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BARGAIN AND SALE DEED WITH COVENANT AGAINST GRANTOR'S
ACTS (INDIVIDUAL OR CORPORATION)
STANDARD NYBTU FORM 8007
CAlrnoN: TillS AORGl!Mh'NT SHOUI..D liE PIltiPARI!U BY AN A11'URNL'Y AND RJ.!:YI~D BY AlTORNEYS FOR SFJJJiR ANI)
Pt:RClIASER BEFORE SIOloIIfo;Cl.
THIS INDENTURE, made thr:.3cJ.. ~ ~J 2004
betweea
HOWARD GROSS AND KAREN GROss, Id. wife,
.....ldlall.C 1130 Ray Dr,
Miami Beaeb, Florida .u 141
pony ofthe fim pan. and
PETER J. JACORS .ad MARY JACOH& 11I......ad and wile,
raldl. .c IZ30 Old Ore..rd ......e
East M.rioa, NY 11939
pony of ihe second part.
WITNESSETH, Ihal the pony oflhe first pon. ill eonsideralion of Ten Dollars and olher lawful
~on.ideralion, lawful mon..y of Ih.. Uniled 5..1.... paid hy th.. pany of the """"nd pan. does hereby JIIlUII and
release unlO the pany of \he second pon. Ihe heirs or .uece"""", and aaillll. of th.. pany of Ihe """"lid port
tbrevcor.
ALL lhal eer1ain plol. piece or parcel of land. with Ihe buildinp and improvements thereon erecled,
situllte. lying and beina III Easl Marion, Town of Soulhold. Counly of SulTolk and S"le of New York.
SEE SCHEDULE' A' A 1T ACHED HERETO AND MADIl A PART HIlREOF
Being and inlended 10 be lhe ssme premioc. conveyed 10 Ihe GranlOn by deed recorded February 4, 2002
in Libcr 12167 ep 393.
TOGETHER wich all riahl. tille and interesl. ifany. of the party oflhe first pan in and lOan)' streels and
road. abutting Ihe above described premilCs 10 the center line. thereof,
TOGETHER with the appurtenances and all the estale and riahts of the party of the first port in and 10
said premises.
TO IIAVE AND TO HOLD the premise. herein Ilranted unlO the pony of the second part. the heirs or
successors and IIYip_ orlhe party ot"the aecand part f()I"CYCr.
.4ND the porty of the first pan, euvenanlS Ihal the pony of th.. finl part has nO\ done or su IT,,recJ anything
whereby the said premises have been encumbered in any way wha"'vcr, excepl as aforesaid.
AND the party oflh.. first part. in eumplianee with Section 13 of the Lien Law. covenants that the part)'
of the fint par1 will receive the consideration for this conveyance and will hold the riabt 10 receive such
consideration as a trust fund 10 be applied finl for the pUrpolle of paying the cost of the improvemenl.nd will
appl)' the same Iirstlo the paymentufthe COlIt afthe improvement before using an)' part oftbe total oflhe same
for any other purpolC.
Th.. word "pany" .hall be eonslrued as if it read 'portie.' whenever the ..,nse of this indenture...
r~qu ires.
NVSlt^ Rftklcll'llial KclaI ElI1nw' FonnI'1II 'kltJ)oc,",WOO.
-I.
C'"upyrlaJlt OIo"lu1\- Drvclupmcnl
'.. .
IN WITNESS WHEREOF, th~ pliny urtM lirst plIn has duly ~"""uted this d~ the day nnd year lirst
above: written,
KAREN ROSS
STATliOF FLORIDA)
)55"
COUNTY OF J1.c.l ~ ".J)".A.
On the .J-a.I...dJl.y of '/?;?~J, . 2004. before ...... ~ undersill"ed. personally appearc:d
HOW ARI) GROSS aad KAREN GROSS, peroonaIly known to me or proved to me on tM baais of satisfactory
evidence to be the individual wh..... name i. soboc:ribed to ~ within instrumentlllKl ""knowledpd to me that sh~
c"ceuted the sa"", in her caplll:ily, IIIKI that by her sisnatun: on the instrument, the individual. or the person upon
behalf of which tM individual acted. ~"llCutcd the instrument. and that such individual made such appearance
befo he und ilP!ed in the o..tl"f O~ It! 'All'" ~."'c:H, "1"1""'" 01- ~IC.I..o~.
NARY PUB
,./ \OfE.YoR.A LetS ml(.L../C..
DEED
Iltl" No. S S..., JS:. S J tf....
e-w-
,~ ..,- . .--.r
--~-
GROSS
Sfttioa 038.00
Block 02.00
Lot 010.000
Cuunty ur Town SUFFOLK
Tu
.JACOBS
Rctut:8 B Mall To:
......... DL8EIt UP
..-..
. 'PO__
CU'IQIOI"- .11.
Rae"'" Thla S "" Fur US" or Reeonlln omce
NYSKA RaMk:nllal Read EsIaIc' Fntms on ..lID.al (~)
-2.
Cup)1'ipll"IIpIUftr Dewla',man
SCIII\DUI.K A-I. (OGcrIpllDII)
" .
ALL that certain plot, picc:c or parcel of land, situate, lying and being at East Marion, Town of Soulhold, County of
Sufl'ulk and Slate of New Yoric, known and designated as Plol 24 on a certain m3p entitled "Map of Marion Manor,
situated at East Marion, Town of Southold, Suffolk County, New York, sUlVeycd November 25, 1952 by Otto W. Van
Tuyl & Son, Licensed Surveyol1, in Grecnpoll, New York, owned and developed by I'ctcr Blank and Son, East Williston,
Long Island, NllW York" and filed in the Office of me CIlll'k of the County ofSulTolk on March IS, 1953 as Map No.
2038, said lot is bounded arid do:scribed as follows:
'.
BEGINNING at a po'int on the westerly side. of Oillelle Drive at a point where the division Ijne between loIS 24 and 25
intersects the said westerly side of Gillelle Drive; , '
RUNNING TfffiNCE along the said westerly side of Gillette Drive South 25 degrees 08 minutes 5 seconds East 100.00
feel to the division line between Lots 23 and 24;
THENCE along said lasl division line South 64 degrees 5 I minutes 10 sccond& WllSlIOO.OO fcelto land now or formerly
of Cherepowich, Santacroce & Polack;
llIENCE along said IlISlland, North 25 degree.~ 08 minutes 50 seconds West I 00.00 fcelto the division line belween Lots
24 and 25;,
llIENCB along last said division line North 64 dcgn:cli 51 minutes 10 seconds East 100.00 fcetto the westerly side of
Oillelle Drive at the point or place of BEGINNING.
TIlE POLICY TO BE ISSflF.D ulllkr llUs cDlllmiIJMIII will llUu,. lire lill. ID IlICh buildi"" lIIIIi imjJl"t1lJemcnu 011 lhe pnmiJu which
bylaw CQIIIlillllO rttal f1I"t1I1C'/y.
,.'OR CONVEYANCING ONLY: TogeIher wilh till lhe righi, lillollllli illlual oJ lhe fKII1Y oJ the [11'1( pori. 0/ ill tmd 10 lhe lond lying
in lhe IIrCtIt in/1'OIfI oJ lIIIIi adJoining loid fN"mUDI,
SCHI::DULE A-I (/JI..ripll",,)
,
I
11111111111111111111111111111111111111
1111111111111111111
SUJ'POLlC COUNTY CLBRlt
RBCORDS OPPICB
RECORDING PAGB
Type of Instrument I DBBDS/DIlD
Number of Pages: 4
Receipt Number :.04-0039466
TRANSPBR TAX NUMBBR: 03-37357
Recorded:
At:
04/07/2004
09;15:42 AM
LIBBR:
PAGB:
D00012312
102
Deed AlIIIount:
Section I . .Block:
038.00 02.00
Il!n~ AND CBARGBD AS POLLOWS
$200,000.00
Loti
010.000
District;
1000
Received the Following Fees For Above Instrument
BY-.pt
NO
NO
NO
NO
NO
NO
Page/riling
COB
IA- CTY
TP- 584
RPT
Transfer tax
$12 . 00
$5.00
$5.00
$5.00
$30.00
$800.00
Banc!ling
NYS SRCHG
IA-STATB
Cert.Copies
SCTII
CCIIIIIII.Pres
Fees Paid
$5.00
$15.00
$50.00
$0.00
$0.00
$2,500.00
$3,427.00
Bx8lllpt
NO
NO
NO
NO
NO
NO
TRANSPBR TAX HOKBIRI 03-37357
THIS PAGI IS A PART 01' THE INSTRtlJIBNT
THIS IS NOT A BILL
Bdward P. RClIIIIllille
County Clerk, Suffolk County
~.
....-
1
Number of pug""
TORRENS
Serial I
Certificste # _
Prior Ctf. It _
Deed . MortS:sge InsU"Ull1enl
Oeed I Mona"ll" Tax Stamp
2J
Page I Filing Fee
FEES
2--_
Handling
'; JllL
~---
TP-SS4
Notation
EA-S217 (County)
EA-S217 (SIDte)
S
~-V
~-
~7
Sub TOl.1
R.P.T.S.A.
Comm. of Ed.
S. JllL
AffidDvil
Certified Copy
ReI:. Copy
111"0 -
J ;.)-
C4>-
Sub TolDl
O[h~r
-
fiJ
Orand Total
:;]. lPOQ
4 DlllJiel
Real
Property
Tax Service
Aaency
Verification
1~!
~1~ 1000 03800 0200 010000
(,~
\~..~~ .::)
~
SstisfoclionIDiachargesiRelease List Property Owners Mailing Address
RECORD & RETURN TO:
OLS(~ ,. 0 L~.J
P, o. "t\l>X IOta
Cv....Vt;!O~V Ej ~'11l~3.s- :o.Name
TIlle It
8
Suffolk County Recordiri
&. Endorselnent Page
This I"'ge. fonn! pan of the attached
DEED
(SPECIFY TYPE OF INSTRUMENT)
",ade by:
RnwAvn GROSS AND KAREN GROSS
RECORDED
2004 Apr 07 09.1'5.42 AM
EdIoard P.RClNi""
ClERK OF
. SUFFOlJ( COUHTI'
L OOOOl~12
. '.. .P.l02
. 'rd. 03-;s7~7
Recording I Filing St.....mpJlt
Monl'lle AmI.
I. Basic TUx
2. Additional Tn.
Sub Total
Spec. I Assit.
or
Spec. I Add.
TOT. MTG TAX _. _
Dual Town _ Dual Coumy _
Held for Appointment _
Transfer lOx ~Q____ _
Mansion Tax
The properly covered by this "'olllaae i.
or wjll be improved by :1 one or two
fwnily dwelling only.
Y
5 Commun
COllsida.ration Amounl
s.s.il~ .
S::J ~m./../
'I
CPF lOx Due
Improyed
Vacant und ~
TO Ib
1'0_..
TO
Title Company InformaLlon
04-3704-55725-surr
The. premiJ;;is heretin is situated in
TO
PETER J. JACOBS AND MAll.Y JACOBS
SUFFOLK COUNTY. NEW YORK.
5OUTllOLD
In lhe Towns:,ip of
In the VILLAGE
or HAMLET or
BOXES Ii THROUGH K MUST BE TYPED OR PRINTlln IN SLACK INK ONLY PRIOR TO RECORDING OR FILING
.
FOR CQUN-ry USE ONLY
C1. SWIS Code
PLEASE TYPE OR PRESS FIRMLY WHEN WRITING ON FORM
INSTRUCTIONS: http://www.orps.stata.ny.us or PHONE 1518) 473-7222
REAL PROPERTY TRANSFER REPORT
;>( ,,/, '), 'ft, <;;',7" 1
-*
RP-S1t' Re~ JI'n
STATE OF NEW VORK
STATE BOARD OF REAl PROPERTY SERVICES
C2. Date Deed Recorded
O~~i
Mont
CJ7/ 0<;/ I
o.y V..r
RP - 5217
C3. Book 1 ./. .;l., ~ /, ..:21 C,. P...
PROPERTY INFORMATION
1. r~:::~ L
STRUT NAME
2. Buyer
Nam.
L ,,~~.H
L J~~7~M~ANY
Peter J.
FIflSTiIlAME
East Marion
VllLAGI!
, 11939
ZJ~COCE
L Jacobs
LAST NAME {COMPANY
Mary
'''STN..ME
3. Tall Indic.llte whlll'8 future 1'l( Bills are to be sent
BiMing if olher than buyer eddren (eI bottom of fann)
Ad....
L-
LASTiIl..ME{COMf'ANY
FIFlS'tNAM[
L
STIIEETNU....ER..NOSTfl,EETNAME
ZIPCODS
CITYOIIW_
(I # o' Parcels OR 0 Part of a ParcRI
ST"Te
4 Indicate th. number of AaseNment
Roll pareell tran".rred on th. d..d
(orny if Plrt of a hroMl Chnk u thr( ap"'y:
4A. Planning Board with Subdivision Authority Exist. 0
48. Subclivlslon Approval wa. Required for Tranlter 0
.tC. Parcel Approved tor Subdivision wit/1 Map Provided 0
5. D.ed ~xl lOR 1 .2 ."3 I
Property ~m , .
SiZll FIlOillTFfET ACRE!>
S. Sell.r L Gross Howard
Name LAST NAME I COMPANY FIfl$TNAME
L Gross Karen
LAiTNAME/COJIIPI\NV fIRlTN.a.ME
7. Check the bux below which most accunrtRly de.oribe. the U$e of the property at ttM thnll of ..Ie:
a-k thll boxn below aa ttley apply:
8. Ownership TyPfl Is Condominium
9. New ConstructIon on Vacant Land
10A. Propllrtv Lo,..ted within an AgrkulturRl District
10B. Bu~r received a dlsclolUte l1otio& il1dlcating
that tlMi property I, In an Agr~u~ura' Districl
o
o
o
o
A~ Olle Family ResidRl1tial
B 2 or 3 Family Residel1tial
C ResldltOlial Vaeaol Lend
D NOI1-F:lIsidllfllial Vacanl Land
I SALE INFORMATION f
11. Sale Contrac:t 0..
E~Agrlcultural
F Commercial
G Apartm.nt
H Entertainment I Amusement
~~
Community Service
Industriel
Public Service
Forest
1 / 'n / q^
-- DIY R'
.J / Sl / 04
"- 0,,, YR'
16. Check _ or ~ of m.. oonditions IS appIlcatN. to u.neter:
A Sale 8etwe<<I Releti,," Of Former Relatives
B Sale Bflween Related Companiea or Partners in Bvsiness
C One of the Buyera III also a Seller
D Buyer or SllU<< Is Governm.nt Agency or Lending Instilution
E Deed TyPll not Warranty or Barge!n and Sale (Specify Below)
F Sal8 of Fractiona! or Lell then Fee Interest 15pooify Below)
G SignifICant Change in Property Between Taxoble Stalu$ and Sale Dates
H Sale of BUllineljs i. ItlCluded in Sale Price
1 Othlt/' Unuaue! FlIctor. Affecting Sale Price (Specify Below)
J None
12. Da~ of Sallil Tran.fer
,2,0,0,0,0,0,001
, , .
(Full Sale Pricl' is thR tot81 amount paid for the property including plIr'SOnal proptlrtv.
This payment may b. In the form of eat/'!, other proparty or good... or the al8umption of
mongege$ or ')lher obligations" P/9MJ round fO rha nee,s,t whole dol/sr amount.
13. Full Sale Price
14. Indicate th. valu. of p8rSOI1al I , 0 , 0 ,
prop.-ty includ.d In tIM ..Ie ,.
ASSESSMENT INFORMATION - Data should reflect the latest Final Assessment Roll and Tax Bill
16. v..... of A.....ment RoO from' 0 LJ -
whfoh Information taken ~ 17.
~~-LJ
0001
Total AneSMd Value lot all pare.l. in vSnller) I .
,
(~..E-~ 9~R...T
,
18. PrOPllrty Ci_1S
19. School DI.trict Name I
20. Tax Map klentifier(.' 1 Roll ld.ntffI....(.) III mOf. thlIn four. attach ahMt with additional identifier(.lj
T nno 1.1~_?_1 ()
f CERTIFICATION
I certify that all ol the IIems of Information entered on dUs form are true and rorrect (10 the beAt of Ply knowledJ:e and beIWJ and I undel"StIInd that the making
of any willful falIse statement of material fact herein will subJect me to the nrtMd....... of lIw oenallaw relative to the making: and filing of faJl;e instnlR1ew.
BOVER C?~"EV
~ ~(V\~ ~,,3/71Ia'1 ~,a.''''ri -.:L?t,~
ul't
~.O. B01{l11 ( 63/) 73 '1'7~1h
STRE6'f NU"'8E~ STReET NAAl~ lAfTfR $l\l.El AIIU. coor. TELEl'HO,*, NUMIIeR
NEW YORK STATE
COPY