I certif). that all of the items of inronnation entered on this form iln.' true and oorrect (to the best of m~ knu\1ledge and belief) and I understand tltat the making
of any willful faL-.e s.tatement of material fact ht>rt'in will subject me tu thl" oro\isions of the oenal law relatiw to the makIng and filing of false instrument~.
/
0w,d~ ATTORNEY
v RO-6-6
BUYER
>>(..U"._-(}".V\
------;~-I(;NATURF
ii:!!i '!;Y
OA~'" -;
,"STNAME
\. A/L..L ...._<.~("--.
[)~
-.L'i!f5
'TREET'IUMBER
631
AAEACODE
c~~~
l/jyC
ZIP COOk
1ft!J,
, ,
q4een'~~a~ #ome-6, SELLER
~ ! Inc./) .
J3.!/: ~2.hz..'-<.. /...-7..c,,(',
Sll,SIGNATURE
d~~
OATE
1_ DanieL C.
"RsrNM"
298
1200
TELEPHON~ NUMBER
6EWYORK~
COPY wu..~ I
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