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Form Stili::! 1'}I'Il)) - .!Il~' - IJwwain:ano.l S-I1i:' Ik~l. ~'llh c,.n..-enlln'..Il8:Un.... OJIII1I11",. A\.'1s-lndivM.luuIR CU'lJUflIliIHl. C,.jnJlC'l'ohrcll
CDllauLT YOUII UWY_ ..POII. ..__ TN.. ......U._T - nll.........UllIIIft IIHOULD" U._.Y LAWY_ _LY.
THIS IND";NTUKI::.II..u"llCae;t~ J3y"r .-JCLr\~ . .9.003 3lld
BI::TWEEN
v...,.... Co. AI w~e-/-kV\
IJ",s,.I,"Y kf ~ ~l.c.;$ a.
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p3nyuflh....Iir..1 ("3rt. and (Je..,.J"f:,1L lA.1t-k.1 ieV'\. .
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CAr..J. ~..., "^ 14'-l 1It"13~
party ('If th~ sC'L.(ln.... part.
\\'ITNF$SETH.lh.u .he pan) 'If the first pun. in ..:onsidcr..nion often dolla.-s and other ,,'aluahle C'onsider:JItion paid hy
Ihe plrty of the sectln..! pan. ~s hcrchy grant and release unto rhe rany of Ihe sel,.'Ond pun. the heir5 C'lT sUC'~51.OI"S and
a...si~ns uf the pari)' of the sC'~llnd p.lr1 fClf'e':er.
ALL Ih.ll ...-crtain pIn!. l,iccC' ur pLlfi.'c1"r lan..1. wilh [he hUlldings and impmvemcnts thereun en'l..'ted. situ~d.c. lying. .and
heing in Ihe
~ce fidJ C/~'J~
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TOGETHER with ~lll rj~ht. lille and iutcrcst. if any. oflhc (larly ,If the firsl pari, in an.... tu any Slreels l.lIuJ road:-.
.llluuing lhc aho"c.dc:-o",'ritlC'd prcmisc:-. In th..: ...",'nt","r lines Ihereof: TOGETHER ",,'jlh Ihe appUR,,"n:mccs unLl ulllh""
\.'SI~IC an..! ri,!!hls llf fltC par1y elf Ih,,' lirsl p;'lrlln and hi :-.uid pn.'mi",,,'s: TO HAVE r\NI)TO HOLI) Ihe premises herein
fr~I1ICl.lllnhl1hl' r;Ir1)' llf Ihl,' !'o.:'''-'Imd pari, tl1l.' hl.'ir!'o 'II'" sU"-'....c!'oMlr!'o ~md a:-.sign:. "flhl\.' parly I'l" Ihe SI.'\.'lllId pan fllI"C\'t.:'r.
,\NI) 111,,' pOJrly (If Ihc firM IIUlI,,'II"CI1;ml" Ih;.lI Ih,,' parl~' III' thL:' lir..., pun hus nlll dllm' Ilr sullcnxl lmYltulIg whcn'tly
Ih,,' s"jLlI'r,,'misl's 1);\,'1,,;' heclI ':-Ill.'umn,,'rcd in ,my wu)' wh.lh,""l.'r. l.""'1,:"'P1 01:"0 .lfCln,'suid,
ANI) IhL" pari}' uf Ihl,' fir,..t pUrl, in ':111Il1,1I.1Ul.'C with Se,,'liCln I.l ..rlhe Licnl,aw. ....u\.cnOlnl!'o Ih:lllh",. P;'1r1Y IIflh",'
first parI will rCI,:cl'\"C thl..' l..'llll...idcf;'lli'lll rllr Ihi", Cllo\'cyall,,'L' l1nd will hllltJ 111,,' ri~hl tu rL'cein' such ",'..nsid,,'f-
atitlll as a Iru:o.\ fundtll he al'plic.... I1rsl fur ,he- purpns~ nl" payjn~ the C:II!oo1 of ,hc ill1rnlVCm~ol ;loLl ""ill ;apply
lhL' !'"al11l.' I1r"'l to Ihe ptlyml"nl of the ,,'ust uf Ihl.." illll,n1vcmclll hefure u!'oin~ an)' ptlrl tlf Ihe Inial uf the s::un,,' fllr
any olhcr pUrjlo!'"e,
Thc wunl "pany" ...h"ll he I.'llnslnll:d a!'o if II rcad hpOlnic:-." wh,,'nevcl'" Ihc :oo:cnsc uf chi", indcnlllrc !'oIl rCLluirl.'!oo.
II\; \VITN..:SS \VHERJo;()"~ thc party III' (hI.' fir.., pOlrl h~l~ dlll~' C:\CI.'lllclllllI.. Llcl..tJ Ih~ d.IY :J1Il1 ycm firsl OIl1"VC
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ALL STATE ABSTRACT CORP.
Title No. 630852711-58
SCHEDULE A
ALl. that ccl1ain 'plot, piece or parcel of land. with the buildings and imllrovemcnts
thereon erectt'd. Situate, lying and being at East Marion. in the Town of Southold,
County of surroll.: and State of New York, known and designated as Lot No.2 on a
certahi map entitled, "Mall of Highl!oiDl Woods:l and filed 10 the Office of the Clerk
of the County or Suffolk on July 25. 1997 as Map NO. 10035.
~ -
----
-
,-
.-.
FOR
CONVEYANCING
ONLY
The policy to be illued under thil report will insure the title to IUch buildlngl end
improvementl erected on the premllel which by law constitute real property.
TOGETHER with eU the right, title end interelt of the perty of the firlt pert. of, in and to
the land lying in the Itreet in front of and adjoining said premlsel.
~
-'
.
~2
]
Number of page5
TORRENS
Serial H
REroRDED
2003 Fob 21 03: 19: 00 PI!
Edward P.Romaine
ClERK OF
SUFFOLK COUNTY
L ??oo12236
p 635
DTI 02-28166
Certificate fI
Prior elr. 1#
Deed I Mort&age Instrument
Deed / Mortgage Tax Stamp
FEES
Recording I Filing Stamps
~
Page I J:iling Fee
Mortgage AmI.
J (andling
1_ Basic Tax
TP-S84
2. Additional Tax
NOlation
Sub TotBI
EA-S2 17 (County)
Sub Total
GRAND TOTAL
(07 --cf.
Spcc.fAssit.
Or
Spec./Add.
TOT. MTG. TAX
Dual Town_ Dual CuunEy_
Ileld for Apportiunment
Transfer Tax. . ~
Mansion Ta~ ___.__ _
The property covered by this mortgage is or
will be improved by a onC' or two family
dwelling onl)'.
YES OI"NO_
If NO. see appropriate lax clause on page"
arthis instrument.
EA-S217 (State)
Conlln. of Ed.
S O.!L-
R.P.T.S.A.
-::?,O-=-
Affidavit
Certified Copy
Reg. Copy
OIher
5.
Sub Total
5
Real Property Tax Service Agency Verification
Dist. Section Block
6 Communit Preservution Fund
(.ot
Consideration Alnount $
Stamp
I1;l
1000 03100 0400 016008
CPI:" -."DX Due
$
Dale
Improved
Initials
Vacant I.and
7
Satisfactions/Discharges/Releases List t"ropeny \..JWIIIC.~ 1..IUI....6. a____.,,;
RECORD'" RETURN TO:
/ef~~'e)lo-'\
:DF .f~t.(5iJ cl-
6ts~IU_ oC:>-y 4/1'
TD
TD
TO
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i../.A..4t'f<
Vtt/~~" ,Cc.. (.
Recordin
)~
- (SPECIFYTYPEOFINSTRUMENT) 0
'(bc premises herein is situated i~K" _j(\\\. \.J
SUFFOLK COUNry. NEW YO;:_~ \ \l"
In the Township of ~
In the VILLAGE ~
or HAMLET of CAs/- UA-rIQ,",
Title Company Information
v.:
9
Suffolk Count
/.
& Endorsement Pa e
'(bis pogc fomlS part ofthc allllChcd
_ lI1ade by:
TO
#~AC!'JiVl
BOXES 5 UIRU 9 MUST BE TYPED OR PRlNIED IN BLACK INK ONLY PRIOR TO RECORDING OR FlUNG.
(OVER)
.;
111111111111 11111111111111111111 11111 11111 1111111111111
1111111111111111111111111
SUFFOLK COUNTY CLERK
RECORDS OFFICE
RECORDING PAGE
Type of Instrument: DBBDS/DDD
Number of Pages: 4
TRANSFER TAX NUMBER: 02-28166
Recorded:
At:
LIBER:
PAGE:
02/21/2003
03:19:00 PM
D00012236
635
District:
1000
Section: Block:
031.00 04.00
EXAMINED AND CHARGBD AS FOLLOWS
$0.00
Lot:
016.008
Deed Amcunt:
Received the Following Fees
Page/Filing
COE
BA- CTY
TP-584
RPT
Transfer tax
$12.00
$5.00
$5.00
$5.00
$30.00
$0.00
For Above Instrument
Exempt
NO Handling
NO NYS SURCHG
NO BA-STATE
NO Cert.Copies
NO SC'l'K
NO COIIIIII. Pres
Fees Paid
$5.00
$15.00
$25.00
$0.00
$0.00
$0.00
$102.00
Exempt
NO
NO
NO
NO
NO
NO
TRANSFER TAX NUMBER: 02-28166
THIS PAGB IS A PART OF THE INSTRUMBNT
Bdward P.Romaine
County Clerk, Suffolk County
FOR COUNTY USE ONLY
PLEASE TYPE OR PRESS FIRMLY WHEN WRITING ON FORM
INSTRUCTIONS: hnp:// www.orps.state.ny.us or PHONE 1518) 473-7222
If. 7. -3.9,. Q. 'il
W"
I ' . ,I
'"
Cl. SWIS Code
I q; / 0;> (I t..3 I
. "'. Monl~ Day V~~' 0'
C3. Book I " ~,;(. '1" .3.6 I C4. Page I /; ,..3. ,
~:~:':::~IN~ I ~~~~A $:
LOC"tiOn, ,AI::' 'M8ER ",;.,.j- ;ff. S II T.lIiAME / *.-'""\
W~'jej-k,,,,
~AST NAME/COMPANY
C2. Date Deed Recorded
REAL PROPERTY TRANSFER REPORT
STATE OF NEW YORK
STATE BOARD OF REAL PROPERTY SERVICES
RP - 5217
11;1'.5211 /l.e,'Jf<l1
2. Buyer
Name
V'l"k~VL
FIRST NAME
ZIPCCOE
L-_____
~AST NAM"_' COMPANY
FIRST NAME
3, Tax
Billing
Address
Indicata whare future Tax Bills are to be sent
if ot1er thar buyer ~ddress lat boncM of fcrm)
'_A$fNAME/COMPANY
- STAEETNuMaERANDsTFl~!'.TNAME-
CITY OR TOW,<
4 Indicate the number of Anessment
Roll parcels transferred on the deed
()P1 U # of Parcels OR D Part of a Parcel
5. Deed
Property
Size
lOR l__.
l.nOI
Il.____J X I
FAOi'ITFEH ~
q:/?::~di-,
OEf>TH
ACIlES
FIRST NAME
STATE
ZIPCODt
(Only if Part of a Parcel) Check as they apply:
4A, Planning B09rd with Subcivision Authority Exists
48. Subdivision Approval was Required for Transfer
4C. Parcel Approved for Subdivision with Map Provided
D
D
D
'"
,
,J ~ -'<---
1'IRST"AME
6. Seller
Name
L
LASfNAME/COMf>ANY
FIASTNAME
7. Check the box belOW which most acc:urately describes the use of the property at the time of sale:
A~. One FiHT'iy Residential
B 20r3Fam-lyResidenti<l1
C Residential Vac<lm Land
D Non-Residemial Vacant Land
E~A9flCultural
F Commercial
G Apartment
H Entertainment I Amusement
I ~ Community Service
J Industrral.
K Public SerVice
L Forest
SALE INFORMATION
Check the boxes below as they apply:
8. Ownership Type is Condominiurn
9. New Construclion on Vacant Land
lOA. Property Loceted within an Agricultural District
108. Buyer received a d'sclosure notice indicaling
that the property is in an Agricultural Dishc:
D
D
D
D
11. Sale Contract Date
I '----t__J
Month Da.y Year
15. Check one or mor. of these conditions as applicable to transfer:
12, Date of Sale I Transfer
LLLd!ii 0 ~ I
Month Day Vear
A
B
C
D
E
F
G
H
I
J
13. Full Sale P~jce I 1""'\ 0 0 I
- , -l--------1----t--L- 'G~ '
(Full Sale Price is the total arrount]J<I'c forthe ,:yopertyincluding personal property.
This payment may be in the form of cash. other property or goods. or tha assumption of
mortgages or other obligations.) Please round to tile nearest whole do mount.
14, Indicate the value of personal
property included in the sale
, ,
ASSESSMENT L\!FORMATION - Data should reflect the latest Final Assessment Roll and Tax Bill
16. Veiil~ of Assessment Roll 'rom ~ ") J
which inforrniiltll:m tiilken ~
'7 f ,/ I-LJ 19.
.
17 Total Assessed Value (of all parcels in triiln5fe~) I
School District Name I 6~, -/-tVL4"m / c;
,
lB. Property Cla~
20. T(I>< Map ldentif~er(s) I Rollldentifier!sl {If more than four, attach sheet with additional identllie~ls)J
u...J..SLc.'" 12
s- ~ -rH/---.d.t<O'T L,. hr/....CX.;:y
L
CERTIFICATION
---.1
L
Sale Between Relatives or Former Relatives
Sale Between Related Companies or Partners in Business
One of the Buyers is also a Seller
Buyer or Seller is Government Agency or Lending Institut;'on
Dead Type not Warranty or Bargain and Sale 1Specify Below)
Sala 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 Pr;ce [Specify BalOW)
None
/9-.cnl
,
....J
BUYER
I certify t1mt 1I11 of the items of inl"orml'ltion cntcn.'<I 011 this fonn are true and correct (to the best of my kno",k'<l~l' and belief) and I understand that the making
or all)' willful false ~temenl of matcrial fact herein will ~"Ub.iect me to the provisions of the lienal law relath:l: to the makiult and filing "I' false imtcument'i.
BUYER'S ATTORN.E.Y.
-4 VI!- J);0l
rd.iz?r ?</..C~ I /6")
BUnRSIGNATJRE --~- DATE:
CAST "lAME
32'0.
STREETNJVlBFR
I }!".~\""ci!'%- Cd::
S REEl NA1'IIE I EASAlE)
AFlEACODE
L~f rY1:;,,<.~
--m:vOOTOWN
l~tF
\ ,Cf:f'\
2rf>C(lOE '
SELLER
. ~~~\\,\JJ~~r..~~I-"'"
-:"FUER GNAT.UR~, DATE
Jt"'1Tl< IUtt.l-idy/t-t".,",L<--~
x-
~\.) \-~'."",^M'
TElEPHONE NUMBER
NEW YORK STATE l
COpy
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