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Standard N.V.B.Y.U. Form 8002 - Balgilin and Sale Deed. with C0V8nant agalnat Grantofs Acts _ Uniform Acknowledgment
Form 3:zeo :
CONSUL'r YOUR LAWYER BEFORE SIGNING TIllS INSTRUMENT-THIS INSTRUMENT SHOULD BE USED BY LAWYERS ONLY
THIS INDENTURE, made the ~ay or September, 20~3
BETWE'EN
,
DAVID J. ZAZESKI and JEAN A. ZAZESKI alkla Jean Zazeski, residing al145 Conklin Road, Mattiluck,
New York 11952,
Party Of the first part, and
DAVID J. ZAZESKI and JEAN A. ZAZESKI, as Tru._s of the ZAZESKI LIVING TRUST, residing at
145 COlnklin Road, Matlituck, New York 11952. party of the second part,
WITNESSETH, that the party of the first part, in considaration of Tan and 00l100-($10.00)-dollars. and other good
and valuable consideration paid by the party of the BBCOnd part, does hereby grant and rele.se unto the party of the
second Ilart, the heirs or successors and assigns of the palW of the second part forever.
I
All that e,ertain. plot, piece or parcel of land. situ.te, lying and being In Mattituck, Town of Southold, County Of Suffolk
end State of New York. known and designated .s and by Lots NO.8 and 9 .s said lots ara shown on a certain map
entitled, -Map of Garden Heights. situated at Mattituck, U." and ftled with the Office of the Clerk of the County of
Suffolk c,n 6124/1929 as Map No. 577. i
The partl;es of the first part are the life beneficiaries 01 the trust, a revocable trust
BEING J\ND INTENDED to the same premises conveyed to the party 01 the first part by deed dated November 30.
1970. rec'orded December 22. 1970 in Uber 6859 page 322.
TOGETtIER with all right, title and interest. if any. of the party of the first part in and to any streets and roads abutting
the abov,. described premises to the center lines theRlOt. TOGETHER w~h the appurtenances and all the estate and
rights of the party 01 the first part in and to said premises; TO HAVE AND TO HOLD lhe premises herein granted
unto the party 01 the second part. the heirs or successors and assigns 01 the party 01 the second part forever.
AND the party of the first part covenants that the party of the first part hes not done or suffered anything whereby the
said pre..1ses have been encumbered in any way whatever,. except as aforesaid.
AND the party 01 the first part, In compliance with Section 1301 the Lien Law, covenants that the party of the first part
will receii/8 the consideration for this conveyance and will hold the right to receive such consideration as a trust fund
to be applied lirst 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 ;lolal of the same lor any other purpose. The word "party"
shall be exmstrued as if it read .parties. when ever the sense of this indenture so requires.
IN WlTNIESS WHEREOF. the party of the first part has duly executed this deed the day and year first above written.
IN PRESENCE OF:
-+M.diLL
I
, aff~fl J. ~P-A.'
David J. Zal"..,ski
I
(ilL..... Q.\.~ ~~ ~
JealfA. Zazeski 'C::S
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,
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BE USED ONLY WHEN THE ACKNOWLEDGMENT IS MADE IN NEW YORK STATE
State of 1\Iaw York. County of Suffolk. sa: State of New YOrk. County of Suffolk ss:
On the l~y of _'rod. In the year 2003, On the t ~ay o~, in the year 2003,
before me, the und~' p~raon.IIY appeared before me, the undersigned, personally appeared
DAVID J.. ZAZESKI JEAN A. ZAZESKI
perBOnB~1y known to me or proved to me on the basis of penIOlIIIIly known 10 me or proved to me on the basi. of
satisfactory evkIenc:e to be the inclividuaJ(s) wI1~ Mlme(s) is .ati.factory evidence to be the indlviclUIIJ(s) whose n.ma(a) is
(Br.) SUtllSCribed to the within instrument and acknowledged to (are) subscribed to the within instrument and acknowledged to
me bul1: he/shellhey executed the same In hlslherltheir me that helshelthey executed the same in hislherllheir
capac:ity(ie.). and that by hiaiherltheir signatural.) on the ,capadty(iea). and that by hlaJherlthelr signatura(s) on the
instrUmBI1L the individual(S). or the p&1'8OI1 upon behalf of whldl I Instrument the individual(s), or the person upon behalf of whid1
the Indlvl~(.~ acted. execu~ the instrument. i the Indl .,1(8), acted execu d the Instrument_
-. - .~.. .-. .....- -- -..-,..-. It"
of individual18kfng acknDWledgment) .of.rndtvl ual taking:.cknowleclg~nt)
ABIGAIL A. WICKHAM '
Notary Public. StaiB of N_ York ABIGAIL A WICKHAM
No. 52-4642B71 . NOIBry Public. State of NBW York
Ouallfied in Suffolk CoUry.pP" No. 52~642871
CommisSion EJeQirftS SePt. 30. Oualified in Suffolk C"..ou!ll}' _ /'WooAC
Commission Expir..! Sept 30?~
TO BE USED ONLY WHEN THE ACKNOWLEoGMENT..IS MADE OUTSIDE NEW.YORK.STATE .7-'; .0.
j . -. ~ ... .-..
,
State (or Olatrict of Columbia. Territory, or FoAtign Country) of
County of
as:
On the
day of
. 11'11 the year 2002,
before me, the undersigned. personally appeared
personaltt known to me or proved to me on the basis of satisfac':Q'Y evidence to be the individual(s) whoae name(s) is (are)
subscribed to the within instrument and acknowledged 10 me thai heisb.elthey executed the same in hialherllheir cepacity(ies), and
d'lal by hi&lherllhelr signature(s) on the 'nsbUman., the individual(s), or :!"le person upon behalf of which the indlvlduales) acted,
executed the instrument. and that such indivfdual made such appearance before the underw.lgned In the
in
(and In88ft;the State or Country or other place the acknowledgment was taken)
(insert the City or other political subdivision)
(sign8lure and office of individual taking acknowMtdgement)
Notary PubliC
SECTiON
BLOCK
LOT
COUNTY OR TOWN
STREET ADDRESS
BARG,IUN AND SALE DEED
WITH CC)VENANT AGAINST GRANTOR'S ACTS
TltlB Ne..
[)JWID J. ZAZESKI & JEAN A. ZAZESKI
TO
ZAZESKlllVING TRUST
Re~datRequeslof
COMMONWEALTH LAND TillE INSURANCE COMPANY
BY
STAND,I,RQ FORM OF NEW YORK BOARD OF nn.E UNDER'-u I~
Distributed by
o Common~~~!~~".~,.",
C~t)IUSWI:.U:1 H I.ASU ....1"l.r.lsSl lRA.....("E C()\IPA....y
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Number of Pll&es
TORRENS
-3
RECORDED
2003 Seo 26 04,10:1: PM
Edward P.Ro~~in~
CLERK OF
SUFFOLK COllNTV
L 000012274
P 418
Onl 03-07960
Serfalll
Cartificah' II
Prior Ctf. II
. Deed I Mortgage In_t
::I:C
Daed I MoJ1&a8e Tax StOmp
PEES
R.oc:ording I PlIIna Stamps
Page I Filiina Fee
Handling
TP-584
Mortp&eAmt.
1. Basic Tax
2. Addldonal Tax
Sub Total
Notation
EA-52 17 (County)
EA.52l7 (State)
RP.T.S.A.
Comm. of Ed.
5 QQ....-
Spoc./Assit.
Or
Sp... I Add.
TOT. MTO. TAX
Dual Town Dual County_
Held for Apportionment
Traftsf\:r Tax - 0 -
Sub Total
~=
Affidavit
ORAND TOTAL
(,;1'1 /'
Mansion Tax
The proporty covered by this mortgage is.or
will be imprOved by a one or two fam it
dwelling o~ly.
YES or NO
(fNO. see appropriate tax clause on page:
of this 1DetrumeDt.
Certified Copy
Reg. ~opy
Other
S"b Total
Stamp
Real property Tax. Service As.erq Verification
Dlst. Seotlon B lock Lot
I
1000' 131100 0300 041000
I
-03
6' Communi Preservation Furid
Con..deratlon Amount S '-1}
:0::
Dele
CPF Tax Due
s ..u .
Initials
~lfaction~LI.J:JCn
Improved f>[.
Vacant Land
TO I. tf1JV
TO
TO
8 Title Company Informathm
Co. Name
Title #
=:r: Suffolk County Recording & Endorsement Page
"Ibis page forms part of the Ill:llIched Bargain and Sa1e Deed
..... '\II,....Ill'.._I...
.U.......... ..
~L'UUI .
'.. ~
made b;
TO
,
(SI'ECFY TIPE OF INSTIUJMENI')
Th.;premises herein is situated in
SUFFOLK COUNIY. NEW YORK.
In the Township of Southold
Dav1.d J. Zazesk:f.. & Jean A. Zaz:eski
Dav1.d. J. Zazeskf. &. Jean A. Za:r.esk1.JI as T'I'u~ees IntbeVILLAGE
",
of 't:he Zazesk:L Llv.1ng Trust or HAlviLET of
Mat:t1tuck
BOXES 51HRU 9 MUST BE TYPED ORPRINIED IN BLACK INK ONL YPRlOR TO RECORDING OR FILING.
. "
,
,
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1111111111111111111111111111111111111 11111 11111 11111111
I
111111111111111111111 I11I
SUPFOLK COUNTY CLERK
I
RECORDS OFFICE
RECORDING PAGE
Type of Instrument: DBEDS/DDD
Number of Pages: 3
TRANSFI~R TAX HUMBER: 03-07960
Recorded:
At:
LIBER:
PAGE:
09/26/2003
04:10:17 PM
D00012274
418
DAVID J ZAZESltI
ZAZESJ:I LIVING TRUST
District: Section: Block:
1000 139.00 , 03.00
EXAMINED AND CHARGED AS FOLLOWS
,
Deed ADKlunt: $0.00
Lot:
041.000
Received the Following Fees For Above Instrument
Exemp~ Exempt
Page/Fi.1ing $9.00 NO Handling $5.00 NO
COE $5.00 NO NYS SRCHG $15.00 NO
SA-CTY $5.00 NO SA-STATE $50.00 NO
TP-584 $5.00 NO Cert.Copies $0.00 NO
RPT $30.00 NO SCTM $0.00 NO
Transfe,r tax $0.00 NO Comm.Pres $0.00 NO
Fees Paid $124.00
TRANSFER. TAX NUMBER: 03-0796(1 !
THIS PAGE IS A PART. OF THE INSTRUMENT
THIS IS NOT A BILL
Edward P.Romaine
I
Count~ Clerk. Suffolk County
t-'LtA~t I yt-'t Ur-t t-'HtS~ t-IKML Y WHI::N WRITING UN fORM
INSTRUCTIONS: http://www.orps.state.ny.us or PHONE (518) 473~7222
FOR COUNTY USE ONLY
C1, SWIS Code
'~-3g
1 y, y, , ,~~-Z'J
REAL PROPERTY TRANSFER REPORT
*
RP-5217R", 3/n
STATE OF NEW YORK
STATE BOARD OF REAL PROPERTY SERVICES
C2. Date Deed Recorded
C? _/'
__ / ac"b / C::::;)1' I
Monlh Day Year
-71 'Sfl C4. Page l-L-. I <<./1 ~
RP - 5217
C3. ""ok I / ,~ ,,~
PROPERTY II\IFORMATION
1. Property i
Location.
..45
Conklin Road
____J
STREH\lIIMBER
S~HT\lAM[
~)outhold
r:rrVOA TOWN
Mattituck
11952
ZIF coo~
VlIAO(
2. Buyer
Name
L..ElaVid J. and Jean A.
IA$TNAME 'COMPANY
Zazeski~ as Trustee!:j of the Zazeski Living Trust
F1RSTNAMl
L
IASTf',AMEICOMF'ANY
~IRST NAMF
3 Tax
Billing
AddrltSliI
1~:liCiJte where futura Tax Bills are to be sent
if otrer than buyer address (at bottom of form I
L-
LA'rr I>4AME I COMPANY
FIRST NAME
L
STRHlr>.UMBERANDSTAEHNAlI.'E
.-.J
CITY OR TOWN
S"tATE
Z:PCODE
4. Indicate the l1umber of Assessment
Roll parcels tnmsferTsd on the deed
/ I # (.f Parcels OR D Port of a Parcel
[Only If Part of a Parcell Check as they apply:
4A. Planning Board with SubdiviSion ALlf)ody E)(i~ls
4.8. Subdivision Approval was Rcqu,red fer Transfer
4C. P~rccl Approved for Subdiv;sioll INitio ,,"'lao Prcvided
o
o
o
5. Deed
Property
Sil'e
..3~
xL.
..----....: OR l~---'-----.L
rrib-NTrfEl
J"FTH
ACRCS
6. Seller
Name
L Zazeski
tAS-:" 'lAMl'.ICOMPANY
David .J.
f'IRSI NAME
L Zazeski
IASTNAME/CQMPANV
Jean A.
FIIlSTNAME
7 Check the bOll balow which most accurately describes the use of the property at the time of sale:
Chack the boxes below as they apply.
8. Ownership Type is Condornirium
9. New Construction on Vacant Land
o
o
o
o
A~ One Family Residentia,
B 2or31'amily Residential
C Residential Vacant land
D Non-REsidential Vacant Land
I SALE INFORMJ~
11. Sale Contract Date
E~Agricultural
F Commerciai
G Apartment
H Entertainment l Amusement
~~
Community Service
Industrial
Pubiic Service
Forest
10A.
108.
Property located witrin an Agricultural District
Buyerreceivadadisclosurenoticeincicating
that the pmperty is;n an AgriC'Jltural District
15. Check one or more of these conditions es applicable to transfer:
L. I I
Month D., Year
"t I f'i,: I <23
Monlh D.' Yea,
Sale 6clweer' Relatives ur Furmer I~elariv(;"
Sale Between Related Companies or Partners in Business
O~e of the Buyers is also a Seller
Buyer or Seller is GovernmElnt Agency or Lnnding Institution
Deed Type not Warranty or Bargain and Sale (Specify Below)
Sale of Fractional or Less than F-ee Interest (Specify Below)
Significant Chal1ge in Property E3etwec~ Taxable STatu~ aod Sale Dates
Sale of BU5iness is Included in Sale Price
Other Unusual Factors Affecting Sulu Price (Specify Below)
None
B
C
D
E
F
G
H
I
J
~\loo.~1e
-hv.st-
12. Date of Sale I Transfer
,0 0,0 I
, , .
(Full Sale Price is the total amount paid for the property Includin~' persona property.
This payment r~ay ba in the form of cash, other property or goods, or the assumption of
mortgageF. or cther obligations.) Please round to the nearest whole dOllar amount.
13. Full Sale Pri~e
\""1^:-"~
-to
14. Indicate the IIlIlue of pe190nal
property included in th& sale
I ASSESSMENT INFORMATION.
; , ,O~ 0 01
Data should reflect the latHst Final Assessment Roll and Tax Bill
16. Year of ASSEWsmen1 Roll from I I.::J 2.J
wlllch Information taken 17.
,b I-LJ ,.
TolllI A~lJd Value (of all porcels In transfer) I
\ ck '
School DI~I,~ Name 1 f'l'a::*k rfv ~ ,?~L
--~-
5 (J<:j 0,
, .~
18. Property Clau
12, I
20. Tax Map Idartifier(s) f Roll Identifier!sl lIf more than four. attach sheet with additional k:lentlfl8t"(sll
1COO-139-3-41
~
L
I CERTIFICATIOI\~
J certify that all of the items of. infonnation entered on this form ace true and l;Qcrect (to fhe best of my knowledge wtd belief) and I understand that the making
of WIy willful raise statement of material fact herein will subjed me to the provisions of the penal law relative to the maJdng and nllng of false instruments.
n ,/) BUYER'S ATTORNEY
,\!//i...v S(.,.
avid J. Z
I
'7:/ D/C. 5
\\ickham
~;::J:'
J1l1...,^R.SG~"d't'eski~ T
(
-~.' - '." '.':
145
Conklin Road
63;
- ~ - - - ~ -
04~_",~ ,
-~~ ----
----.-
STAlE"t ,"UM8Lt<
::;-"On'.;...., '-'-,'9-
Hattituck
. "TIoe;o~
.,f ~y - J:u,.J?' SELLER
David J. a s~
~ ~" ~ ,~.
""'~. \..J' :-. '~oC.Jtr,
SELl.ERSIGIIlATIJRE ....
Jean A. Zazeski-
Xy
11952
STAT<
ZIPCOOE
NEW YORK STATE
COpy
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