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St8nderd N,V.B T.U. Form 8002 ~ s.rg.in and Sale Deed. with CowenIInt .g11ln.t G...nlol"s Ac:ts - Uniform Acknowtedgment
CONSULT YOUR lAWYER BEFORE SIGNiNG THIS INSTRUMeNT-THIS INSTRUMENT SHOULD BE USED BY LAWYERS ONLY
THIS INDENTURE, made the S""" day Df ~AH. ,- 4'-1-- , 2004
BElWEEN l '
FRANK D. DRIES, residing at 4655 MillingtDn Road. Clayton, Delaware and
WAYNE T. DRIES, residing at 1347 Aldrich Lane, Laurel, N_ YDrk
DOLORES D.IRVlN, residing at 1321 Dover Drive. Medina, OhiD,
and
FRANK D. DRIES, residing at 4655 Millington Road, ClaytDn, Delaware and
WAYNE T. DRIES, residing at 1347 Aldrich Lane. Laurel, N_ YDrk. as Tenants in CDmmDn
WITNESSETIl, th"t the party Df the filllt pari, In consideratiDn Df Ten (510.00) dDllars, and Dther good and
valuable consideration paid by the party Df the second part, does hereby grant and ....ease unto the party Df
, the second part, tha heilll Dr successors and assigns Df the party 01 the second parllorever.
All. that certain plot. piece Dr parcel 01 land, situate, lying and being at Mattltuck, In the Town 01 Southald,
County 01 SuffDlk and State 01 New York, a certain map termed SUbdlvlslan Map 01 Property owned by Abbie
G. Conklin situate In Matlliuck, SuffDlk County, New YDrk, based on actual surveys completed 3/6/1937, being
designated as Lot 113, IIIcx:k A Dn the abcM! described map bounded Dn the North by Pike Street, on the East
by Lat 114, on the South by Lot 1110 and on the west by Lot 112, being I1lDR! particularly described as fallows:
BEGINNNG at the northeasterly comer thereof which palnt is formed by the Intersection 01 the southerly line
01 Pike Street and the wcst.<.r1y line Df ather lands or the party 01 the first part, which palnt is distant 165.36
feet easterly measured alang the southerly side or Pike Street from a monument set at the nartheasterIy
comer Df land now or formerly 01 William V. Duryea; running thence In a southerIv directlDn the dlstllnce Df
260 feet to ather lands or the party or the first part; thence running In a generally westerly direction a
diStance 01 SO feet to ather lands Df the party or the first part; thence running In a generally northerly
direction a diStance or 260 feet to the southerly side or Pike Street,; thence running In a generally easterly
direction a diStance of SO feet along the SOUtherly'sIde 01 Pike Street to the paint Dr place 01 beginning.
RESERVING AND GRANTING to Hope J. Dries a ure Estate In the Premises.
SUBJECT TO covenants and restrld:lans Df record.
TOGETHER with all right IitIe and Interesl, if any. ilf the party 01 the rolllt parlin "and ID any s!reels and roads
abutting the abcM! described premises to the cen18r lines lhereoI; TOGETHER with the appurtenances and all
the eslale and rights Df the party 01 the filll' pari in and ID said premises: TO HAVE AND TO HOLD the
premises herein granted untD the party Df the second pari, the heilll Dr SUCC8SSDlS and assigns Df the party Df
the second pari forever.
AND the party Df the first pari CDvenants that the party Df the first pari has nDt dDne Dr sullered anVlhing
whereby the saki premises have been encumbered in any way whatever I except as aforesaid.
AND the party Df the filllt pari, in compliance with SectiDn 13 of the Lien Law, covenants that the party Df the
first pari will receive Ihe consideration for this convevance and will hold the right to receive such cansideratlDn
as a !rust fund to be applied first for the purpaae 01 paying the cast Df the Improvement and will apply the sama
first ID the payment 01 the cast Dr the improvement before using any pari 01 tha IDIaI Df the same for any Dther
purpose. 'The WDrd "party" shall be construed as if R read "parties" when _r the sense Df this indenture sa
requires.
IN WITNESS WHEREOF, the pal1y Df the first pari has duly executed this deed the day and year filllt above
written.
IN PRESENCE OF:
tVt~~b '- ~, .
Dolores D. Irvin
-;;:J~t/'
Frank . Dries
4J~ti! 1. a;."
Wayne T. Dries
.'
]0 BE USED ONLY WHEN THE ACKNOWl...~DGMENT IS MADE IN NEW YORK STATE
Stale of Uew York. County of SuffoJk sa:
On !he :rP;;., of .nJ.,"''''"-r-;in !he year 2004,
before me, the u~':l pej!lO~ apjJeared
':ii<<'" ~ iJjJ~ ,-4......
peraonall~ known to me or proved 10 me on Ul. basis of
satiofaClCry evidance 10 be \ha individual(o) _ nama(o) is
(are) aubacrtbed to the within instrument and ~owIedged to
me that helshellhey exea..1ed the same in h1a1herltheir
capacity(180), and l11li1 by hiolMrllhelr olgnatureCo) on \ha
inotrvmenl, thelndivid~1half 0Iwhic:h
the individual(.) .ded, ex .
"'~
(a;gnetuAl and office of indlvkl~edgmenl)
NoIary Public ....,1'UIlIIc;_0I...'lIIIIl
No. 1'1-4117D341
lIuolnlod In S_ Cllar!\r ,.-,
~ irpIno follnwJ'4;lO~ .
State 01 New YOIl<, County 01 SUlfolk u:
Onthe Gay~_~
before me, the J~nclerSiGned~y appeared
__ ~~J_4r;- ~
petOOnIIlIy k_ 10 me or proved to me on the _0 01
satiofactory evidence 10 be the Indiviclua~o) _ name(o) is
(ere) oubocrIbed 10 the within InOlJUmanl and _llCllModged 10
me that helshellhey executad the sama in hialherltheir
capecily(ieo), and thaI by hloll1erlthalr oIgnoture(o) on the
In.trumenl. the individuat(.), or the peI'8OI1 upon behalf of which
thelndM~7~monl
(olgnature lInd oIIIce 01 Individual laking acknowledgment)
aoor,t SImo..
NDlllryPull~c, SIotI 01 NIW'AlIIl
No. 3t-4970341
Qualified In Suffolk County
I:onIINIilon Expire. Fob","')' 4, 20..Q
TO BE uSeD ONLY WHEN THE ACKNOWLEDGMENT IS MADE OUTSIDE NEW YORK STATE
Stete (or IJistrict of Columbia, Territory. or Foreign CoWltly) of OHIO n:
On the ~11-1---'day of November In the yea' 2004 before me, the underaigned. person8ay BppeBred
DOWRES D. J:RVJ:N
personally known 10 ma or pnoved to me on the beal. 01 oatiefacloly evidence to be lhe Indivldual(o) who.. nama(o) is Care)
sub8crtbed to ttw within instrument and acknowledged to m. that helahelthey executed the ume in htalherltheir Cllpecity(iH). and
that by hlalhertlhair signature(o) on the inotrurnent, the Indlvldual(o), or the person upon behalf 01 which !he individual(.) .ctec:I,
executed the lnstroment" end that such Individual made such appearance bef'cM-. the undersigned in the
--Ir1QOIJU c..... in " h
(inaert the Cit~ Of other political subdivision) (end IMen the S\I1It or
I taking .ckr'lOWledgment)
.
ICAIlEN A. VETOVITZi-." _...... 01 0hJ0
.., Cl...... ---, ~, 141.aG05
BARGAIN AND SALE DEED
WITH COVENANT AGAINST GRANTOR'S ACTS
SECTION
BL::lCK
LOT
COUNTY OR TOWN
STREET ADDRESS
TItle N(lI.
Frank D. Dries., Wayne T. Dries &
0010res D. Irvj.n
TO
Formsldeeddries2
Frank D. Dr~es and Wayno T. DriQs
Recorded at Request of
COMMONWEALTH LAND TITLE INSURANCE COMPANY
ST~I'ORII OF ~YOIU( BOARDOP' nnEUNO..~A\.I_
D;olribuOBd by
o COmmOn~!~~t~,.,_".
W~cJduua, Bressler Gordon Ii Geas&, P.C
P.O. Box 1424
Mattituck, New York 11952
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Prior Ctf. H
\
RECOI1DED
2004 o.c 01 04:29.33 PH
Edward P. RaNine
ClERK OF
SlIFFOLK COOHT't
L ??oo12358
P 108
on 04-19293
Nwmheror~. ,
TORRENS
SerlalH_
Certificate #I
Deed I Mortpgo IDlIlIUIIIenl
Deed / Monpp TIx StUIp
FeES
ReconIIn& I FIlIna Stomps
::D
1'11&0 I Filing Fcc
Handling
TP-S84
Monao&. AmI.
5'
z;- _
I. SUic TIx
2. Additional Tax
R.P.T.S.A.
Comm. of Ed.
Affidavll
~-~-
~f
Sub Total
Noladon
EA-S2 17 (CowIly)
EA-S217(S_)
S <12..-
Spcc:JAssil.
Or
Spec./Add.
TOT. MTQ. TAX
Dual Town Dual Coonl)'_
Held ror Apportionment ~
Tronafer Tax /11 u --
Olhcr
I 5 =-. Sub TocaI
GRANtl TOTAL
/:2-.)
/L/q.-"jJ
Mansion Tax .
The propel1)' covered b)' Ibi. mongoge ill or
will be Improved b)' a on. or IWO famil)'
dwclllnloal)',
YES orNO_
If NO. - _rime lOX clauso on ~a.,~ HI
_oflbiliDsaumcDL I/o' -uy
6: Communi Preservation Fund
Con.ideration Amount S
Ccnifled CoPl'
Reg. Cop)'
S_
Dote
H
~_ Property Tax ~icc ~ V~fictllion
04051005 1000 14000 0300 01&000
0~
(R CFE A
~~
CPF Tax Duo
s
S
Improved
7
SatisfactiOllSlulO\,OlI4IPlllolAD1CllSOS LJlt noperty Uwnen Mai1inl
RECORD'" RETURN TO:
W~ckham. Bressler, Gordon & Geasa. P.C.
P.O. Box 1424
Matt.ituck, New York ~~952
acant Land
J~
lnitiala
TO
TO
TO
~
8 Title Company InCormation
Co. Name
Titlo#
Suffolk County Recording & Endorsement Page
1bis page forms plIrt of the nft""h"Cl
OE1<O
made by:
TO
(SPECIFY TYPE OF 1NSlRUMENT)
1'he premises herein Is situated in
SUFFOLK COUNIY. NEVfYORK. . '.# .
In the To....mp of ...5-o-t/-l;~ ,/
In the VILLAGE
or HAMLET of
Frank D. Dries
Wayne Ta Dries
n-.'Q-9'l7 n T-.iA
Frank D. Dries
Wayne T Dries
BOXES 5 nnw 9 MUST BE lYPED ORPRINIED IN BLACK INK ONLY PRIOR TO RECORDING OR FILING.
111111111111 11m III~ 11111111111111111111111111111111
I IUIII 11111 11111 11111111
suprOLlt COUNTY CLBRIC
RECORDS orFICE
RECORDING PAGE
Type of Inltrumsntl DBEDS/DDD
NUmber ()f Page. 1 3
Receipt NUmber 1 04-0131757
TRANSrBR TAX NUMBBR: 04-18293
Recorded I
Atl
12/01/2004
04129133 PM
LIBER:
PAGB:
D00012358
108
District: I Section I Block. Loti
1000 140.00 03.00 016.000
1l'''1lJII1lBD AND CIllRGBD AS FOLLOWS
Deed Amountl $25,000.00
Received the Following Fees For Above Instrument
Bx~t Bxlllllpt
Page/Piling $9.00 NO Handling $5.00 NO
COB $5.00 NO NYS SRCKG $15.00 NO
EA- en $5.00 NO IlA-STATE $75.00 NO
TP- 584 $5.00 NO Cert.Copies $0.00 NO
RPT $30.00 NO SCTM $0.00 NO
Transfer tax $100.00 NO CQIIIIII.Pres $0.00 NO
Pees Paid $249.00
TRANSPER TAX HOMBBR. 04-18293
THIS PAGB IS A PART OP THE INSTRmmNT
THIS IS NOT A BILL
Edward P.Romaine
County Clerk, Suffolk COunty
FOB COUNT'{ USE ONLY
r-U:A::1t: IVt-'!: UH PHl::::i::i t-IHMLV WHEN WRITING ON FORM
INSTRUCTIONS: htlp:// www.orps.stale.ny.us or PHONE 1518) 473-7222
REAL PROPERTY TRANSFER REPORT
C3. Book I
a
Lj, 1..3, g, g , 7 I
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*.........
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,
STATE Of NEW YORK
STATE BOAFlD OF REAL PROPERTY SERVICES
RP - 5217
RP-5217 Rev 3197
C:1. SWIS Coda
C2, Date Deed Recorded
PROPERTY INFORMATION
1, Property L-.!.440
Le,cltion STllHTNUMBE~
Pike .5treet
STREETNA'-'ii
Mattituck
-CTYO~TO""N
2. Buyer L__Dries
Nume LAST NAME: COM~ANY
L___Dries
LAST "JAM~ :GOM~1<NY
3_ T2<X
Billing
Addrll56
Indicatll where future Tax Bills are to be sent
if other than buyer addr8SS (at bottom of form) L
l.ASTNAME/CQMPANY
L-
STREU NUMBER ANO STREET NAME
4, Indicate the number of Auessment
Re,1l pa"*s transfelTed on the deed
LJ
If of Parcels
OR 0 Part of a Parcel
.~~
(Only H Part of a Pareel) Check .. they apply.
4A. Planning Board with Subdivision Authority Exists 0
4B. Subdivition Approval was Required for Transfer D
4C. Parcel Approved for Subdivision ....ith Map Provided 0
5.0tl8d
Pr,opllrty
Si.~e
L
fflONTF~n
Ix I
O.~TH
i OR I
6. Seller
N~.me
Dr-ies, Frank D.
~ries, Wav~e T. aHBxBxiKs~x>>B
LAST "JAM~ICOMPANY
~rvin
LAST NAME I COM~1<NI'
11952
YILLAG(
Zl~ GODE
Frank D.
FlflST N1<M~
Wayne T.
FIRSTNAN~
,IRSTNAM!
--!
CITY OR TOWN
STAn
ZlPCOOE
ACII!$
"RSTNAM~
Dolores D.
1 Check the box below which mOfl lIIGl:Urately descrlbelll the ....e of the property at the time of nle:
FIRST"N...ME
A~DneFamilYR6$idential
B 20r3FamllyAesidential
C Residentitll Vac:antland
D Non.ResidEntial Val<ant land
I SALE INFORMATION I
11. SlIle Contract Oiltll
E~A9ril<ultural
F Commercial
G Apartmerrr
H Entertainment I Aml,lS8mlll"lt
~~
/ Vear
Month "'"
11 05 / 2001
.."" Do, ,_.
12. Date of Sale J TrlllnRlIr
13. FuU S.lePrice , ,2,5~', 0. 0,0,0,01
, , .
IFull Sale Price Is the totel amount paid fo, the property i~ctuding personal property.
This payment may be in the form of cash, other property (lr goods. or the aAumptiOn of
mortgages or other obligations.) Plallse round to the nBarBst whol6 dollar amount_
14. lndicatll the yalUll of parRlnlll
plOperty included in 'the n'e
I ASSESSMENT INFORMATION
Community Service
Irtdustrial
Public Service
Forest
Check tl1ll box. below lIS thllY applv:
8. Ownerehip Type is Condominium
9. New ConBt:ruction on V"cant Land
10A. Property Located within an Agricultural District
1DB,Bl/'ferreceivedadiaclosUfenoticeindic8ting
thllltthe property is in an Agricultural District
o
o
o
o
15. Check one or more of 'these concIhlon. lIS epplicllble to transfer:
A
B
C
D
E
F
G
H
I
J
SlIle Between Relatives or Former Relatives
Sale Be'lvlleen Related Companies or Panneffl in Busin8S5
One of the 8uyers is also e Seller
Buyer or Seller is Government Agency or Lending Institution
Delld Type not Warranty or Bergaln and Sale (Specify Below)
Sale of Fractional or LIlss than Fee Interest {Specify Below)
Significant Cheng. In Propurty Between T8xable Status and Sale Date8
Salaof BuSin&sll is Included in 581e Price
Other Unusual Factors Affecting Sale Price (Specify Below)
None
, 0 , 0 I
, , .
" Data should reflect the latest Final Assessment Roll and Tax Bill
16, V..ar of Assessment Roll from
which information tlken
~
18. PropertyCJass
Id-.-l ,Ol-LJ
19. School Dlstriet Neme 1
17. Total ,bseued Value tof all pa"*s in transfer) 1
, ,
/'1rlhkL- ~-::6~/~
20. Tax Map ldentifllltls) J Rollldentifier(s) (If more than four. attach sheet with additionill identifierisJl
L 1000-140.00-03.00-016.000
L-...
---.J
~lFICATION
I cenify that ldI 01 the items of infonnadon entered on this fann are true and correct (to the best of my knowledp and beHeI) and I undenfand that tbe mllkina:
of any willful faIse statement of material tact herein will subject me to the Drovision$ of the oenaJ law reladve to the maUta and ftIIog of false inIIlnInmlt&.
BUYER'S ATTORNEY
~~:;;~
l~i"'lot/
oon
,I "fc./ D _ I f!., lu 5:;"""
-:VTREET NUMBE~ " S1'REET NAME IAFTER SAL61
?y".hJ" )\~.
Dolores D. Ir n
I
+ /fIa/l-h" 1:..
/I/l-t J1tfQ
STATE~
SELLER
-SELLE~SIGNATURE
1-111";-ID'I
oon
Wickham, Bressler, Gordon & Geasa, P.C.
Wickham
LASTN~E
Abiqai1 A~_
FIRST NAMe
631 298-8353
ARE1<COllf. Tnl'PHONENUMIIER
(NEW YORK STATE
I COpy
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