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cor;SUL T YOIJR LA WYER DEFl)RI~ SIGI'ISG TIllS INSTRUMENT . TIIL~ IS!>TRUME"'T SIIOULD BE USED B" LA W\'ERS Or;L y,
THIS INDENTURE, malk this 'Z.V day of
1II~U1
, two thousand and four
BETWEEN
JONATUAN GILSO~ & REGINA EBEL-GILSON.
being married to "'Beh other, residing at
310 East 4611I Street, Suite 23H
New York, NY 10017
pany of the tirst part, and
AI JTWfl.~s.
MICHELLI-: ADAMS & LAURA NELSE} residing at
214 Park Place, #3, Brooklyn. NY 11238
party of the second part,
WITNESSETH, that the party of the first part, in con~ideration of len dollars and other valuable
consideration paid by the parI)' of the second pan, does hereby grant and release unto the party of the
second part, the heirs or sUI:cessors and assigns of the party of the second part forever,
AU, that certain plot. piece, or parcel of land. with the buildings and improvements thereon erected.
situate. lying and being at
SUE SCHEDULE "A" ANNEXED HERETO.
BEING AND INTENDED TO BE the same premises described in the deed of tile parties of the first
part herein by dCt.'d. dated Jluly 2, :!O02. recorded in the Suffolk Cuunty Clerk's Office on July 16,
2002. in Liber 12197, Page 664.
TOGETHER with all right.. title and interest. if any, of the party of the first par[ in and to any streets
and roads abutting the abovc described premises to the center lines thereof; TOGETHER with the
appurtenances, and also all '[he estltc and rights of the party of the first part in and to said premises;
TO HAVE AND TO HOLD the prcmises herein granted unto the party of the second pari, the heirs
or successors and assign~ olr the parI}' of the second part forever.
A1'I,'D the pany of the tirst pan 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. exccpt as aforesaid.
AND the party of the first Ilan. in compliance with Section 13 of the Lien Law. covenants tbatthe
parI)' of the tirst part will receive the consideration for this conveyance and will hold the right to
receive such consider.llion as a trust fund to be applied first for the purpose of paying the cost of the
improvement and will apply the same flfStto tbe payment of the cost of improvement before using any
pan of tbe total of the same for any other purpose.
The word "parI)'" shall be l:onslrul.'lI as if it read "parties" whenever the sense of this indenture so
requires.
IN WITNESS WHEREOF, the party of the first pan has duly execuled this lk:cd tht: day and yt:ar
first above written.
IN PRESENCE OF:
JONATHAri GILSON
BEL-GILSON
STATEOFNEW~p~K,COUNTYOF J 10 58:
On the O1day of Mb /1;, in the year 2004. before me. the undersigned. a NOlary
Public in and for said State, nally appeared JONATHAN GILSON personally known to me or
proved to me on the basis 0 satisfactory ev' to be the individual(s) whose name(s) is (are)
subscribed to the within ins ment and nowle ed 10 me that he/she/they executed same in
his/her/their capacity(ies), al I by hislh r/th ir si re(s) on the instrument, the individual(s),
or the person upon behalf of whl e indi id . (s) ac . xecuted the instrument.
* 1l0ELIAPO'WELL
llOTAIlY PUBLIC
ITATE OF HE'W YORK
IPO'06B:r67
111"-'-'-, Expires l~o..mllcr
AJ l
ture and office of the person taking acknowledgment)
On the!:l-i day of in the year 2004, before me. the undersigned, a Notary
Public in and for said Slate, pe nally appeared REGINA EUEL-GILSON personally known to me
or proved to me on the basis of satisfactory evidence to be the individual(s) whose name(s) is (are)
subscribed to the within insuu lent and acknowledged to me Iliat he/shC'/thC'y execuled same in
his/her/rheir capacity(ics), aind I I by hislhe their signature(s) on rhe instrument. Ihe individual(s).
or the person upon behalf of whi the indivi al' ct ,e uted the instrument.
hW\~D
SS:
turC' and office of the person laking acknowledgment)
f.<l-- e.. h>
-z~rl,"i (;.?Jel"...a..~1 ~ .
I S" C/art. 5t.
~~('1"1 rn 11).0/
* 1l0ELIAPOWELl.
I IIOTAIlY PUBLIC
, IT/irE OF HEW YORK.
lPOl068767
Y,ClamiJl",OElpirc'NoVCmb<rJ .
.
TltlEI Number: MOO-S.77221L 3127722
Schedule A
District 1000 Section 110.00 Block 08.00 Lot 012.000
ALL that certain plot, piece or parcel of land, situate, lying and being at New
Suffolk, Town of Southold, County of Suffolk and State of New Yorl<, bounded
and described as follows:
BEGINNING at a point on the northerly side of Oak Street, said point being
147.26 feet westeriy as mei~sured along the northerly side of Oak Street from its
intersection with the westerlly line of New Suffolk Road;
RUNNING THENCE along Ithe northerly side of Oak Street, North 73 degrees 21
minutes 00 seconds West, '150.00 feet to land now or formeriy of Grathwohl;
THENCE along said lands North 16 degrees 39 minutes 00 seconds East,
150.00 feet to land now ortormerly of Majewski;
THENCE along said lands South 73 degrees 21 minutes 00 seconds East,
150.00 feet to land now or tormerly of Donoghue;
THENCE along said lands ~lnd lands now or furmeriy of Orio\Y.ski South 16
degrees 39 minutes 00 seccmds West, 150.00 feet to the northerly side of Oak
Street at the point or place ()f BEGINNING.
.. . . . -..
C!::2
Number of pagn
TORRENS
Prior ar. N
RErolOEO
2004 Ap' 13 02.41,16 ~
Edward P. ROllaine
CLERK OF
SUFFOLK COUNTY
L 000012313
P 368
on 03-38345
Serial U
Certificate #I _
'f
DL"t.-d / Mortgage Instrument
Deed I Mortgase Tax Stamp
FEES
ReconJing I Filing Slamps
::0
Page I Filing t:ce
1:2
5
S-
Mortgage Alnt.
llandling
TP-S84
1. Basic Tax
2. Additional Tax
Notation
Sub Total
R.P.T.S.A.
_-----5 _
~(1)_
iJo-
SubTollIl
;:17
F..A-S2 17 (Cullnly)
EA-S217 (Slale)
Reg. Copy
IS
Sub Total
/IV
1;)7 ic!.
Spec j Assit.
0.
Spec.fAdeI.
TOT. MTG. TAX
Dual TOWR_ Dual Cuunty_
Held for Apportionmenl _
Transfer Tax I ~ --
Mansion Tax
The property covered by this ~~rtgagC' is or
will be improved by a one or two family
dwelling only. ,./"""
YES_or NO_
If NO. see appropriate tax clause on page II
_oflhis instrument.
mW
Comm. of &1.
S~
Affidavit
Ct."I1.if"ted Copy
Other
GRAND TOTAL
I
Real Property Tax Service A~ency Verification
. I n 1__'.
S18mp
04015325 1000 110'00 0800 012000
0~~
~. DTY "'A
12-APR
--
_. _0.
6 Comnluni
Consideration Arnounl $
I
:0
I
CPF Tax Due
$
,,,,,, -
Dale
Improved
,/'
Initials ___._1_ _. .
7 Satisfacti~)nslDischarges/H.eleases Lb;t Propl=rly Owners Mailing Addn:s
RY-CORD '" RETURI~ TO:
L.erl,.:.e.. Cz:.6.;{"'<:(:", ~.
15 CA a..r "-- 2m c..J
%>ra:>o-Ll'tt'\ IN. Y. 11.:lD I
Vacalll Larid
TO 10
TD
TD
=:J
8 Title Company Information
n lC"e.s
Tille" 7:
Suffolk County Recording & Endorsement Page
lbis roge fonTIS part of \he Illlachcd b....... d
(SPECIFY TYPI:i OF INSlRUMENf )
.J(;neL tha (l a; bt:>n l1tc premises herein is situated in
R~(jl ;'a..... e:b~..I- GiA50n SUFFOLKCOUNIY. NEW YORK..
TO In the Township of ~DicL
~, Oda",.;" In the VILI.AGE
~ ~se'l or HAMLET of No.u 3~
BOXES 5 nlRu 9 MUST BE TIPEI> OR PIl~Nn:;U IN BLACK INK ONLY PRIOR TO RECORDING OR FII.Ir-..'G.
(OVER)
made by:
11111111111111111 111111111111111 11111 111111111111111111
1111111111111111111111111
SUFFOLK COtJNTY CLERK
RECORDS OFFICE
RECORDING PAGE
Type of Instrument: DEIDS/DDI)
Number lIf Pages: 4
Receipt Number : 04-0042212
TRANSFJ~R TAX NUMBER: 03-:l8345
Recorded I
At:
04/13/2004
02:41:16 PM
LIBER:
PAGE:
D00012313
368
JONATHAlr GILSON
MICHELLII ADAMS
District: :
1000
Section: Block I
110.00 08.00
EXAMIlllBD AND CHARGED AS POLLOWS
$460,000.00
Lot:
012.000
Deed Amclunt:
Received the pollowing Pees I'or Above Instrument
Exempt
NO
NO
NO
NO
NO
NO
page/PHing
COE
BA- CTY
TP-584
RPT
Transfelr tax
$12.00
$5.00
$5.00
$5.00
$30.00
$1,840.00
Handling
NYS SRCHG
lA-STATE
Cert.Copies
SCTM
COIIIIII.Pres
Fees Paid
$5.00
$15.00
$50.00
$0.00
$0.00
$6,200.00
$8,167.00
Exempt
NO
NO
NO
NO
NO
NO
TRANSFBIl: TAX NUMBER: 03-38345i
THIS PAGB: IS A PART OF THE INSTRtlMBNT
THIS IS NOT A BILL
Edward P.Romaine
County Clerk, Suffolk County
PLEASE TYPE OR PRESS FIRMLY WHEN WRITING ON FORM
INSTRUCTIONS: hltp:/1 www.orps.state.ny.us or PHONE (5181 473-7222
FOR COUNTY USE ONLY
11-{, 13,6,);,11
I MO:r ; (,:3; ~f~
(, ~C'P...16,6 )5,
RP - 5217
),,::1- RP-S217 Hn 3I'J7
REAL PROPERTY TRANSFER REPORT
C1. SWIS Code
C2. Date Deed Recorded
STATE OF NEW YORK
STA.TE BOARD OF REAL PROPERTY SERVICES
C3 Book I /, c? .~
PROPERTY INFORMATION
1. ~::I~~ I
405
. ._....1
...J
Oak Road
STREET NU","llEf\
S"TREHNAME
L
Southold
New Suffolk
VILLAGE
ZIPCQDE
CITY OR TOWN
2. Buyer
Nama
Adams
Michelle
LAST NAME I COMPAN"
F.RSTNAME
Nelsen
Laura
3. Talll
Billing
Address
ll>.ST NAME I COMPAN't
Indicate where fiJlura Tax Bills are to be sent
if other than buyer address (at bottom of form)
F1RSTNAME
LAST NAME/COMPANY
fiRST NAME
STREET NLJMIIER AND s:rnEH NAME
CITY OR TCWN
ZIPOOOE
STATE
4, Indicate the number of Assessment
Roll pareelt; trli!lnsl.".d on "tie deed
I # of Parcels OR D P<lrt of a Par<:el
lOnly if Part of 8 Parcel) Check as they apply'
4A. Planning Board with Subdivision Authority E"ists
48. Subdivision Approval was Required for Transfer
4C. Parcel Aoproved for Subdivision with Map Provided
o
o
o
1
5. Deed
Property I..
SlzlII
lOR 1
ACRES
D.5.01
J X I
~RONTHH
DEPTH
6. Seller
Name
Gilson
LAST~EICO"'PAN~
Jonathan and RE~ina Ebel-
FIIlSTNAME
LAST NAME / COMPA""
FIIlSTNAME
7. Cheek the box bllllow which most ilccurlltely describe, the us. of the property at the time of slIle;
Ch_k the bOlles below as they apply,
8. Ownership Type is Condominium
9. New Construction on Vacant land
o
o
o
o
A ~ One Fem'i1y Residential
B 2or3FamilyResidential
C ReSidential Vacant Land
o Non-Residenlial Vacant Land
E~A9;;,"I"'" I~
F Comme(cial J
G Apartment K
H Enleflainment { Amusement L
10A. Propeny Located within an Agricultural District
lOB. Buyer received a dillClOllllra notica indicatinij
thalth,~ property is in an Agricultural District
Community Service
Industrial
Public Service
Forest
SALE INFORMATION
15. Cheek one or more of thasa conditions as applicable to transfer:
11.511111 Contract Date
01
16 ; 200,,!
A
B
C
D
E
F
G
H
I
J
Sale Satween Relatives or Former Relat;ves
Sale Between Belated Companies or Partners in Business
One of the Buyers is also II SeHer
Buyer or Selle. is Government Agency or Lending Institution
Deed Type not Warranty or Bargain and Sale (Specify Below)
Sale of fractio'1111 or Less thiln Fee (nterest (Specify Below)
Significant Chllnge in Property Between Taxable Status and Sale Dates
Sale of Busine:;s is Included in Sale Price
Other Unusual Faclors Affecting Sale Price (Specify Below)
None
M<lnt"
D.,
Vaar
12. Date of Sale I Transfer
'3; :7-&;
Month Day'
20041
'H;
13_ Full Sale Price
~
4 6,0 0,0,0 0,01
14. IndlW8 the value of personal
property Included in the 8ar.
ASSESSMENT INFORMATION
N,oNE, ,0.01
, .
Data should reflect the latest Final Assessment Roll and Tax Bill
16. Vll8r of A58i1Sllment Roll from I 0 41-
which iof'O.mati'On taken
.3 S- 0 01
;
17. Taul Assessed Value lof an parcels in turnsfer) I
18. Proparty Class
L1....L..Q.J-LJ 19. School District Name I
New Suffolk
_.........--1
20. Tax Map Identifier{s)I Rollldentlflerls) {If more than four, auach sheet with additional idantifler/sn
L_
1000-110.00-08.00-012.000
~
I CERTIFICATION
] certify that all of the it.em5 of information entef'ed on this fonn are true and correct (10 the best of my knowledge and beliel) and I understand that the making
of any willful false statement of material fact herein will subject me 10 the Drovi~lons of the oenalla,,' relative to the IIUlklng and filing of false lnstnanwnts.
BUVER
BUYER'S ATTORNEY
/14 ,..(.tUlL- #~
IIVYERSIONATUIIE
3/)-(./"1
'An
Goodman, Esq.
Zerline
LAST NAME
FIIISTNA-ME;
214 Par~ P1ace 113
718
,r.S8-7764
STREET NUM8EIl
STflEETNAME(A,<'T'EFlSA'-EJ
AREA cOO!;
TELEPHONE NUMBEII
Brooklyn
11238
C:
YORK STATE I
COpy j
NY
CITYOllrDWN
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