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N. Y .9. T'.U. Form 8002 - Silrgein end !~Ia DMd. with Cov.n.nlllgllinet GrtIntor". Acta _ Unifonn Acknowledgment
Fann 3280
CONSULT YOUR LAWYER BEFORE: SIGNING THI8 INSTRUMENT-THIS INSTRUMENT SHOULD BE USED BY LAWYERS DHL Y
~
THIS INDENTURE, made th~ day 0'1 November, 2004
BETWEEN
ALICE D. SUROZENSKI, sllrvivin.ll tenant by the entirely of Michael Surozenski, Jr., who died a
resident of Suffolk Counly on z.~.., Iqqo , residing at 41095 Route 48, Southold, New York
11971, party olthe first part"
SUZANNE A. WIEL T, residi"g at 4205 Main Road, laurel, New York 11948, party of the second
part,
WITNESSETH, that the party af the first part, in consideralion 0'1 Tsn and 00/100---
-- ($10.00) dollars,
and other good and valuable consideration paid by the party 01 the second part dOBll hsreby 9rant snd
ralease unto the party 0'1 the second part. the heirs or SUCCSIl8Ol1l and a.signs 01 the party 01 the second part
forever,
Allthst certain. plot, piece or parcel 01 land. with the buildings and improvemenm therson erected. siluste,
lying and being at Southold. Town 01 Southold, County 01 Suffolk and State 01 New York, bounded and
described as follows:
BEGINNING 81 the SOUlheasie<!y comer 0'1 the premises herein described an the nartherty side 01 North Road
a distance 01148 feet, mono ar Ie.., as meaSUnad along the northerly line 0'1 said Narth Road lrom its point af
intersection with the westerly lim, of Kenney's Road:
RUNNING THENCE in a general westerly dirsction along the northerly side oI88id Narth Road a distance af
75 reet mors or less. to' land naON or formerly of Conway Bros.:
RUNNING THENCE in a general northerly dirsctlon along lands now or formerly oI88id Conway Bros. Narth
41 degrses 57 minutes 50 secortds West a distance 01 162 Ieet. mors or less, to a point;
THENCE Narth 46 degraes 48 minutes 00 seconds Eest a distance al72.43Ieello a point;
THENCE Soulh along" land now '>rformerly 01 Joaeph M. and Julia D. Conway South 41 degrses 57 minutes
50 secands easl a distance af M51eet mara or less, to the poinl or place 01 BEGINNING.
LESS 351ee1, mare ar less. taken by the Caunty af Suffolk for Widening County Route 48 (Narth Road).
TOGETHER with all the righI, WI> and interesl, If any, oIlhe party 01 the firsl part in and 10 the Narth Road
lying in fronl oland adjacenlto thle said premises.
BEING AND INTENDED TO BE.llhe 88me premises as conveyed 10' the party of the firsl part by deed dsted
March 22. 1957 and recartled in Ine office 01 the Clerk 01 the County 01 Suffolk on March 25, 1957 in Liber
4277. page 73. Reserving to ch. party of the first part a l~f. estate in the premises.
bPS
TOGETHER with all righi, litIe arid inlenBBt If any, af the party af the firsl part in and to any stream and roads
abulling the ebove described prsmiaes to the center lines thersot. TOGETHER with the appurtenences and all
the estate and righIB af the party 01 the first part in and to 881d pramises; TO HAVE AND TO HOLD Ihe
pramises hsnain granted unto the party af the second parL the heirs or SUCCSIl8Ol1l and asslgns 0'1 the party af
Ihe second part Iorever.
AND the party 01 Ihe firsl part covenants that the party af the first part has not done ar suflersd anything
whersby the said premises have t_n encumbersd in any way whatever, except as aforssaid.
AND the party 0'1 the firsl part. in compliance with Section 13 01 the Lien Law, covenants that the psrty af the
firsl part will rsceive the considemllon lor this conveyance and will hald the right to receive such consideratian
as a lnust fund to be applied first lor the purpose 01 paying the cost af the improvement and will apply the 88me
first to the payment allhe cosl 01 the Improvemenl before using any part af the latal 01 the 88me for any ather
purpose. The wortl "party" shall t.. construed es if it read .psrtJes" when ever the sense 01 this indentura so
requires.
IN WITNESS WHEREOF, the patty 01 the firsl part hes duly executed this dead the day and year firsl above
written.
IN PRESENCE OF:
ti.A- .9~, ~.
Alice D. Surozenskl
.7doed5
-~
TO BE USED ONLY WHEN THE ACKNOWLEDGMENT 18 MADE IN NEW YORK STATE
State of New York. County or Suffolk lIis:
On the 3d'" day ot Novem_ in the year 2004
before me. the understgned. personallll' Bppnred
^L1CE ID. SUKOZENSKI
personally known h) me or proved EO me on the basis of
salisf:u.1'DI'Y C'vidence to be the individual(S) whose name(,) is
C:ue) sub~ribc-d 10 the within instrument and acknowledged to
me Ihal he/shC'lIhey executed ahe same in hislhcrlthcir
capacily-{ic,,). and thill b)" hislhcr/lhcir signatun.....s.t ,,In the
insln.n)CTlI. the indi\..idual(sJ. or the rers<'f11 upon be-ho.lf of
which ~i.\'idual(5 acted. <<uted the inslrumcml.
Stale of New YOlk, County ot SUllolk aa,
On the day of . in the year
before me, the undenigntld, peraonally appeenad
peraonally known to me or proved to me on the basta of
_dory _ to be the individuBI(a) _ name(a) ia
(8") aubacribed to the within inslrumllnt end 8cknowllldged to
me that heIahefthey executed the ume in hisJherllheir
capacity(in). and that by hiBlherllheir signlllure(a) on the
instrument. the Indlvldual(a), or the penIOn upon behalf ofwhid1
the indlvldual(a) 8CIed. .)C8QJ1ed the Instrument.
(Big"""''' 8nd oftIce of IndNiduel18k1ng 8ck-*lgrnenl)
. lInd ot!ice.ot-indivlduall8klng.ec;Im'1!l!!!!l.!!mant) .
I:lublic ~._-.:..~
ABIGAIL A. WICkHAM
NotB'" Public, Slate ot New Vootl
No. 52-484287'
Com Q!,BIi1ied in.SuHoIk County ~ "rt!f
mlS8lon Elcp;... S.PL 30. n C
TO BE USED OJ.tL Y WHEN THE ACKNOWLEDGMENT IS MADE OUTSIDE NEW YORK STATE
--.............'""..~...'ll:Ii:...:_,:....._
State (or Ciatrid 01 Columbia. Territory. or Fontign Country) or
n;
On the
dByof
In the ,.r
before me. the undersigned. personally 8pptNl1red
peraonaUy known to me or proved 10 me on the bIIs.. of UU....ctory evidence to be the indlvidU8I(.) whose name(s) is'(are)
subaaibed to the with'" ins.rument and IICknowledged 10 me Ih8t he/lihelthey executed the lame in hillherllheir C8pecity(1ee). end
lhel by hlalherllhttir Bignalure(a) on Ih8 inaltumen', lI1a indivldu8l(al, or the person upon behelf of which II1e indivldu81(a) 8cl8d,
executeclllhe instrument. and that auch indlvkl.... mad. uch appunlnce before the undersigned in the
(In.11 the Cdy or other poIIdc81 subdlYialon)
in
Cend inIIert the hie or Country or at., plaCe lhe ec:knowJ.dgment w.. blken)
Caignelure Bnd _ 01 indMduellBkJ"ll ackn""'*'llment)
BARGAIN AND SALE DEED
WITH CO'IIENANT AGAINST GRANTOR'S AC'rS
TO
SUZANNE A. WIEL T
SECTION
BLOCK
LOT
COUNTY OR TOWN
STREET ADDRESS
TItle No.
ALICE D. SUROZENSKI
Recorded 8' Request of
COMMONWEALTH lAND TITLE INSURANCE COMPANY
Tn.
8TAM)AftDFORII Of" NEWYOIUC BOARD OF TTn.I!! L>>4.&.__._
~""by
o CommOn~~~!!~..,_.,,~
Wickham. Bnassler, Gordon & Geas8. P.C.
P.O. Box 1424
10315 M8in Road
MBttituck, New York 11952
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EA-.5217 (County'
Sub 'Jinal
E.-\-:'li217 (Slilh.')
R.P.T.S.A.
Curnm. of [.:t.l.
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...\Iliduvil
c.:rtifi.:J Cl.""Y
Reg. Copy
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Suh T.na) -:-/7r-
Grund 1'nlal-1.1 7 -A ~
Olher
..& IOistric.:t,OOOF
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Pn11"CTt)' !
Tax S..~rvic:c
A):'cncy
VcriIiL'.lti,m
" _n - -- ..... "00 S
1000 OSgOO 0700 032000
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~ Si.I'iSrUL'li'ln/()isl.'ll:.Irg~R,,",r~a!ol.." List l>>n,'~ny Ownen. ~ailinG Aud~ss
KEl"OIU) & Kt:-rIJKN TO:
1IICIlIlAII,IIIlESSISt, IlIRIIllIIIIfASA, I!C.
UDlllIAII RIIAD, P.l1. .. I4Z4
IIA11II\lCII., Lt WII
7
ell, :"I:UIlh.:'
RECORDED
2004 Dee 1504.12:49 PM
Edward P.Ro~ine
CLERK OF
5I.FFOLK COUNTY
L 000012360
I' 756
DII 04-20371
Kccordillg I filin~ Slumps
.J
Mnrl~agc Ami.
I. Diill'oi....l11x
~. AJdilionol1 T:1'
Sub Tv.al
Spr..'\:. I Assil.
or
Sp.."C. I "'''d.
TOT. MTG. TAX
0.1011 TlJWII _ Ou.al CnUnl)' __
.. II~.I'" for Al'pcJinlll1C."nl __~
I r.mslcrT:.IX --.. <::1,(- -
:\1all~inn Tax _
'111.' pn'pt:'rly L'\,WCn.'\J hy Ihi~ II1nl!!aa:~ is
or "'ill he imprnvc."ll hy .1 III1C ur tWII
fwnily dwelling only.
YI.l."'_ ur:"O
If NO_ SI."C appmpriale lax duu:'e ('n
ruse II of this in"l i0l>...0 ~
Clmsic.kraliulI Amount
s
s
CPF Tax lJu~
Impro\"L-d
Vac:mll.alld _
TO _n . /0
TO
TO ..
Title Compoan)' InronnuUlln
TItlc#
~utTolk County Recording & Endorsement Page
This ~~~ furm:, Jl<.ln ",r rile :'llla~haJ Barll.ln and Sale Deed made hy:
(SPECIFY TYPE OF INSTKUMENTt
Aliu_D..li'II.I:IW'"ski
-111C prcmil'lis h.:rcin .:0; situateu in
SUFFOI.K COUNTY. NEW YORK.
TO
In the Tnwn,.;hip of Southo.ld
III lIIe VILLAGE
or "'IAMLL:.T uf Southold
_S.UZllllD'-'~. _WklC_.
BOXES 1\ TIIKOUGII K MUST IJE TYPED OK PRINTED IN "I.ACK INK ONI.Y PKIOK TO ROCOKDlSG OK FILING
(over)
-
111111111111 111111111111111 11111 11111111111111111111111
1111111111111111111111111
SOFFOLK COUNTY CLIRX
RECORDS OFFICI
RECORDING PAGI
Type of Instrument. DEEDS/DDD
NUmber of Pages: 3
Receipt NUmber . 04-0136988
TRANS FIR TAX NUMBER: 04-20371
Recorded:
At:
12/15/2004
04.12149 PM
LIBER:
PAGE:
D00012360
756
District:
1000
Section: Block.
059.00 07.00
BXAMINBD AND CHARGED AS POLLOWS
$0.00
Lot:
032.000
Deed Amount.
Receivs,l! the Following rees ror Above Instrument
Bxempt ~."'lpt
Page/F:iling $9.00 NO Handling $5.00 NO
COE $5.00 NO NYS SRCHG $15.00 NO
EA-CTY $5.00 NO EA-STATE $75.00 NO
TP-584 $5.00 NO Cert.Copies $0.00 NO
RPT $30.00 NO SCTM: $0.00 NO
TriIDsfer tax $0.00 NO COllIIII.Pres $0.00 NO
rees Paid $149.00
TRANSFER TAX NUMBER. 04-20371
THIS PAGE IS A PART or THE INSTRUMENT
THIS IS NOT A BILL
Edward P.Romaine
County Clerk, Suffolk County
.
FOI'l CO~NTY USE ONLY
t"Lt:A;:'t:. I yt'!: UI"'I t'1"'Il:::>:" ~II"'IIVlL Y VVHI:I" VVt"\III1"1.J Ul" ....UMlVI
INSTRUCTIONS: http:// www.orps.state.ny.us or PHONE 1518) 473.7222
REAL PROPERTY TRANSFER REPORT
(:1. SWIS Code
W"':;'
\,.
"-
1. Property L- 41095
location STRFn~l!MllfR
Count.y Route 48
STREET N~.ME
L-Southold
CI-Y OR TOWN
Southold
VIL.....GE
2 Buyer L_Wielt
N~me LASTNAMEICOMP"'f,J~
Suzanne A.
FlRST"lAME
~
LAST NAlI'EICOMrAN~
HRSTNAME
3_ TilX Indicate where luture Tax Bills;lrE! to be sent
Billing if other Ihan buyer address (at bottom of/orm!
A,::ldress
L.ASTNAMEICOM~AN~
~ .
STR,ET NUMSER AND STREET NA\1E
CITVORTOWN
4. Indicate the numb.r of Asussment
Roll pareefs tranllfer""d on 1111 dHd
!.J /I 01 Parcels OR 0 Pllrt of II Pllrcel
5_ DOled
Property L
Size
Ix
i OR I
. 2 0 I
"I'IQNTFEn
DEPTH
ACRI;S
6. Sllller
N;lml
L- Surozenski _
lAST~MEICOMrANV
Alice D.
FI~ST NAMIi
~
LAS"rN"'MEICOMPAN~
FIRST NAME
]. Ch&ek the box billow which most lIc:curat.ly delllcrlb<ls th. U$e of the property at the time of IIIle:
A~OneFamil'fResidential
II 2or3FarrilyRasidential
C Residen:;Il'VacantLand
D Non-Resid,~ntiaIVacant Land
I SALE INFORMATION I
,,_ Sale Contract Dilte
E~AgricUllUral
F Commerdal
G Apartment
H Entertainment/Amusemelll
~~
Community Service
IndlJsnial
PublicServict
Forest
STATE OF NEW YORK
STATE BOARD OF REAL PROPERTY SERVICES
RP - 5217
RP.S217ll.eyYJ7
11971
ZIPCOOlO
FlllSTNAMf
STATe
~POOOf
(Only if Part of a Pate..) Check iI$ thlY apply:
4A. Plllnn;ng Board with Subdivision ALlthority Exists 0
48. Subdivi6ion Approvill was Required for Transfer 0
Ie. Parool Approved for 5ut/division with Map Provided 0
Cheek 1M boQ. below .. thev epply:
8. Ownership Type is Condominium
9. New Construction on Vacant Land
lOA. Property Locatltd within an Agricultural District
108. Buyer received II disclosure notice indicating
lhat the property is in an Agricullvral Di$lrict
o
o
o
o
Month
D.,
Yellr
15. Check one or monI of th_ condhions u applicable to trantfer:
A
B
C
D
E
F
G
H
I
J
12. [llIte of Sale /Transf"'r
II
MontI)
?o
D.,
04
Year
13. Full Sale Price 1----1.....- ' 0 , 0 , 0 I
, , .
(F\II: Sale Prire is the tota; amount paid for ttle property including pars onalproperty.
This payment may be in the form of cash, other property or goods, or the a$llumption of
mortgages or other ot/ligations.) Please round ro rhe nfmfCst whole dollar itfflOunt.
14. Indic.tethe value of personal I 0 , 0 . 0 I
property included In the NIle, , e
I ASSESSMENT INFORMATION - Data should reflect the latest Final Assessment Roll and Tax Bill
16_ Year of Assessment Roll from LQ3 OAj Total ASH!lsed Value lot all parcels in transferll
which Information taken - -'---" 17.
18, Property CIa,.,.
I~ 1 , Oi-L.J 19. SGhoc)1 District Name I Southold
20. Tax Map ldentffi,trlsl / Rollldentifierls} lIf more than four, attach .heet with additional identifier!,))
L__.IcOOO-059. 00-07.00-032.000 .
Sale Betwaen Relativeli or Former Relatives
581. Between Related Companies or Partners in Business
OneoftheBuyersisalso;I~II'r
Buyer or Seller is Government Agency or Lending Institution
Deed Type not WarrBnty cr Bergain and Sale (Specify Below)
Sale of Fractional or Less than Fee lnt&r'est ISpecify Below}
Significant Ctlange in Property Betwean Taxable Status ond Sale Dates
Sale of Business is lncludlld in Sale Price
Other Unusual Factors Affl!'Cting Sate Price (Sp8cify Below)
None
3 3
o 0 I
L
I CERTIFICATION
I cer1ify that all of [he items or information entered on tms fonn are true and correct (to the best of my knowk-dgc and belief) and I understand that the nmking
of any \\i1lful fllhe ~>tatement of material fact herein will subject me to the provisions of the uenaJ law relative to the making and riling of false instrumenb.
BUVER
~
'~Bl!Vcf\SI
(M<_ r:,./,~
ATL'RE Suzanne A. Wielt
J~
lAST NAME
P .0. Bo~ 66
~smH1NU"BFR
631
STRcCl NAMEIAFTERSALEI
MU_
Laurel
C~"'OR TOWN
11948
NY
Sl:iTE
ZIP CODE
SELLER
i~D~ l,tU',?O\D<l-
SEllER SIGNA-WRE ice. Surozensk:L 0 c
BUVER'S AlTORNEV
Wickhalll
Abigail A.
FIRST NAME
298-8353
THEP~O"'E "lUMS.~
NEW YORK STA~
COPY )