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CONSULT YOUR LAWYER BEFORE __ TllIB INBTRUIIIENT -TllIlI _TRUIIIENT SHOULD BE USED BY LAWYERS ONLY
THIS INDENTURE, made the
BETWEEN
GEORGE C. DORMAN, residing et1619 TIfTeny RIdge Road. Pittsburgh, PA 15241
l.;l~ of August, 2004
es encillary executor of the last will and testament of MARIE A. DORMAN, late of Pittsburgh. PA (Suffolk
County Surrogate's Court File No. 1320P2004), dllC888ed.
party of the first part. and NORTH OAKWOOD PARTNERS, a Pennsytvanla partn.....hip. with offlces et PMB
223.10592 Perry Highway, Wexford. PA 15090-9244
party of the second part,
WITNESSETH, that the party of the lirst part, by virtue of the power end authority given In and by said last will
and testament, and in conslderetlon of TEN and no/1001hs (S10.00) dollars paid by the party of the second
part, end the terms and provisions of the Last WUI and Testament of said Marie A. Dorman deted November
17, 1978 does hereby grant and re_ unlo the party of the second pert. the hen or successors and lISlIigns
of the party of the second part forever,
ALL thet certaWl plot. piece or parcel of lend, with the buildings and Improvements thereon erected, situate.
lying and betng in SouIhold Town. Suffolk County, New YorI<. known end designated es Lot 4. es shown on
Map of Laurel Park SubdIvision No. 212. fUed In the Suffolk County Clerk's Olllce at Rlvarhead:New York. on
December 2. 1930.
BEING AND INTENDED TO .BE the same premises conveyed 10 MARIE A. DORMAN by dead made by
KATHRYN P. BUSCH and VERONICA WOOD dated April 29. 1955 and recorded in the Suffolk County
Clerk's Office on Mey 25. 1955 in LIber3B92 at Page 162.
TOGETHER with ell right, title and interest, if any. of the party of the tht part, in and 10 any streels and roads
abutting the ebove descrtbed premises 10 the center lines thereof; TOGETHER with the eppurtenances. and
also ell the estete which the said decedent hed at tha time of deoedanrs death In said premises, and also tha
_tete therein, which the party of the Orst part hea or hea power 10 conveyor dlBpoaa of. Whethar individually.
or by virtue of said will or _sa; TO HAVE AND TO HOLD the pramlsas herein gnsnted unto the party of
the second pert, the heirs or successors and assigns of the party of the sacond part forever.
AND the party of the first part covenants thet the party of the first part hes not dona or suffansd anything
whereby the said pnsmlsas have II-. encumbansd In any way whatever. axcept.. aforesaid.
AND the party of the lirst part. In compliance with Section 13 of the LIen Law, covenan.. that the party of the
first part will nscelve the .conslderation for this conveyBnce and will hoklthe rlghtlo I'1IC8ive such consideration
as a trust fund 10 be applied first for the purpose of paytng the cost of the Improvement and will apply the same
Orstlo the payment of the cost of the Improvement before using eny part of the Iotal of the same for any _
purpose. The word .party" shall be construed as if it nsed .parties" whenaver the sense of this indenture so
requires.
IN WITNESS WHEREOF, the party of the first pert has duly executed thlB deed the day and year first above
written. .
IN PRESENCE OF:
~M
GEORGE C. DO
. .
. TO BE USED ONLY WHEN THE AcKNOWLEDGME.NT .S ManE IN NEW YORK STATE
State of _ YOfk. COunty of
On the dB)' of In Ihe year
before me. the undBnllgned, penIOI1a11yappeared
peraonally _ to me or proved to me on Iha ...... of
..-.:lory __ to be Ihe individual (a) whose nama(a) ..
(are) oubacrtbed to Ihe within InaIrum8nI _ acknowlBdged to
me lhat hall1he11hay ellllCuted Ihe ..me In hlolher1lhelr
capactty(lao), and that by hlolher/lhelr oIgnatura(a) on the
Inobuman~ the IndMcluaI(a). or the peraorl upon _ of which
!he Indivldual(a) acted. exacul8d the Inotrument.
..:
(oIgl18ture and ofIIce of Indlvlclualtaklng ~)
State of New York. COunty of
On the dB)' of In the year
Before me. the underoigned. pereoneIly ~
Panonally _ to me or proved to me on the ...... of
oatl$f-.lD.y evIdenat to be the lndIvIdual(a) whose name(a) ..
(are) IIUbacr1bed to the wtthln lnolrumenl and "'*'-l8dged to
me that hall1h81lh11)' 8X8CUl8d the ..me In hlolherllhelr
capllCity(leo). and thBl by hlolherllhelr oIgnature(a) on the
Inotrument. the lndIvIduaI(a), or the peraorl upon behalf of which
the I_usl(a) acted. exac:utad the Inlllrument.
..:
(oIgnalure and office of individual taking ecknowladgrnant)
TO BE USED ONLY WHEN THE ACKNDWLEDOIIENT IS ..ana:: OUTSIDE NEW YORK STATE
State (or DiIltJtcl of COlumbia, Territory, or Foreign COurriry) of Pannoylvanta ..:
On the / 'Z ~B)' of Auguot In the year 2004 before me, the underolgned, peraorl8lly _nod GEORGE C. DORMAN
PerlIoI18IIy _ to me or proved to me on Ihe ...... of .._ry evIdenc:a to be the Indlvldual(a) _ name(a) 10 (are)
oubecr1bed to Ihe within Inolnl,,*,1 and aclu 1Ow18dr<1to me that heIshaIlhey 8lIIICUted the ""'"" In hlolher1lhe1r capacIty(....), and
that by _r/lheir algn8lure(a) on Ihe 1naIrum8nI. the Indlvldual(a), or tha penIOI1 upon behalf of which the Indlvldual(a) ac:tad,
executad the tnolrument, and that such tndMdual _ such appeerance -.tha undenIIgl18d In the
P1ttobunlh In
(_!he Qty or _ political oubd_1
"a'-" .-\'.t"
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EXECUTOR'S DEED
Till. No.
GEORGE C. DORMAN, as Ancillary Executor
TO
NOKnlOAKWOODPARTNERS
STANDARD FORII OF NEW YORK IIOAIlD OF TITLE UtmElll _ow .-a
DI_by
. Commo~~a-_
CC'l!\.IIWCJNWEAL1H l.ANuTITlJ! 1N5U"ltANCD.CoN;p^",oy
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DISTRICT 1000
SECTION 127.00
BLOCK 06.00
LOT 006.000
COUNlY OR TOWN
STREET ADDRESS
Racardad at Request of
COMMONWEAlTH LAND TIne INSURANCE COMPANY
J. KEVIN MCLAUGHLIN, ESQ.
P.O. Box 1210
Southold, NY 11971
f'
.,
I
.:3
2
J
Serial #
~CIlROED
, 1004 ll<Jg :!1 01,41: 17 ""
EC-I.I.!r.j ~,RCWla!.ne
f.!. E~ OF
5UFFO~v COLl'lTY
l LlOCOI2:!40
Co 7&6-
!IT. 04-05012
Number of pages
TORRENS
CenificatC' #
Prior Of. #
Deed I Mort_e Instrument
Deed / Mortgage Tax Slamp
fEES
Recording I Filing Stamps
~
''age / Filing Fee
Handling
TP-5g4
Mortgage AmI.
I. ltasic Tax.
2. Additional Tax
Notation
Sub Tolal
EA-:02 17 (County)
Sub 1'0141
Comm. (,f Ed.
5~
SreeJAll,il.
Or
Sp.:e./Add.
TOT. MTG. TAX
nual T(lWn_ Dual COUllt).~
Ilcld for Apportionment .,;
Transfer Tax ..l~:::;7
,
Mansion Tax
"Ille property COYeR:d by this monpge is or
will be improved by a one or two family
dwelling unly.
/ /L YES orNO_
/~f If NO. see iippropriate lax &:Iause un puge N
(l1~ .=--oflhlllnl'
EA-S217(S..te)
RI'. T.SA
\~
Affidavit
Certified Copy
Reg. Copy
Other
Sub Total
GRANO TOTAL
Slamp
~3~1 1000 12700 0600 006000
00
6 COOlJnunity I ation Fund
Consideralion Amount $ 0.00
CPr- Tax Due S 0.00
j/riProved X
Renll'roperty Tax Service Agency Verification
DiaL Section B lock Lot
~~
RCWHA
Initials 19-AU
7 Satisfactk. - -- .--..-.0--..............-.. &..,0....11..1-"-1" VW'IIC'I::'IVUIIII1I8J\dd
RF.coRIJ.. RETURN TO:
J. KEVIN MCLAUGHLIN, ESQ.
P.O. Box 1210
Southold, NY 11971
flate
Vacant Land
m /0
TI)
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Title Company Information
9
Co.N.me
T;tl,,/I
Suffolk Count Recordin & Endorsement Pa e
"Ibis page forms part of the attached
Executor's Deed __ ..~. .. _ ______.. .. __ m....c by:
(SI'EOFYTYPE OF INSTRUMENT)
GEORGE C. DORMAN, as ancillary executor
TO
1lK: prcn~""" herein is sil\lll1cd ill
SUFFOLK COUNIY. NEW YORK.
SOUTHOLD
In the Township of
..
In the VII .LAGE
or HAMI.!::T of
LAUREL
of the Estate of Marie A. Dorman
NORTH',IOAKWOOD PARTNERS
BOXES 5 -111RU 9 MUST UE TYPED OR J'RlNIH) IN BLACK INK ONLY ('RlOR'JU RECORl)JNG Ol{ I'II.II'G.
(OVER)
IIII~IIIIIIII~IIIIIII~IIIIIIIIIIIIIIIIIIIIIIIIIIIIII
IIIIIIIIIIIIIIIIIII~ IIII
SUFFOLK COUNTY CLBRK
RECORDS OPPICE
RECORDING PAGB
Type of Instrument: DEEDS/ODD
Number of Pages: 3
Receipt Number : 04-0096475
TRANSFBR TAX NUMBBR: 04-05012
Recorded:
At:
08/31/2004
01:41;17 PM
LIBER:
PAGE:
D00012340
766
District:
1000
Section: Block:
127.00 06.00
Tl!YlI,MINED AND CHARGED AS FOLLOWS
$0.00
Lot:
006.000
Deed Amount:
Received the Following Pe.s
Page/Piling
COE
EA-CTY
TP-584
RPT
Transfer tax
$9.00
$5.00
$5.00
$5.00
$30.00
$0.00
por Above Instrument
Bxempt
NO
NO
NO
NO
NO
NO
Handling
NYS SRCHG
EA.-STATE
Cert.Copies
SC'l'K
COIIID.Pres
Fees Paid
$5.00
$15.00
$50.00
$0.00
$0.00
$0.00
$124.00
Bxempt
NO
NO
NO
NO
NO
NO
TRANSPER TAX NCMBER: 04-05012
THIS PAGE IS A PART OP THB INSTRmmNT
THIS IS NOT A BILL
Edward P.Romaine
County Clerk, Suffolk County
REAL PROPERTY TRANSFER REPORT
15. Check one or more of these conditions as applicable to transfer.
A Sale Between Relatives or Former Reliltives
B Sale Betwaen Related Companies or Partners in Business
COne of the Buyers isalSOB Sellor
D Buyer or Seller is Government Agency Or lending Institution
E X Deed Type not Warranty or Bargain and Sale (Specify Below)
F Sale of Fractional or Less than Fee Inlerest (Specify Below)
G Significaflt Change in Property Between Taxable Status and Sale 0"t08
H Sale of Business is Included in Sale Prica
1 Other Unusual Factors Affecting Sale Price (Specify Belowl
J None
Executor's Deed
.
FOR COUNTY USE ONLY
PLEASE TYPE OR PRESS FIRMLY WHEN WRITING ON FORM
INSTRUCTIONS: http://www.orps.state.ny,us or PHONE (518) 473-7222
^/,:;, '3JjJ391
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Month Day 'fear
Cl. SWIS Code
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1H'.S217 Ro, 3197
STATE OF NEW YORK
STATE BOARD OF REAL PROPERTY SERVICES
C2. Date Deed Recorded
C3. Book II ,;;L, -3, AIr 01 C4, Page 17,<:" (A
PROPERTY INFORMATION
RP - 5217
1. r~~~~:~ I
1980
North Oakwood Drive
STRfET '\U',:BE~
sr~",,. '''~'''r.
L-.. Southold
UTYQR'GW~'
Laurel
."_''''G,
2. Buyer L North Oakwood Partners
Name LASTNA!.'o 'CO~IPA"Y
O'~S~ ",; ..'"
LA$T NAME Il;OMPANY
FIRST NAME
3. Tax
Billing
Address
Indica:e where future Tax Bills are to be sent N h 0 k
if other than buyer address lat bOttom of forml I art a wood
LAS1NAM,.COMF'Ar-y
PMB 223, 10592 Perry Highway
Partners
FIRST r-AM~
\.Jexford
IPA
STATE
STIlHlNUM8ERANOSfREETNAM,
:ITYO~TGWN
4. Indicate the number of Assessment L
Roll parcels transferred on the deed
11 # of Parcels OR DParfofaparcei
(Only if Part of a Parcell Check as they apply:
4A. Pla"n~ng Board ,,...ith Subdivision Authority I,xists
48. Suba\'<s'on f'.Dprova; \.~a5 Required for Tran5ter
4C. Pcrc,-,~ AimrOved fOI SubdiviSiOn with Map Provided
5. Deed
Property
Size
L
IxL.
lOR [
o 3
.
fRONT ~,ET
OEP~",
AC"S
6. Seller
Name
Dorman
George C., as Ancillary Executor
OIi'ST \'A'.'~
LASTNAME/cm"F'ANY
L
LASTNAMEICOMF'ANV
FIAST"AME
7. Check the box below which most accurately describes the llse of the prOperty at the time of sale:
Check the boxes below as they apply'
8. Ownership rype is Condominium
A~OneFam;IYRf:Sidential
B 2ar3FamilyResldentlal
C Residential Vacant Land
o Non-Residen~ial Vacant Land
E~A9(iCultural
F Commercial
G Apartment
H Entertainment I Amusement
J ~ com.munity. Service
J l'1dustriai
K PubhcServlce
L Forest
9.l\e.... COnstruction on Vacarl! Lar.d
lOA PI'operty Located within an Agr1C;Jltl1.al District
lOB. 8uye,- received a di,~losl1rC notice ;ndJcating
th~t the property i5 in an Agricultural District
SALE INFORMATION
N/A
11. Sale Contrlllct Date
L. /
MOrlth 0", Ye~r
LOB / ,~/ 04.J
Monlt1 '"y Year
12. Date of Sale I Transfer
13. full S.le Price
~.,
, 0 . 0 0 I
, , .
(FuU Sale Price is the totaf amount paidfol the propertyincludin gpersonalproperty.
This payment may be In the form of cash. other property or goods, or the assumption of
mortgages or other ohligations.1 Please round!o the nellrest whole dOllar amount
14. Indicate the value of personal
property included in the sale
L, ,0 , 0 I
, , .
- Data should reflect the latest Final Asse5sment Roll and Tax Bill
ASSESSMENT INFORMATION
16, Year of Assessment Roll from
which informiltion takan
~
17. TOlal ASlnsed Valua (of all parcels in transferl !
?
?
18. Property Class
L..?~-u 19 School District Name i
Mattituck
20. Tal< Map ldentlfier(sll Rolllderttifier(s) (If more than four, attach sheet with additional idenlifier{s))
L-1000-127.00-06.00-006.000
.-----.J
L-._
CERTIFICATION
( certif~' that all of the items of informatioll entered on this form are true and corrl~cl (to tht- best uf Ill" knowledge and belief) and I unde~land that th(> makinj!
of any willful fal.~e slatement of material ract herein \\ill sUhjl'Ct me to the prO\'ision~ of the Dellal law rclatiw 10 the making and filing of false instrument~.
B~ ~UYER'S ATTORNEY
McLau9hlin Kevin
O..T~
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"~S1 "':"."
(631)
765-6085
STRE oT NU~.I&: R
Perry Hiqhway
ST"E:,7 . .A\~: .,,'~,~ 5A_<
>.R,ACOOE
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Wexford PA
15090-9244
ll~COOE
r:V YORK STA:l
L COPY...-J
C,"VORTOW,", sr,:.n
SELLER
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DATE
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[1194B ...J
liP CODE
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15090-9244
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