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Standard N.Y.a.T.U. form 8002-20M-Bargain and Sale Deed with Covenants against Gmntor's Acts
CONSULT YOUR LAWYER BEFORE SIGNING THIS INSTRUMENT-THIS INSTRUMENT SHOULD BE USED BY LAWYERS
ONLY.
THIS INDENTURE, made th/p~ay of~~sand and two
BETWEEN
GARY D. SMITH, residing at
And DANIELLE MARIE SMITH, his wife, residing at 15 Hildreth Road
Hampton Bays, New York 11946
party of the first part, and
DANIELLE MARIE REMPE-SMITH, 1'5 Hildreth Road,
Hampton Bays, New York 11946
party of the second part,
WITNESSETH, that the party of the first part, in consideration of ten dollars and other valuable consllderation
paid by the party of the second party, does hereby grant and release unto the party of the second part, the heirs or
successors and assigns of the party of the second part forever,
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, County of Suffolk and State of New York, being bounded and described as
follows:
SEE ANNEXED SCHEDULE A DESCRIPTION
BEING AND INTENDED TO BE the same premises conveyed to the party of the first part herein by deed from
Kim Elizabeth Diefendorf dated 3/9/0 I and recorded 2/24/0 I in the Office of the Clerk of the County of Suffolk in
Liber 12104 page 123,
TOGETHER with all right, title and interest, if any, of the party of the party of the first part in and to any streets
and roads abutting the above described premises to the center lines thereof; TOGETHERwith th" ,apJlurt~nances
amtallthe estat'!. anqrightsoftho party. of the first part in and to said premises; TO HAVE ,AND TO HOLD the
premises herein granted unto"the party of the second part, the heirs or successors and assigris of the party of the
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second:p,artforever. l" ,.,' '~, ,
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AND the party of the first part covenants that the party of the first part has not done or suffered anything whereby
the said premises have been encumbered in any way whatever, except as aforesaid.
AND the party of the first part, in compliance with Section 13 of the Lien law, covenants that the party of the first
part will receive the consideration for this conveyance and will hold the right to receive such consideration as a
trust fund to be applied first 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 total of the same for any other purpose.
The word "party" shall be construed as if it read "parties" whenever the sense of this indenture so requires.
IN WITNESS WHEREOF, the party of the first part has duly executed this deed the day and year first above
written.
IN PRESENCE OF:
'it
Fidelity National Title Insurance Company of New York
TITLE NO. 00-3704-31189.SUFF
SCHEDULE A-I (Descriptioll)
ALL that certain plot, piece or parcel of land, situate, lying and being in the Town of Southold, County of Suffolk and
State of New York, being known and designated as Lot # 1 on a certain map entitled, "Subdivision Map of Kouros Acres",
which said map was filed in the Office of the Clerk of the County of Suffolk as Map No. 6692 on June 20, 1978.
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Number of pages
TORRENS
RECOPDED
....:uu.... F eb 0::: 11: 02: :'!,f:; Rt'1
Edl...L~(d P.Romaine
CLEi':K OF
~;UFFOU< COUNT\'
L D0001216:3
P ::'01
DT# 01-26021
Serial #
Certificate #
Prior Clf. #
Deed / Mortgage Instrument
Deed / Mortgage Tax Stamp
Recording / Filing Stamps
2]
FEES
Page / Filing Fee
Iv
t-
r
Mortgage Amt.
Handling
TP-584
I. Basic Tax
2. Additional Tax
Notation
RP.T.S.A.
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---
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---
Sub Total
.J-(
Sub Total
EA-52 17 (County)
EA-5217 (State)
Comm. of Ed.
50~
Spec.lAssit.
Or
Spec. / Add.
Certified Copy
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TOT. MTG. TAX
Dual Town Dual County
Held for Apportionment -'
Transfer Tax .f!!!!l'
,
Affidavit
Sub Total
&/f
9/
,
Mansion Tax
The property covered by this mortgage is or
will be improved by a one or two family
dwelling only.
YES or NO
If NO, see appropriate tax clause on page #
of this instrument.
Reg. Copy
Other
GRAND TOTAL
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Real Property Tax Service Agency Verification
Dist. Section Block
Lot
6 Community Preservation Fund
Consideration Amount $ -0-
1000
117.00
06.00
016.002
CPF Tax Due
$ -0-
Satisfactions/Discharges/Releases List Property Owners Mailing Address
RECORD & RETURN TO:
,/
Improved
Vacant Land ~
Deborah Kooperstein, Esq.
45 Hampton Road
Southampton, N.Y. 11968
9
8 Title Company Information
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Title # f:)ler it'S # CO 9 t)OC)S
Suffolk Count T Recordin & Endorsement Pa e
This page fonus part ofthe attached
Deed
(SPECIFY TYPE OF INSTRUMENT )
made by:
GARY D. SMITH
DANIELLE MARIE SMITH
The premises herein is situated in
SUFFOLK COUN1Y, NEW YORK.
TO /?eM(f?, -.sM.,~
DANIELLE MARI~U'l'II
In the Township of Southold
In the VILLAGE
or HAMLET of New Suffolk
130XES 5 ll{RU 9 MUST BE TYPED OR PRINTED IN BLACK INK ONLY PRIOR TO RECORDING OR FILING.
(OVER)
.
111111I11111111111111I111111111111111111111111111111111
1111111111111111111111111
SUFFOLK COUNTY CLERK
RECORDS OFFICE
RECORDING PAGE
Type of Instrument: DEEDS/DDD
Number of Pages: 4
TRANSFER TAX NUMBER: 01-26021
Recorded:
At:
LIBER:
PAGE:
District:
1000
Section: Block:
117.00 06.00
EXAMINED AND CHARGED AS FOLLOWS
$0.00
Deed Amount:
Received the Following Fees For
Above Instrument
Exempt
NO Handling
NO EA-CTY
NO TP-584
NO RPT
NO Transfer tax
NO
Fees Paid
Page/Filing
COE
EA-STATE
Cert.Copies
SCTM
Comm.Pres
$12.00
$5.00
$25.00
$4.00
$0.00
$0.00
TRANSFER TAX NUMBER: 01-26021
THIS PAGE IS A PART OF THE INSTRUMENT
Edward P.Romaine
County Clerk, Suffolk County
02/08/2002
11:02:38 AM
000012168
301
Lot:
016.002
$5.00
$5.00
$5.00
$30.00
$0.00
$91.00
Exempt
NO
NO
NO
NO
NO
PLEASE TYPE OR PRESS FIRMLY WHEN WRITING ON FORM
INST~UCTIONS: http://www.orps.state.ny.us or PHONE (518) 473-7222
FOR COUNTY USE ONLY
C1.SWIS CoM I Y ,7., P $ "l~ ;~j :
C2. Date Deed ft8CDl'ded I ~ / ,;. .
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REAL PROPERTY TRANSFER REPORT(
STATE OF NEW YORK j
STATE BOARD OF REAL PROPERTY SERVICES
RP - 5217
RP-S217 Rev 3197
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Loc.,.on I .>T:~:' ~!'"
~"\'~TOWN
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LA T :AME I COMPANY
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STREET NAME
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2. Buyer
Name
K e TY\ {2e - S"", +h
L-
LAST NAME I COMPANY
FIRST NAME
3. Tax
Billing
Address
Indicate where future Tax Bills are to be sent I
if other than buyer address (at bottom of form) L-
..AST NAME! COMPANY
FIRST NAME
L-
STREET NUMBER AND STREET NAME
CITY .OR TOWN
ST~TE
ZIP CODE
4. Indicate the number of Assessment
Roll parcels transferred on the deed
1/ of Parcels
OR 0
(Only if Part of a Parcel) Check as they apply:
Part of a Parcel
5. Deed
Property
Size
L
FRONT FEET
Ixl
DEPTH
lOR I
'ACRES'
ql
. ,
4A. Planning Board with Subdivision Authority Exists
48. Subdivision Approval was Required for Transfer
4C. Parcel Approved for Subdivision with Map Provided
D
D
D
6. Seller
Name
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LAST N~ME I COMPANY
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FIRST NAME ') ,
I ~Cl \~ ,Q \\/
FIRST NAME
L)\ .,', ,~"
LAST NAME I COMPANY
A ~ One Family Residential
B 2 or 3 Family Residential
C Residential Vacant Land
D Non-Residential Vacant Land
~~
Agricultural
Commercial
Apartment
Entertainment I Amusement
I ~ Community Service
J Industrial
K Public Service
L Forest
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
108. Buyer received a disclosure notice indicating
that the property is in an Agricultural District
D
D
D
D
7. Check the box below which most accurately describes tho use of the property at the time of sale:
SALE INFORMATION
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Month Year
;).. / ~, / (') ;+ I
Month Oe,y Year
15. Check one or more of these conditions as applicable to transfer:
11. Sale Contract Date
A
B
C
D
E
F
G
H
I
J
Sale Between Relatives or Former Relatives"
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
12. Date of Sale I Transfer
13. Full Sale Price , , - () -;- , 0 , 0 I
, , .
(Full Sale Price is the total amount paid for the property induding 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. Indicate t.he value ~ personal j , -, (.l. -, I 0 , 0 I
property Included In the sale, , - .
I ASSE5SW:NTINl'ORMATldN - Oats ehpuld- re~~ ,he latllJ'1'il\l1! Ae_1l<>i1 ~ Till( Bill 1
16. Year of Assessment Roll from Q; I
which information taken
,0~
17. Total Assessed Value (of all parcels in transfer) I
/ / 7 - ~ - / G, ;).
18. Property Class
aJ12.J-LJ
19. School District Name I
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20. Tax Map ldentifier(sll Rollldentifier(slltf more than four, attach sheet with additionalldentifier(sll
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I certify that all of the items of infon:nation entered on this fonn are true and correct (to the best of my knowledge and belief) and I understand that the making
of any willful faIse'statement of material fact herein will subject me to the orovisions of the oenallaw relative to the making and filing of faIse instruments.
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R SIGNATURE I -
BUYER'S ATTORNEY
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FlRSTNAME
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STREET NUM8ER
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. STREET NAME ( SALE)
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SELLER
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ZIP CODE .
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V CITY 0 ' WN
CITyrrOwN ASSESSOR
COPY
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