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CONSULT l'OIIR LAWYER BErnRE 51CSING TIIL~ INSTRU)IE.'T . THIS INllTRUME.'T 5801ll.D BE USED Bl' LAW\'ERS osu'
THIS INDEH11J... _.. ~ '" of ~"'..... , 2003 BETWEEN
SHIRLEY ANNE FENDERSON, residing at 2585 Marratooka Road, Mattituek, NY, 11952
as Executrix of the Last Will and Testament of ANNA J. CORWIN
late of Suffolk County. deceased, who dlrd on September 28, 2003, Suffolk Count)' Surrogate's Court
File Number 2134P2003
party of the first part, and
SHIRLEY ANN FENDERSON, residing at 2585 Marratooka Road, Mattituek, NY 11942
party of the second part,
WITNESSETH. that the party of the first part, by virtue of the power and authority given in and by said last
will and testament and in consideration ofTEN and no/lOOth. ($10.00) dollars,
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 piece, parcel or tract of land with buildings and improvements thereon situate on the west
side of Aldrich Lane at Mattituck in the Town of South old, County of Suffolk and State of New York
bounded and described as follows:
North by John G. Reeve
West by John G. Reeve and Henry J. Reeve
South by George H. Riley
F.ast by Aldrich Lane
Containing 6 acres of land be the same more or less,
BEING AND INTENDED TO be tbe same premises conveyed to Ann J. Corwin, now deceased, as
devisee under the Last Will and Testament of Mary Bakowski wbo aquired title by deed datrd
September 29,1942 wbicb deed was reconlrd in the Office oftbe Clerk oftbe County of Suffolk on
May 7, 1946 in Liber 2561 Page 16.
TOGETHER with all righi, title and interest, ifany, of the pany of the first part in and to any streets and
roads abutting the above described premises to the cenler lines thereof; TOGETHER with the
appurtenances, and also ail the estate which the said decedent had at the time of the decedent's death in said
premises, and also the estate therein, whieh the pany of the first part has or has power to convey or dispose
of, whether individual, or otherwise;
.
TO HAVE 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
whc:reby the said premises have been incumbered 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 10 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 ~ord "party" shall be construed as if it read "parties" whenever the sense of this indenture so requires.
IN WITNESS WHEREOF, the party of the first part has duly executed this deed the day and year first
above written.
IN PRESENCE OF:
~~. tQ'YM~ r~~
S IRLEY A~ E FENDERSON
STATE OF NEW YORK:COUNTY OF SUFFOLK) 51;
On the 1J5 1+'1 day of June, 2004, before me, the undersigned, personally appeared SHIRLEY
ANNE FENDERSON, personally known to me or proved to me on the basis of satisfactory evidence to be
the individual whose name is subscribed to the within instrument and acknowledged to me that she executed
the same in her capacity, and that by her signature on the ins ent, the individual, or the person upon
behalf of which the individual acted, executed the instrument.
otary Public
GARY FlANNER OL8EN
Nol8ry Public Slale 01 New M .' . ,
No. O2OL2959800 :~:'.'
Cu8l1ff1ld In SuIIoIk coUIlly 1::71 . .
Comml8alon ExpIJH M8n:h 30. ~I
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I
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Number of pages
TORRENS
Serial It
CertificD'e It
Prior Ctf. It
Deed . Mortsagc Ins.rumenl
Deed / MDrtllDle1lur. SlAmp
FEES
3
P:Ige / Filing Fee
HDndling
5 JI1L
TP-584
Notatiun
EA-5217 (County)
EA-5217 (Slate)
SubTowl
.10_
5 .nIL
--<<-
Sub TotDI Kll' 4.,
Grand TOlIlI
120.00 Block 03.00 Lot 012.000 5
R.P.T.S.A.
Comm. of Ed.
Affidavit
C:&rtified CoPY..:,)
Reg. Cupy
Other
4
Reol
Property
Tux Service
Agency "
Verification :
04036216 1000 12000 0300 012000
~
[R_~8~ .~)
'~""11
6
SDrisfacrionlDischDrJlesIRelease List Property Ownel1l Moiling Add.....
RECORD &< RETURN TO:
Gary FJaoner Obeo, Esq.
PO BOll 706
Cutchogue. NY 11935
7
Co. Name.'
lirlell": ___
8
Suffolk Count Recordin
& Endorsement Page V'
REl:ORDED
2004 Dee: 22 09.10.54 AH
EdlMnl P .RoIIa1....
a..ERK OF
SUFFlJU( COI.M'Y
L 000012361
P 752
DTI 04-21156
Reeonlill8 / Filing Stamps
Mortsage Amr.
I. Basic Tax
2. Additional 1'...
Sub Toral
Spec. / Assit.
or
Spec. / Add.
TOT. MTCl TAX
Dual Town _ Dual County_
Held for AJlPDinrmenl _
Transfer 1lur.
Mansion Tax
The property cOY1lled by tIUs motgage i.
or will be improved by u one or two
family dwelling unly.
YES or NO
If NO. see appropriare IDX clause on
page II of this in..~tlUmr:nt.
Commuoi PreRrvatioo Fuod
Consideration Amount S 0
CPF 1lox Due S Ii
Improved X
VacanlLand
TO
TO
TO
TIde Company lofonnatlon
,
This page fonns pan of the anached Executor's Deed
(SPECIFY TYPE OF INSTRUMENT)
made by:
Th~ li:at.tiP of' Ann..1 Cnnlrin
1be premisis herein is sitU3ted in
TO
SUFFOLK COUNTY. NEW YORK.
In me Town>>hip of Southold
In lhe VILLAGE
Shlrl~ Ann. Ji".ndeonon
or HAML"-" or Mattlruck
BOXES 6 THROUGH 8 MUST BE TYPED OR PRINTED IN BLACK INK ONI.Y PRIOR TO RECORDING OR FILING
(over)
1111111111111111111111111111111111111111111111111111111
1111111111111111111111111
SUFFOLK COUNTY CLERK
RECORDS OPPICE
RECORDING PAGE
Type of ID.trumeDtl DBEDS/DDD
Number of Page.: 3
Receipt Number : 04-0138973
TRANSFER TAX NUMBER: 04-21156
Recorded:
At:
12/22/2004
09:10:54 AM
LIBER:
PAGB:
D00012361
752
Di8trict:
1000
SectiOD: Block I
120.00 03.00
II!nMIIlBD AND CHARGBD AS POLLeNS
$0.00
Loti
012.000
Deed AIlIoUDtl
Received the Following Fee. For Above ID.trulll8J1t
Exempt
NO
NO
NO
NO
NO
NO
Page/FiliDS
COB
IA- CTY
TP-584
RPT
TrlU18fer tax
$9.00
$5.00
$5.00
$5.00
$30.00
$0.00
KaDdling
IIIYS SRCHG
BA-STATI
Cert.Copie.
SCTM
COlIIIll.Pre.
Fee. Paid
$5.00
$15.00
$75.00
$5.00
$0.00
$0.00
$154.00
lI!Y'""Ipt
NO
NO
NO
NO
NO
NO
TRANSnR TAX NtlJIBBR: 04-21156
THIS PAGB IS A PART OF THE INSTR1lJIBNT
THIS IS HOT A BILL
Bdward P.RomaiDe
COUDty Clerk, Suffolk COUDty
.
FOR COON.TV USE ONLY
. G1. SWI'S Code .
"LeA"e I y"~ UH "H~~~ fiRMLY WHEN WRITING ON FORM
INSTRUCTIONS: http://www.orps.st..e.ny.us or PHONE (5181 473-7222
7<~), ~s"'7'
/.:J/ .;(;:2/0Y I
Mo"'~ Diy Yesr
it,
. .
I: ... /;
, .
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C2. Date Deed Recorded
03. Book 1 /, ~" ?,,b ,
PROPERTY INFORMATION
,7, <).21
J I C4. Pagel
1. ~~:i~1 5625 Aldrich Lane
STRHTtfUMBER STllEETNAME
Southold
CITVORTCMlN
,. Buyer Fenderson
Name LASTNAME/COMPANV
Mattituck
VILLAGE
REAL PROPERTY TRANSFER REPORT
STATE OF NEW YORK
STATE BOARD OF REAL PROPERTY SERVICES
RP - 5217
HI'.S217 R~~ 3191
Shirley Anne
111952
ZlPCOOE
RIISTNAME
LA5T NAM~ I COMPANY
3. Tax Indicare where future Tax Bills lire to be sent
Billing ifothllflhan buyerllddress(atbonomofformll
Address
fiRST NAME
lASTNAMEICOM~ANY
STREET NUM6~R AND smnT NAME
CITY OR TOWill
4. Indicate thll number of Assessment
Roll J)arcell transferred on the deed
1
11 of Parcels OR 0 Part 01 II Parcel
5. Deed
Property
Sh:.
lOR 1
'ACAES'
7 0
.
Ix I
FAONTFEET
CfPTH
6. Seller
Name
Estate of Anna J. Corwin
IJ\STNA"'E/COMPAfIlY
FIRSTN"ME
lAST~EICOMPANV
FIRSTNAM!;
7. Check the box below which most Ilccur8UIly describes the use of the property lit the time of lale:
A~oneFamilYReSidentilll
B 20rJFamilyResidential
C Residerltilll Vatant land
D Non-Residential VaCllnt land
E~AgrjCultural
F Commercial
G AplIrtmerlT
H Erllertainment I Aml.lsement
I ~ community. Service
J Irldu6trlal
K Pl.lblicServlce
L Forest
SALE INFORMATION
flRSTN""'E
STATE
ZIPCOOf
(Only if Part of e Percell Check as they apply:
4A. Planning Board wilh Sl.lbdivision Authority Exists
48. Sl.IbdivisionApproval was Aequired for Transfer
4C. Parcel ApprOll8d for Subdivi5ion wilh Map Provided
o
o
o
Check the boxes below .1 they apply:
8. Ownership Type is Condominium
9. New Construction on Vacant land
10A. Property located within an Agril;ultural Distrir;t
10B.Bu~rreceivedadiS1:IOlurenotiC&indicating
that the property is in an Agricu!turlll District
o
o
o
o
Y9'
15. Check on. or more of th... conditions as applcilble to vansfer.
11. Sale Contract Date
/ NONE /
Month Day
~/dS/
Monltl DilY
2004
1
Y~
A
B
C
D
E
F
G
H
I
J
12. Date of Sale (Transfer
NONE
1J. Full Sale Price ,,0 , 0 I
, , .
(Full Sale f'rice is the lotal C1mount paid for the property includingper,onal property.
This paymenT may be in the form of casl1, olher property or goods. or the C1Ssumption of
mortgages or other obligations.) Please rO/Jnd ro rhe nftlfftsl whole dD/!af /lmount.
14. Indicate the value of penonal 1 NONE , 0 , 0 I
property included In the s.le, , , e
ASSESSMENT INFORMATION - Data should reflect the latest Final Assessment Roll and Tax Bill
16. Year of Assessment Roll from L.Q..L.J 17. Totel ~Ised Valuelof all paroettl in transfer) I
which information taken
18. PropertyCfau
I 2 ,I 0 I-U 19. School District Neme I Matt1tuck
20. Tax Map ldentlnerlll' J Rollld.ntifier(1II1 (If more than four, attach sbpt with addltionlll identlfi.rllllfl
1000-120.00-03.00-012.000
Sale 8&tween Relllti~s or Former Relatives
Sale Between Related Companies or Partr18f11 in Business
Olle of the Buyal'$is C1lso a Seller
BUyet or Seller is Government Agency or lending lnstitutioo
Deed Type not Warranty or Bargain and Sale (Specify Belowl
Sale of FractIonal Or lass thlln Fee Interest {Specify Below)
Sigrlificant Change in Property Between Taxable Status and Sale Deltas
5&18 of Business la Inoluded In Sllle Price
Other Unusual Factors Affeoting Sale Price (Specify Below)
None
Exp.C'Ilt"nr'.<:: nep.rl
,
4 6 0 0 I
,
I CERTIFICATION
I cet1if:~' that all of thc items of information entered on this fonn are true and loX)f~t (to the bell vi m)' knowlooge and belief) and 1 understand that the maldDJ
of an~ willful faL..e sbltemelll of nmterlal flilct lIerein ",111 subject me 10 the pr"O\is,ions of the penal law relative to Ihe makJng and flllna; of fll1'ie instnunents.
BUYER
Olsen, Eaq.
lAST NAME:
2585
Marratooka Road
631
ST~nTNUflileeR
BUYER'S ATTORNEY
Gary Flanner
FlflSTNAM!;
734-7666
ARE"OOOE
STAEHNAI,OElAFTEASALEI
Mattituck
CI!Y OR TOWN
NY
11952
STATE
ZlPCOO.
SELLER
~~~~~
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sn(!;IG rum; ~ -
OATE
TELfPlloNENUMaEfl
NEW YORK STATE
COPY