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BARGAIN AND SALE DEED WITH COVENANT AGAINST GRANTOR'S
ACTS (INDIVIDUAL OR CORPORATION)
FORM 8007
CAUTION THiS AGREEMENT SHOULD BE PREPARED BY AN ATTORNEY AND REViEWED BY ATTORNEYS mR SELLER AND
PURCHASER BEFORE SIGNiNG.
THIS INDENTURE, made the December 19, 2001, 1/ 5
between
General Stephen Forman, Jr., of 65 Cardinal Driye, Mattituck, NY 11952
party of the first part, and
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Dennis M. Roses and Karen Lee Roses', as tenants by the entirety of 1455 Pike Street, Mattituck, New York
11952
party of the second part,
WITNESSETH, that the party of the first part, in consideration of Ten Dollars and No Cents ($IO.OO)and
other valuable consideration, lawful money of the United States, 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, with the buildings and improvements thereon erected,
situate, lying and being at Mattituck, Town of Southold, Suffolk County, New York, known and described at Lot
NO.5 on a certain map entitled, "Mattituck Estates, Inc." filed in the Office of the Clerk of the County of Suffolk
on September 3, 1965 as Map No. 4453 and more particularly bounded and described as follows:
BEGINNING at a monument set in the southerly side of Main Road at the extreme easterly end of an arc
of a curve connecting the easterly side of Cardinal Drive with the southerly side of Main Road;
RUNNING THENCE North 88 degrees 08 minutes 20 seconds East along the southerly side of Main
Road a distance of 80.00 feet;
THENCE South I degree 51 minutes 40 seconds East a distance of 200,00 feet;
THENCE South 88 degrees 8 minutes 20 seconds West a distance of 133.92 feet to the easterly side of
Cardinal Drive;
THENCE the following three (3) courses and distances along the easterly side of Cardinal Drive:
I. North 6 degrees 37 minutes 10 seconds East a distance of26.58 feet
2. North I degree 51 minutes 40 seconds West, a distance of 123.71 feet
3. Along the arc of a curve bearing to the right having a radius of 50.00 feet, a distance of 78.54 feet to the
point or place of BEGINNING.
Premises being the same premises described in the deed recorded in Liber 11798 page 962.
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 HA VE 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" whenever the sense of this indenture so
reqmres.
L'V WITNESS WHEREOF, the party of the first part has duly executed this deed the day and year first
above written.
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General Stephen Fa an, Jr.
IN PRESENCE OF:
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NYSSA Residential Real Estate Forms on H01DocslO(9/00)
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Acknowledgment by a Person Within New York State (RPL 9 309-a)
STATE OF NEW YORK
COUNTY OF SUFFOLK
)
) ss.:
)
On the 19th day of December, 2001, before me, the undersigned, personally appeared General Stephen
Forman, Jr., 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 executed the same in
his capacity(ies), and that by his signature(s) on the instrument, the individual(s), or the person upon behalf of
which the illdividual(s) acted, executed the instrument.
JOYCE E. PHILBIN
Notary Public, St3te of New Yorll
No. 4880553
Qualified in Suffolk County
Commission Expires December 15, w..::;? aD d-
JJEEJJ
Title No. RH80014114
Section 115.00
Block 06.00
Lot 001.800
County or Town Suffolk
Street Address 65 Cardinal Drive
Mattituck, New York 11952
General Stephen Forman, Jr.
To
Dennis M. Roses and Karen Lee
Roses'
Return By Mail To:
Janet Geasa, Esq.
Wickham, Wickham & Bressler
P.O. Box 1424
Mattituck, New York 11787
Reserve This Space For Use Of Recording Office
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Serial #
F' 2E:2
Certificate #
DT# 01-2317'1
Prior Clf. #
Deed / Mortgage Instrument
Deed! Mortgage Tax Stamp
FEES
Recording / Filing Stamps
4
Handling
TP-584
C\
es
lJ
Mortgage AmI.
Page / Filing Fee
1. Basic Tax
2. Additional Tax
RP.T.S.A.
s
OS
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Sub Total
~~
Sub Total
Notation
EA-52 17 (County)
GRAND TOTAL
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Spec.! Assit.
Or
Spec. / Add.
TOT. MTG. TAX
Dual Town Dual County
Held for Apportionment
Transfer Tax M ~ ()
Mansion Tax
The property c vered by this mortgage is or
will be impr ed by a one or two fam ily
dwelling only.
YES or NO
If NO, see ap ropriate tax clause on page #
of this nstrumenl.
EA-5217 (State)
Comm. of Ed.
50~
Affidavit
Certified Copy
Reg. Copy
Sub Total
Other
00
//5'00
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6 Communi
Consideration )1mV
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CP Tax Due ~ / q OD,
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Date\It'610a-
Real Property Tax Service Agency Verification
Disl. Section B lock Lot
Initials [)Y
7 Satisfactions/Discharges/Releases List Property Owners Mailing Address
RECORD & RETURN TO:
Vacant Land
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Title #
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Title Company Information
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& Endorsement Pa e
TIus page forms part of the attached
made by:
Ge(/o.raLS~~ -t;fmQY1 J :r r .
(SPEOFY TYPE OF INSTRUMENT)
TO
\}04lI1'':> oJ? O~ ') r:uvJ jG rG!{l
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The premises herein is situated in
SUFFOLK COUNfY, NEW YORK
In the Township of ,SntJA 0 /)
In the VILLAGE
or HAMLET of
BOXES 5 THRU 9 MUST BE TYPED OR PRINIED IN BLACK INK ONLY PRIOR TO RECORDING OR FILING.
(OVER)
" .
111111111111 111111111111111 11111 11111 1111111111 1I111111
1111111111111111111111111
SUFFOLK COUNTY CLERK
RECORDS OFFICE
RECORDING PAGE
Type of Instrument: DEEDS/DDD
Number of Pages: 3
TRANSFER TAX NUMBER: 01-23171
Recorded:
At:
LIBER:
PAGE:
01/18/2002
12:33:14 PM
000012164
282
District:
1000
Section:
115.00
EXAMINED AND
$245,000.00
Block:
06.00
CHARGED AS
Lot:
001.000
FOLLOWS
Deed Amount:
Received the Following Fees For Above Instrument
Exempt
Page/Filing $9.00 NO Handling
COE $5.00 NO EA-CTY
EA-STATE $25.00 NO TP-584
Cert. Copies $0.00 NO RPT
SCTM $0.00 NO Transfer tax
Comm.Pres $1,900.00 NO
Fees Paid
$5.00
$5.00
$5.00
$30.00
$980.00
Exempt
NO
NO
NO
NO
NO
$2,910>\.00
TRANSFER TAX NUMBER: 01-23171
THIS PAGE IS A PART OF THE INSTRUMENT
Edward P.Romaine
County Clerk, Suffolk County
PLEASE TYPE OR PRESS FIRMLY WHEN WRITING ON FORM
INSTRUCTIONS: http:// www.orps.state.ny.us or PHONE (518) 473-7222
REAL PROPERTY TRANSFER REPORT
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STATE OF _ YORK
STATE BOARll OF REAL PROPERTY SERVICES
RP - 5217
RP.5111 Rev 3WI
1. Property I 65
Location stREET NUMBER
Cardinal Drive
STflEETNAME
Mattituck
CITY OR TOWN
VILLAGE
111952
ztPCOOE
2. Buyer
Name
Roses
LAST NAME I COMPANY
Dennis M.
FIR$TNAME
Roses
. lAST NAME I COMPANY
Karen Lee
FIRST NAME
3. Tax indicate where future Tax Sills are tabs sent
Billing if other than' buyer address (at bottom of form)
Address
LAST NAME I COMPANY
FIRST NAME
STREET NUMBER AND STREET NAME
ClTYORTOWN
ST~TE
ZIP CODE
FfI0NTFEET
DEPTH
'ACRES'
.
(Only if Part of. Parcell CMck as they apply:
4A. Planning Board with Subdivision Authority Exists 0
48. Subdivision Approval was Required for Transfer D
4C.' Parcel Approved for Subdivision with Map Provided 0
,
4. Indicate the number of Assessment
Roll parcels transferred on the deed
# of Parcels OR [] Part ofa Parcel
5. Deed
P,operty
Size
Ixl
lOR I
5
81
LAST NAME f COMPANY
General Stephen
FIRST NAME
6. Seller
Name
Fo:rman
LAST NAME f COMPANY
FIRST NAME
,'iii
A~ One Family Residential
B 2 or 3 Family Residential
C Residential Vacant Land
D Non-Residential Vacant Land
J.~
E ~. Agricultural
F . Commercial
G Apartment
H . Entertainment / Amusement
I~. . . .comm\.ln. ity Sa rvice
J . Industrial
K Public Service
L Forest
Check the boxes below as they apply:
8. Ownership Type is Condominium
9. New Construction on Vacant Land
10A. Property Located within an Agricultural District
10B. Buyer received a disclosure notice indicatin!;l
that the property is in an Agricultural District
o
o
o
o
7. Check the box below which most accurately describes the use of the property at the time of sale:
11. Sale Contract Date
10 / 1 /01
Month Day Year
12 / 19 / 01
Month Day Year
16. Check one or more of these conditiOns as appUcable to transfer:
A Sale Between Relatives or Former Relatives
B Sale Between Related Companies or Partners in Business
C One of the Buyers is also a Seller
D Buyeror Seller is Government Agency or Lending Institution
E Deed Type not Warranty or Bargain and Sale (Specify Below)
F Sale of Fractional or Less than Fee interest (Specify Below)
G Significant Change in Property Between Taxable Status and Sale Dates
H Sale of Business is Included in Sale Price
I Other Unusual Factors Affecting Sale Price (Specify Below)
j / None
12. Date of Sale./ Transfer
13. Full Sala P,i.a ,2,4,5,0,0,0,0,01
, , .
(Full Sale Price is the total amount paid for the property including personal property.
This payment may be in the form of cash, other prope'rty or goods, or the assumption of
mortgages or other obligations.) PleaSe round to the. nearest whole dollar amount.
14. Indicate the v"lue of personal I . 0 0 . 0 1
i-o.a..i.I....rIlnth..... . I I I. I I I I I.
_'J~~
16. Year of ~ Roll from I /~'~ I I 17. Total Assessed Value (of all parcels in transferll
which lnfonri~on taken " I
;
900/4,700
; ;
18. Property ClasS
1 2 , 1 , OI_LJ IS.School Dlatrlct Name 1
I ~}...
20. Tax Map Identlfler(sI/Rollldentifier(s) (If more than four, attach sheet with additional identifier(s))
11'.::,-- It-I
, ,
115.00-06.00-001.000
I
....
I certlfythat aD of tile itoms of infonnolion enrered on 1hls ronn are true and eorrect (to the best of my knowledge and belief) and I underaland that the making
()f any willful falSe statemeot.of material fact herein will subject me to the urovisions of the oenallaw relative to the making and filing of false instruments.
BUYER BUYER'S ATTORNEY ./
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BUYER SIGNATURE
II/I't/O I
I, '1 I ~,
Geaaa, Esq.
Janet
i)
, ,
DATI;
LAST NAME
FIRST NAME
65
Cardinal Drive
631
298-8353
STREET NUMBER
STREET NAME (AFTER SALE)
AREA CODE
TELEPHONE NUMBER
ZlPCODE
.
Mattituck
CITY OR TOWN
INY
STATE
11952
SELLER
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SEL ~R SIGNATURE
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