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QUITCLAIM DEED
THIS QUITCLAIM DEED, executed this IS' day of t)c. TO 0,; t<. , 200 J.
by fustpany, Grantor, fIl-T~.Jc../~ ~L j fitf"P'2./tF"S'k/
whose post officl:tlrfs:frrl'bQK~/r"ffG I#" fUrN'-f(, MY. I r'-<'
!o second pany, Grantee, rl+/?1)f)t1,!~ If". I'~ ~Ht..o~~..' A',,~. 'jI9J4..( c.:r:" "8'>F
whosepostofticJ<.ac!.!Iress.is.UNI..f.I..i<'CA';'t,..'4nlf~". ..... '1D """v''Z5"o:l.:z..
. . _.t~~7,11J' 'A1((,p H/4-tf1 Cou'Rr /-.0 wiFl{ Y'10f;(. N I f'o ~
.
WITNESSETH, That the said fits! pany, for good consideration and for the sum of
ONG' DoIIMs ($/ g:g. )
paid by the said second pany. the receipt whereof is hereby acknowledged, does hereby remise. release
and quitclaim unto the said second pany forever, all the right, title, interest and claim which the said first
pany has in and to the following described parcel of land, and improvements and appurtenances thereto in
the County of SIA ~ ~o l.K,. , State of N G1.o.I Yo I{ k to wit:
bl~Tre"'" 1000 Se.c.41on 01..&4-.00 I .~10l!.I( 0&".0{) kD4 030.000
TOLOf' ~ SO~Dld I ~~ 4 Suftc>l'K, ~-k- o~ ,\leu) ~
01992.2001 M_ Jl.Z I'roduI:lI, Inc. ..... I .... 1.002
1bI. ........ _ ... __Ie "'" "acIerina oIlcpl_ or ....i<eL 1'IiI pIUoIucI i. __ lor 101........., ... oaIy ud i. ... . IUbslilult lor....'
IlIvlce. SuR II" VW)'.IO coaJIIb aD lUOnIry 01 aD lepll'lllllcn.. 'lbil produclMl .. neceuIriIy IftpIRId.bJ' . penanliceuld 10 ....tier II" iD JUUl'IIIIe.
ATAK
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IN WITNESS WHEREOF, The said firsl party has signed and sealed Ihese presenls the day and year
farsl above wrillen. Signed, seaIcd and delivered in presence of:
bdLlld/l/ ';:=~~. "e~;.(i;
nalure of Willless ~re of First Party
J~e.,,+tc... 8.a.~t"\~" rll!J..':'. \..... ~\ed~I~AiJl
Prinl name of Witness Piinl name of First Party
SiglUllure of Wilness
Signature of Firsl Party
Print name of Witness
Prinl name of Firsl Party
Slale of lv' 1/ }
County of~~IJ.
On ~~. :)..q I' :1003 before me, ' ",",\,''':,'''' ,
appeared P""""'e.~a... ~. '6\ed~eAio.j{1 ,.~,:', ", ,_ "0".
personally known to me (or proved 10 me on the basis of satisfactory evidence) to be the persol\(s) ~,h~', ,
name(s) Ware subscribed to the within instrumenl and acknowledged 10 me that belshelthey executed thir .. ,
same in hislher/their authorized capacity(ies), and thai by hislherltheir signalure(s) on the instrument the
person(s), or the entity upon bebalf of which the person(s) acted, execuled the insuumenl
WITNESS my hand and 0 '81 seal. SUSAlt 101. ~ _
IlOl'AIlV P\JBUC llIal8 a1..- -- -
o.=~~
Affianl Known_Produced 10
Type of ID
(Seal)
Slale of
Counly of
On
appeared
personally known to me (or proved to me on the basis of salisfactory evidence) to be the person(s) whose
name(s) is/are subscribed to the within inslnlment and acknowledged 10 me thai belshe/they executed the
same in hislherltheir authorized capacily(ies), and lhat by bislherltheir signature(s) on the instrument the
person(s), or Ihe entity upon behalf of whicb the person(s) acted, executed the instrument,
WITNESS my hand and official seal.
}
before me,
Signature of NOlIry
Affianl_Known__Produced ID
Type of ID
(Seal)
Signalure of Preparer
Print Name ofPreparer
Address of Preparer
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~'~ii ihll oerllin plOl, piece 0< pan:e. or land, whh Ihe buildin., and improvements .hereon e<eclcd, silUlle,
~!y1... Ind bclnlllaXrllll at Southold. in the 1'own of Southold, County of Suffolk
:~.Dd'Stato of Hev York. known and designatad as Part of Locs Numbered 116
'~'~aa.d .117 on a. map entitled" IISubdivision Map of Founders Estates. IRe.. Ii"
~..~t.uate at Southoid. New York, made by Otto W. Van Tuyl. Engineer and Surveyor,
~Cr..nport. New York. March 1927 and filed in the Suffolk County Clerk's
~: Office at R1verhead. Suffolk County, New York, May 10, 1927 8S Hap Number
'-:, ~3..4.. and hounded and described as follows:
.,./
" BEGINNING at an iron plpe stake locut.Hl "I.. the :;.outh~rly line of Old Shipyard
Lane. IOOf.et distant from where Old Shipyard .Lane intersects the oasterly
l:lne uf Hob.art Avenue; runn1.na thence along the southorly line of Olod
.. Sh.1pyari:f'.i..u.ne. Nurth -J8 deKL.ees 21 mluui:t:l:tlI 20 8.,a:UUUtf Bact. II cl.i.llI1ciluicc
of SO feec'co an 1.ron pipe stake and the property oC Clem Thompson; South
SI degrees 28 minutes 40 seconds East. a distance of 140 feet to an ~ron
-.pipe st.ake and the propl!rty of .:uf:,p.ne Carter; running thf!ncf'O 810"& the
"'pruplllrty 01' .e;U&....~ t..:oIIctllir ::;(.Iui:n '38 deiiceeJ ~l Ini...utes 2D St:C","m;s We..t.
· diseance of 60 feet to an 1.ron pipe stake; running thence st~ll along
.cbe prDperty o~ Eugene Curter. Dona~d Fahey and Frederick Bach. North 47
~d.lree. 23 minutes 30 seconds West. Q dlotance of 140.3S.feet to an 1ron
'~p'1pe 'staka on the sourherly side oC OlcJ Shipyard Lane. the point or place
"~ufo BEGINNING.
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Number of p.:Iges
TORRENS
s.,ril1l#
Cenificate II
Prior Of. #
l
RECORDED
2003 Nov 19 04.01:26 PM
Edward P.ROIIain.
CLERK OF
SUFFOLK COUNTY
l 0000 12284
P 866
D11 03-16215
3
Deed I Mongage Instrumenl
Recording I Filing Stamps
Page I Filing Fee
Ilandling
TP-584
Notation
EA-52 17 (Cuunty)
EA-5217 (SUlle)
R.P.T.S.A.
Comm. of Ed.
Affidavit
~co~
n:l&iu''gC
Other
4
~ooo
0'.1.
Real Prnpeny
Tax Service
Agency
Verification
Deed I Mongng. Thx Stamp
PEES
/{J.
Murtgage Arnl.
I. Basic Tax
2. Additional Tax
Sub Total
Spec./A..it.
5. ()()
5
5 Sub Thtlll d,
~O
_.~.....
or
Spec. I Add.
TOT. MTG. TAX
l)ual Town __ Dual County
Held fur Appuintment _ I
Transfer Tax --f1
Mansion Tax __ _
5. ()()
Tbe pmpeny covered by this mongage is
or will he improved by a ORC or fWQ
family dwelling only.
YES __ ur NO
If NO. SL~ .appnlprialc Ia.X clause on
page # of this instrument.
Y')
15. ..!!!L
Gmm.l Tnlal
Seclion 0104.
Lot 030.
5 CommWlity PntHrvatlO
Block 0$.
Consideration Amount $
1000 06400 0500 030000
CPF Tax Due S
Impro\'ed
Vacam Land
6 SalisfoclionsJDischargcslRclca.ores Lha .-rupeny Owners Mailing Addn:sli
RECORD &< RETURN TO:
'1Y\eaiore. ~. Pra.h \6W
-Z~ ~ho.M C+-.
~\ tSWlA. ~6\.W.~ ,IK -:t-soZ 2-
TO
TO
TD
7
Title Com n Information
Cu. N:lnlC
Tide #
Recordin
L::>e~~
(SPt;;Cll'y,:rYPE OF INSTRUMENT)
L. ""';;( d 'Z.(' e,,:>b:..
8
Suffolk Count
& Endorsement Pa e
_ made I>y:
This p.:Ige forms pan or the atlached
?a.-\-'(\'CA.'a
-=:1J,t , rti &'V ~
The premis~s h~rcjn is situnted in
SUFFOLK COUNTY. NEW YORK.
TO
cz: ?ro..h I &,J
In the Townsbip of Sl5lA~
In the VJ~Ln~..E J
... HAMLET of ~~Dla
.
1i0XF..s 6 THRU R MUST BE TYPED OR PRINTED IN BLACK INK ONLY PRIOR TO RECORDING OR FILING.
(over)
1111111111111111111111111111111111111111111111111111111
1111111111111111111111111
SUPFOLK COUNTY CLBRK
RECORDS OPPICB
RBCORDING PAGB
Type of Instrument I DllmS/DDD
Humber of Pagesl 4
TRANSPBR TAX NUMBER: 03-16215
Recorded I
Atl
LIBBR:
PAGB:
11/19/2003
04101126 PM
D00012284
866
TBBODORB I PRAHLOW
TBBODORB I PRABLOW
Districtl
1000
Section: B10ckl
064.00 05.00
IXAMINBD AND CBARGBD AS I'OLLOWS
$0.00
Lot:
030.000
Deed Amount I
Received the Pollowing I'ees I'or Above Instrument,
""'""lpt B:w'""'Pt
Page/riling $12.00 NO Handling $5.00 NO
COB $5.00 NO NYS SRCHG $15.00 NO
BA-CTY $5.00 NO BA-STATB $50.00 NO
TP-584 $5.00 NO Cert.Copies $5.00 NO
RPT $30.00 NO SCTM $0.00 NO
Transfer tax $0.00 NO Ccmm.Pres $0.00 NO
Pees Paid $132.00
TRAHSPBR TAX NUMBBR: 03-16215
THIS PAGE IS A PART 01' THB INSTRUMENT
THIS IS NOT A BILL
Idward P.Ramaine
County Clerk, Suffolk County
FOR COUNTY US!: ONLY
PLEASE TYPE OR PRESS FIRMLY WHEN WRITING ON FORM
INSTRUCTIONS: hllp:/! www.orps.state.ny.us or PHONE (518) 473.7222
C1. SWIS Code
ILl, (,,3, g, g11
I ! / / ! q /.031
Month nay V",ar
i q", K L-{ I C4. Page t'.
*
CZ. Date Deed Recorded
C3. Book I
/,
PROPERTY INFORMATION
,. P'operty II 6 0 .>
Location :'lTRFFT NUM!;!(n ..--
2. Buver
Name
I 1.7 t.];> _rH', "/-')/;4 ~ D
STREET NAME ,
I S,,:n~TU:V '--7:>
CITY OR TOWN
I fdT~!!;!-:S'~
/...I-1fN E3
REAL PROPERTY TRANSFER REPORT
STATE OF NEW YORK
STATE BOARD OF REAL PROPERTY SERVICES
RP - 5217
HP.S217 H"vJi1l1
1 T He----O t'> <.) I( cr
FIIlSTNAME r
VILLAGE
J
t~17/ I
zr ()l
--.I
LAST NAME I COMPANI'
3. Tax
BIlling
Address
Indicate where future Tax Bills are to be sent
if other than buyer address (at bottom of form)
LAST NAME I COMPANI'
I ~ s2JluMBER~ s~i? !tfrl1 ~:(J fA fl. ,I
rt..C;>iA/e~
CITY CIl TOWN
4. Indicate the numbet' of Assessment
Roll parcels transferred on the deed
I # of Parcels OR D Part of a Parcel
5. Deed
Property
SIze
L
IxL
lOR I
.
FRONT FEET
J[nll
ACRES
FIFlSTNAME
..---.1
FIRST NAME
--.I
r>1t:7'-'fN D
I r 'X 17'-0.J.2 I
S'ATE ZIP ~ODt
L.J
(Only if Part of a Parcel) Check as they apply:
4A. Planning Board with Subdivision Authority Exists 0
4B. Subdivision Approval was Required f,~r Transfer D
4C. Parcel Approved for Subdivision with Map Provided D
6. Suller
Name
IS L.cFD7z../ G.s."ft I
LAST NAME/COMPANY l .
j2 4-77'<',,- C i ~
FIRST NAME
--.J
lAST NAME I COMPANY
7. Cl1eck the box below which most accurately describes the use of the property at the time of sale:
A~ One Family Residential
B 2 or 3 Family Residential
C Residential Vacant Land
D Non.Residential Vacant L,lnd
E ~ Age'",,",,, I ~
F Commercial J
G Apartment K
H Entertainment / Amusement L
Community Service
Industrial
Public Service
Forest
SALE INFORMATION
FIASTNAME
Cheek the boxes below as. they apply:
8. Ownership Type is Condominium
9. New Construction on Vacant Land
lOA. Property Located within an Agricullllral District
10B. Buyer received a disclosure notice indicating
thattne property is in an Agricultural District
o
o
D
D
.1
15. Check one or more of these conditions as applicable to transfer:
11. Sala Contract Date
/
Year
A
B
C
o
E
F
G
H
I
J
/
D',
Monlh
12. Date of Sale I Transf.r
/0/.;;(9! 031
Month Day va-ar
13. Full Sale Price L_-1- I 0, 0 I 0 I
, , .
(Full Sale Price is thll tot,,1 amount paid for the property including personal properly.
This payment may be in the form of cash, other property or goods, or the assumption of
mortgages or olher obligations,) PlrJ<1se round to the nearest whole dollaf amount.
14.. Indicate the value of personal
property included in the sale
I ASSESSMENT INFORMATION
~ , 0 .cJLJ
, , .
- Data should reflect the latest Final Assessment Roll and Tax Bill
16. Year of A5S8ssment Roll from ~J 17. Total Assessed Value (of all parcels in transfer) I
which Information taken
18. Property Class
L......._~-L~ 19, School District Name I S()U-t~ t..-h
20. Tllx Map Identi'-..,..(,ll Rollldentifier{$1 (If more than tour, attach sheet with additionalldentifier{sll
'-DOt") Otcl..\;O\.J
OS. c'V
0"',,, on.'')
CERTIFICATION
Sale Between Rejati~s or Formar AelativlJs
Sllle Belwlten Relllted Companies or PatTnf!n, in Husine~s
One of lhe Buyers is also a Seller
Buyer or Seller is Government Agency or Lending InstitLltion
Deed Type not Wllrranty or Bargain and Sllle lSpec:ify Belowl
Sale of Fractional or Less than FIX: Interest (Specify Below)
SignifiCl'lnt Change in Property Between Taxable Status Bnd Sale Dates
Sale of Business is Included in Sale Price
Other Unusual Factors Affecting Sale Pricll (Specify Below)
None
~J
---..-I
---..-I
BUYER
I certify that aU of the items of inComtation entered on this fonn are true and correct (10 the best of my knowledge and belief) and lunderslland thai the makiny
of any willful fal'ie statement of material Cuel hemn will subject me to the provi'\;lons of the oenal law relative to the making and filing or Calse iru;trumcn~,.
BUYER'S ATTORNEY
.~ ~..,t,U-- c.e.. C1iJ~
BUVER$IGNATUHE OATE
LAST NAME
" C ~
',0 )
J STl'lEE NUMBER
old '~J,Q.,c(d
- STREE AMEI R &.AlE)
d\fi
STATE
1107'
I I ~ I
ZIP CODE
0~
AREA CODE
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CITY 011 TOWN
SELLER
AI <. .:C:..O -
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SEllEflSIONATURE
DATE
FIRsrNAME
THENIOI'l[I'lUM[I[R
[NeW
YORK STATE
COPY
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