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BARGAIN AND SALE DEED WITH COVENANT AGAINST GRANTOR'S
ACTS (INDIVIDUAL OR CORPORATION)
STANDARD NYBTU FORM 8007
CAUTION: THlS AGREEMENT SHOULD BE PREPARED BY AN ATTORNEY AND REVIEWED BY ATTORNEYS FOR SELLER AND
PURCHASER BEFORE SIGNING.
TffIS INDENTURE, made the September ) 1 2001
between ELEANOR PEDERSEN, as snrviving tenant by the entirety, residing at 2815 Sigsbee Road,
Mattituck, New York 11952
party of the first part, and
ELEANOR PEDERSEN, as Trustee of The Eleanor Pedersen Living Trust dated May 1,2001, residing at
2815 Sigsbee Road, Mattituck, NY 11952
party of the second part,
ff7TNESSETH, that the party of the first part, in consideration of Ten Dollars and other lawful
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 in Pecan ie, Town of Southold, County of Suffolk and State of New York,
SEE SCHEDULE 'A' ATTACHED HERETO AND MADE A PART HEREOF
The grantor herein is the same person as the grantee in Deed dated July 6, 1972 recorded in Liber 7199 Page 352.
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 .!lnd 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
considerati on 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 ifit 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.
A; .?
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ELEANOR PEDERSEN
.
NYSBA Residential Real Estate Forms on HotDocsoo (9100)
-1-
Copyright Capsoft@ Development
STATE OF NEW YORK
)
) ss.:
)
COUNTY OF SUFFOLK
On the ) q day of September , 200 I, before me, the undersigned, personally appeared
ELEANOR PEDEkSEN, personally known to me or proved to me on the basis of satisfactory evidence to be
the individual(s) whose n e s) is (are) subscribed to the within instrument and acknowledged to me that he
executed l!he same in . cap city(ies), and that by his signature(s) on the instrument, the individual(s), or the
person upon behalf whic;Jl the individual(s) acted, executed the instrument, and that such individual made such
appearance befor t~un er~i ed in the
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GARY FLANNER OLSEN
NotarY Public, State of New Yorl<
No 020L2959600 ....., ".-y)'"'L
Qualified if! Suffolk County ~
Commission Expires March 30,_
NOTARY
DEED
!ill~
Section 126
Block 6
Lot 3.1
County or Town SUFFOLK
Street Address 2815 Sigsbee Rd.
Mattituck, NY 11952
PEDERSEN
To
PEDERSEN
Return By Mail To:
GARY FLANNER OLSEN, ESQ,
P. O. BOX 706
CUTCHOGUE, NY 11935
Reserve This Space For Use Of Recording Office
.
NYSBA Residential Real Estate Forms on HotDocs~ (9/00)
-2-
.
Copyright Capsoft Development
SCHEDULE A
ALL that certa1n plot, piece or parcel of land, with the buildinCI and improvemenll thereon erect". .ituatf~.
lying and belng>i1klho! at Mattituck', in the 'I'own of Southold, County of
Suffolk and State of New York, known and designated as and by the
Lot Number 115 and part of Lot 107A, on a certain map entitled,
"Amended ~Iap of Property of Mattituck Park, Properties, Inc.,
Mattituck, N.Y." made by Daniel R. Young, Surveyor, and which
said map was filed in the Office of the Clerk of the county of
Suffolk all 1/12/26, as Map 1tA01, which lot and pad, of lot wldch
taken together are more particularly bounded and described as folLow,,:
BEGINNING at a point on the east,erly side of Sigsbee Hoad (listnn\
100 feet southerly as measured along the easterly side of Sigsbee
Road from corner formed by the intersection of the easterly side
of Sigsbee Road and the southerly side' of Peconic Bay BoulevanJ;
from said point of beginning; running thence North 650 07' 40"
East 140.39 feet; thence South 20. 38' East 104.55 feet; thence
South 660 59' West 140.13 feet to the easterly side of Sigsbee
Road; thence North 20. 38' West along the easterly side of 8igsbee
Road, 100 feet to the point or place of beginning.
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Number of pages
TORRENS
RECORDED
2001 Oct 12 09:22:07 AM
Edr.,Jard P.Romaine
CLEF'f< OF
SUFFOU::: COUt'~T\i
L D00012146
Serial #
Certificate #
F 685
Prior Clf. #
D1"# 01-10058
Deed / Mortgage Instrument
Deed / Mortgage Tax Stamp
Recording / Filing Stamps
4
FEES
Handling
~-
_.!:L _
--
-~-
Mortgage AmI.
Page / Filing Fee
I. Basic Tax
TP-584
2. Additional Tax
Notation ---
EA-52 ! 7 (County) -~- Sub Total
EA-52!7 (State) -6>~ _
IU.T.SA -D-_
Comm. of Ed. _---.2 O~
Affidavit ---
Certified Copy ---
Reg. Copy ---
Sub Total
Other --- '7 XO
GRAND TOTAL
Sub Total
Spec.lAssit.
Or
Spec. / Add.
TOT. MTG. TAX
Dual Town Dual County
Held for Apportionment/f,
Transfer Tax ~
Real Property Tax Service Agency Verification
Dist. Section .B lock
Mansion Tax
The property covered by this mortgage is or
will be improved by a one or two family
dwelling only.
YES or NO
If NO. see appropriate tax clause on page #
of this instrument.
Lot
6 Community Preservation Fund
Consideration Amount $
1000
126" 00
06.0D
OO~. 00\
CPF Tax Due
$
11~\
Initials ~
7 Satisfactions/Discharges/Releases List Property Owners Mailing Address
RECORD & RETURN TO:
Improved -r:.
Vacant Land
GARY FLANNER OLSEN, ESQ.
P. O. BOX 706
CUTCHOGUE, NY 11935
TD~
TD~
TD
9
8 Title Company Information
Co. Name
Title # LoI
Suffolk Count Recordin & Endorsement Pa e
Ths page forms pm"! of the attached
DEED
(SPECIFY TYPE OF INSTRUMENT )
made by:
FTFANnR pF.nFR~F.N
The premises herein is situated in
SUFFOLK COUNTY, NEW YORK
.
TO
ELEANOR PEDERSEN, AS TRUSTEE OF THE ELEANOR
In the Township of
In the VILLAGE
or HAMLET of
SOUTHOLD
PEDERSEN LIVING TRUST
BOXES 5 THRU 9 MUST BE TYPED OR PRINTED IN BLACK INK ONLY PRIOR TO RECORDING OR FILING.
(OVER)
111111I111111111I1111I111111111111111111111111111111111
/1111111111111111111I1111
SUFFOLK COUNTY CLERK
RECORDS OFFICE
RECORDING PAGE
Type of Instrument: DEEDS/DDD
Number of Pages: 4
TRANSFER TAX NUMBER: 01-10058
Recorded:
At:
LIBER:
PAGE:
10/12/2001
09:22:07 AM
000012146
685
District:
1000
Section: Block:
126.00 06.00
EXAMINED AND CHARGED AS FOLLOWS
$0.00
Lot:
003.001
Deed Amount:
Received the Following Fees For
Page/Filing
COE
EA-STATE
Cert.Copies
SCTM
Comm.Pres
$12.00
$5.00
$25.00
$0.00
$0.00
$0.00
Above Instrument
Exempt
NO Handling
NO EA-CTY
NO TP-584
NO RPT
NO Transfer tax
NO
Fees Paid
$5.00
$5.00
$5.00
$15.00
$0.00
Exempt
NO
NO
NO
NO
NO
TRANSFER TAX NUMBER: 01-10058
THIS PAGE IS A PART OF THE INSTRUMENT
$72.00
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
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Location STREH NUMBER
Sigsbee Rd.
STl'lEETNAME
Snllthnld
CITY OR TOWN
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V GE
REAL PROPERTY TRANSFER REPORT
STATE OF NEW YORK
STATE BOARD OF REAL PROPERTY SERVICES
RP - 5217
RP.S117 Rev 3m
I Kleanor Pedersen as Trusee of the Kleanor Pedersen Living Trust
LAST NAME I COMPANY FIRST NAME
11~~~
dated 5/1/01
2. Buyer
Name
L-
LAST NAME I COMPANY
"
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FIRST NAME
~
,.
,
3. Tax Indicate where future Tax Bills are to be sent
Billing jf other than buyer address (at bottom of form)
Address
LAST NAME I COMPANY
L-
STREI"r NUMBER AND STREET NAME
CITY OR TOWN
4. Indicate the number of Assessment
Roll parcels transferred on the deed
OR D Part of a Parcel
# of Parcels
5. Oeed
Property
Size
lOR I
Ixl
L-
FRONT FEET
'ACRES'
.
DEPTH
6. Seller
Name
~lerseJl
LAST NAME I COMPANY
Eleanor
FIRST NAME
L-
LAST NAME I COMPANY
FIRST NAME
7. Check the box below which most accurately describes the use of the property at the time of sale:
A~ One Famil'r' Residential
B -2 or 3 Family Residential
C ; Residential Vacant Land
D Non-ResidEintial Vacant Land
E ~ Agricultural
F Commercial
G Apartment
H Entertainment I Amusement
I ~ Community Service
J Industrial
K Public Service
L Forest
SIQl A
A
B.
C
D
E
F
G
H
I
J
FIRST NAME
STATE
ZIPCOOE
(Only if Part of a Parcel) Check as they apply:
4A. Planning Board with Subdivision Authority Exists
48. Subdivision Approval was Required for Transfer
4C. Parcel Approved for Subdivision with Map Provided
D
D
D
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
109. Buyer received a disclosure notice indicating
that the property is in an Agricultural District
D
D
D
D
15. Check one or more of these conditions as applicable to transfer:
/ /
Month D., YeE!r
/ <7*
9 / 01
J /
Month of' Year
11. Sale Contract Date
12. Date of Sale I Transfer
Iioue
13. Full Sale Price 1 1 1 0 1 0 I
, , .
(Full Sale Price is the total amount paid for the property including personal property.
This payment may be in the form of cash, other property or goods, or the assumption of
mortgages or other obligations.) Please round to the nearest whole dollar amount.
14. Indicate the value of personal I 0 0 I
property inctuded in the sale .1 1 1 1 , 1 ~ - 1 _ .
1;~""~!IIlIfiI"l!NlII!lIJ.t~~~_~~
16. Year of Assessment Roll from I 0 D I 17. Total Assessed Valuelof all parcels in transfer} I
which information taken I
!
18. Property Class
t
~\G\:)\\iU\\
I D I-U 19. School District Name
20. Tax Map ldentifierlsll Rollldentifl8f'lslllf more than four, attach sheet with additional identifierls))
1000-126-6-3.1
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Sale Between Relatives or Former Relatives
Sale B~en Related Companies or Partners in Business
One of the Buyers is also a Seller
Buyer or Seller is Government Agency or Lending Institution
Deed Type not WarrarWy or Bargain and Sale (Specify Below)
Sale of Fractional or Less than Fee Interest (Specify Below)
Significant Change in Property Between Taxable Status and Sale Dates
Sale of Business is Included in Sale Price
Other Unusual Factors Affecting Sale Price (Specify Below)
None
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I certify that aU Of the items of infonnation entered on this fonn are true and correct (to the best of my knowledge and belief) and I understand that the making
Of any willful false statement of material fact herein will subject me to the orovisions of the oenaIlaw relative to the making and filing of false instruments.
BUYER
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DATE
LAST NAME
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BUYER SIGNATURE
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STREET NUMBER
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STRE~NAME (AFTER SALE)
AREA CODE
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CITY OR TOWN
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STATE
Z1PCOOE
SELLER
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SELLER SIGNATURE
7/9/0/
DATE
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BUYER'S ATTORNEY
FIRST NAME
TELEPHONE NUMBER