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T 691-SlandardN,Y,BTU. Form 8002: Bar~ajn&sah,decd.
~/ithcovcnanlagajnstgranlor'sacls~lnd_orCorp.:singJc.\hcet.11.911
DISTRIBUTED BY BlumbergE,.xcelslor, Inc..
NYC 10013
CONSULT YOUR LAWYER BEfORE SIGNING THIS INSTRUMENT - THIS INSTRUMENT SHOULD BE USED BY LAWYERS ONLY
9 ,j
, day of. ;VIa y
BETWEEN WARREN W. JACKSON and MARY A. JACKSON,
300 Deep Hole Drive, Mattituck, NY 11952.
THIS INDENTURE, made on
in the year
his wife, both residing at,
206! .
the
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party of thefiratpart, and WARREN W. JACKSON REVOCABLE TRUST, Warren W. Jackson and Mary A.
Jackson as Co-Trustees, both residing.at 300 Deep Hole Drive, Mattituck, NY 11952.
party of the second par~
WITNESSETH, that the party of the first part, in consideration of Ten Dollars and other valuable consideration
paid by the party of the second p.rt, does hereby grant and release unto the party of the second part, the heirS
or successors aod assigns of, the party of the second part forever,
ALL that certain plot, piece or parcel of land. with the huildings and improvements thereon erected. situate,
Iyin~ and being in the
See Schedule "A" hereto attached and made apart hereof.
TOGETHEH with all right. title and interest, if any. 01 the part} of the firs.1 part in and to any ~trcct~ and
road~ abutting the ahove described premises to tilt' cculer lille~ tlll'l"eof; TOGETHEH with the appurtenance~
and all the e.t.te a",1 ri~hls 01 the party 01 the first part in and to .aid premises; TO HAVE AND TO HOLD
the premises herein granted unto the party of the ~ecolHl part. the heir~ or successors and assip.ns of the parl~ of
Ihe second pari forever.
AND the party of the first part covenants that the party of tht' fir~t part has not 0011(' or ~uffen>d anythill~ wlH'n'hv
the said premises have heen encumbered in any way whatever, except as aforesaid.
AND the party of the first part, in compliance with Section 13 of the Lien La",., covenanL..:; that the party of the first
part will receive the consideration for this c:onveyance and will hold the right to receive such considt'ration as a
trust fund to be applied first for the purpose of paying the co~t (If tilt" impruvclUcllt <lnd will apply the :;ame first to
the payment of the cost of the improvement before using any part of the total of the 5ame for any other purpose.
The word "party" $hall he construed as if it read "parties" whenever the ...ense of thi!'i indenture so requires.
IN WITNESS WHEREOF, Ihe party of the fir!'t part ha.. dlJl~ t'xf'cuted thi~ deed tht, da~ and yen!" first ahove
written.
IN PRESENU; OF:
tt.)CI~~~~
WARREN W. JAC ON
lJ~y\ ~!J S1c~~~' {,c' (r-1U
~~
SCHEDULE "A"
ALL that certain plot, piece, or parcel of land, with the buildings and improvements
thereon erected, situate, lying and being in the Town of Southold, at Mattituck, County of.
Suffolk and state of New York, bonded and described as follows:
BEGINNING at a point on the westerly side of Deep Hole Drive, said point being distant
264.28 feet southerly from New Suffolk Avenue; Thence along the westerly side of Deep
Hole Drive, south 2 degrees 40 minutes 40 seconds west, 150.00 feet to lands now or
formerly of Turchiano; Thence along said lands north 87 degrees 19 minutes, 20 scconds
west, 238 feet more or less to Deep Hole Creek; Thence along Deep Hole Creek north 6
degrees 6 minutes 40 seconds east, 150.27 feet to land now or formerly of Edgett; Thcnce
along said lands south 87 degrees 19 minutes 20 seconds east, 229 feet more or less to the
westerly side of Deep Hole Drive, the point or place of beginning.
SAID PREMISES also known as 300 Deep Hole Drive, Mattituck, NY 11952.
BEING AND INTENDED to be the same premises conveyed to the party of the first part
by deed dated August 18, 1995, and recorded in the Queens County Clcrk's Office on
August 18, 1995, in Libel' 11739, page 613.
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Number of pages
TORRENS
Serial H
Certificate H
Prior etf. H
Deed i Mortgage Instrument
Deed / Mortgage Tax Stamp
4
FEES
Page / Filing Fee
I.J- --
5'-
Handling
TP-584
--- ----
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Notali'on
EA-52 17 (County)
5-
dS--
-+S=-
Sub Total
,;)1-
EA-5217 (State)
R.P.T.S.A.
Comm. of Ed.
5_0~
Arridavil
Certified Copy
Reg. Copy
Sub Tolal
Other
GRAND TOTAL
Real Property Tax Service Agency Verification
Ois!. Section D lock
Lot
507..)
'6J(JPO
ZCJU
00 (0)
Satisfactions/Discharges/Releases List Property Owners Mailing Address
RECORD & RETURN TO:
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RECOP[)E[)
2001 ~i-~ld 1.1. 02: 14~ 34 r.:'1'1
Ed!..,L3rd Po RomainE'
CLERf::: OF
SUFFOLK COUtH'/
L [:{I00121.1':::
P JA7
DT# 00-3751.0
Recording / Filing Stamps
Mortgage Am!.
I. Dasic Tax
2. Additional Tax
Sub Tolal
Spec.lAssil.
Or
Spec. I Add,
TOT. MTG. TAX
Transfer Tax
Mansion Tax
The property covered by this mortgage is {Jr
will be Improved by a one or two family
~cllin!\"only.
o YES orNO
If NO, see appropriate lax clause on page H
of this instrumenl.
6 Community Preservation Fund
Consideration Atll0unt $
CPF Tax Due
$
Improved
Vacant Land
TO
TD
TO
Title Company Information
V.47'/c///h1? /,4",,;<) /Z.ry'<7~
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& Endorsement Pa e
llis page fomlS part of the allached
M /lJ. a (SPECIFY TYPE OF INS'ffiUMENr)
Wt/'~ CY' ~ // ,~_ 111e premises herein is situated in
-----/,L- SUFFOLK COUNTY, NEW JORK.., '--/- 'd
In the Township of ~
/
8
Title #
9
Suffolk Count
Recordin
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~T~
ILl.
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In the VILLAGE .,.
orHAMLETof~~0~
r
made by:
BOXES 5 llIRU 9 MUST BE TYPED OR PRINTED IN BLACK INK ONLY PRIOR TO RECORDING OR FILING.
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111111111111111111111111111111111111111111111111111 1111
1111111111111111111111111
SUFFOLK COUNTY CLERK
RECORDS OFFICE
RECORDING PAGE
Type of Instrument: DEEDS/DDD
Number of Pages: 4
TRANSFER TAX NUMBER: 00-37510
Recorded:
At:
LIBER:
PAGE:
05/11/2001
02:14:34 PM
D00012118
147
District:
1000
Section:
115.00
EXAMINED AND
$0.00
Block:
12.00
CHARGED AS
Lot:
004.000
FOLLOWS
Deed Amount:
Received the Following Fees For Above Instrument
Exempt Exempt
Page/Filing $12.00 NO Handling $5.00 NO
COE $5.00 NO EA-CTY $5.00 NO
EA-STATE $25.00 NO TP-584 $5.00 NO
Cert.Copies $0.00 NO RPT $15.00 NO
SCTM $0.00 NO Transfer tax $0.00 NO
Comm.Pres $0.00 NO
Fees Paid $72.00
TRANSFER TAX NUMBER: 00-37510
THIS PAGE IS A PART OF THE INSTRUMENT
Edward P.Romaine
County Clerk, Suffolk County
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PLEASE TYPE OR PRESS FIRMLY WHEN WRITING ON FORM
INSTRUCT1Oj\lS: http:// www.orps.state.ny.us or PHONE (518) 473.7222
1. Prop~rty I
Location
)C'O
I'll
1':(''"'\) r\(k
ST1lEETNAME
STREET NUMBER
Hili I ti 'i L
CITY OR TOWN
2. Buyer
Name
on
,.
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~
)
REAL PROPERTY TRANSFER REPORT
STATE OF NEW YORK
STATE BOARD OF REAL PROPERTY SERVICES
RP - 5217
RP-5217 Rev 3/97
i IS}
ZIP CODE
lOll (C'
LAST NAME I COMPANY
FIRST NAME
3. Tax Indicate where future Tax Bills are to be sent
Billing if other than buyer address (at bottom of form)
Address
LAST NAME I COMPANY
FIRST NAME
STREET NUMBER AND STREET NAME
CITY OR TOWN
4. Indicate the number of Assessment
Roll parcels transferred on the deed
j I # of Parcels OR 0 Part of a Parcel
ii) .;'.' ,1/'
,I" /4'Af';,(f7""'..;" d!.
FRONT FEET DEPTH
~
. Size --,y
lOR 1
'ACRES'
.
'\,/(')rt)
LAST NAME I COMPANY
I \VCI I Ie n
FIRST NAME
6. SeUer
Name
!I i I<)l' I i
LAST NAME I COMPANY
1 ~1Cl tit
FIRSTNA E
7. Check 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 Land
E~ Agricultural
F Commercial
G Apartment
H Entertainment / Amusement
~~
Community Service
Industrial
Public Service
Forest
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. 15. Ch
'PI
B
c
D
E
F
G
H
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J
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Year
,
I
t
Month
D',
I
12. Date of Sale / Transfer
~
Month Day Year
13. Full Sale Price , , , 0 , 0 I
, , 0
{Full Sale Price is the total amount paid for the property including personal property.
This payment may be in the form of cash, other property or goods, or the assumption of
mortgages or other obligations.) Please round to the nearest whole dollar amount.
14.
o
0,01
1~ear of Assessment Roll from
which information taken
.)-:/.) I 17. Total Assessed Value 'of all par-cels in transferl
18. Property Class
.,;, I, Ol-LJ 19. School District Nome 1 H (I ti 1 t I J( I<.
20. Tax Map Identifierfsl / RoUldentifierlsl (H more than four, attach sheet with additionalidentifier(sll
I. Ie::. ,- , ()()
( i(}() .- i ) I ) () - ! I ,
Dif 00d) 1
STATE
ZlPCOOE
IOnly if Part of a Parcell Check as they apply:
4A. Planning Board with Subdivision Authority Exists 0
48. Subdivision Approval was Required for Transfer 0
4C. Parcel Approved for Subdivision with Map Provided 0
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Check the boxes below as they apply:
8. Ownership Type is Condominium
9. New Construction on Vacant Land
10A. Property Located within an Agricultural District
10B. Buyer received a disclosure notice indicating
that the property is in an Agricultural District
o
o
o
o
k one o~;_~T ~~ these ~on~,ns as applicable to J.ransfer:
S~le B~een Relftives 'or Fg~mer Refatives ~ '
Sale Between Related Companies or Partners in Business
One of the Buyers is also a Seller
Buyer or Seller is Government Agency or Lending Institution
Deed Type not Warranty or Bargain and Sale (Specify Below)
Sale 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 Price (Specify Below)
None
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I certify that all of the items of information entered on this form are true and correct (to the. best of my knowledge and belief) and I understand that the making
of any willful false statement of material fact herein will subject ~ to the provisions of the penal law relative to the making and filing of false instruments.
BUYER
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BUYER SIGNATURE ' .
5/dOf
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LAST NAME
..~
DATE
f!t1';;1~i
STREE: ,- UMBER
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STffEET NAME (AFTER SALEI
151
AREACOOE
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If Ii r.
Vi
STATE
I i I"))
ZIP CODE
CITY OR TOWN
SEllER
1/'1/( t,/
sf, 01
//?,~
SELLER SIGNATURE DATE
, '-... ..~,'.,
BUYER'S ATTORNEY
iI."' t)(
FIRST NAME
II
)3)14'50
TELEPHONE NUMBER
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