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C::ONSUL T YOUR LAWYER BEFORE SIl3NINO THIS INSTRUMENT. nllB INSTRUMENT SHOULD BE USED BY LAWYERS ONLY
THIS INDENTURE, made Ihe I~ "'2.. "l"H dB) -of September.. two thousand three..
I~ETWEEN EUGENE R. PUSMARZ and GENEVIEVE PUSKARZ, as Trustees under the
PUSKARZ FAMILY LIVING TRUST..dated March 29. 1999. as amended. 330 5th Street.
Sugar Land. Texas 77-478.
party of the first part, end WALSEI PARK BENEVOLENT GORPORATION,
P.O.. Box 684. FiBhers Isl.lnd. New York 06390.
(no #) Equestrian Avenue,
p'arty of the second pert, ,. . .
WITNESSETH, thet the party oflhe fflst pert, In conslderaUon of Two Hundred Seventy-Five
Thoueand and 00/100 -----'------.($275,000. Oo---------------------<lollara
.pald by the party of the lI8COnd part, does heraby grant and releasa unto the party of the B8cond part, tha hairs
o,r SU0C8saora and assigns of the IJarty of the second part forever,
Il.LL that certain plot, piece or p.,rcel of land, with the buildings and Improvements Ihereon erectad, situate,
Il'lng and being 1fI.t.... at Fishe:cs Island, Town of Southold, County of Suffolk and State
elf New York. be1.ng more particularly bounded and described as set forth on Schedule
A berete..
TOGETHER with ell right, 1It1e and Interes~ If any. of the parly of the flrat Rart In end to any slnlels end roads
abulllng the aboye described premises to the cenler lines (hereof; TOG EntER with lha appurlenances and all
th" eslate and rights of Ihe party of the flrsl psrl In and to said premises; TO HAVE AND TO HOLD the
pt"mlses heraln granted unto tha party of lha second pari, the heirs or successors and assigns of Ihe party of
th" second part forayer.
AND the party of the first part COO'l!nants that the perty or tha flrsl part has not done or suffered anything
whereby tha said premises have been encumbered In any wey whatever, aXC8pt as aforeaald. .
A"'D the party of Ihe firal part, In c<,mpllance with Sactlon 13 of (he Lien Law, covenants that the party of lhe
flrs;t pari will receive Ihe cOl1aldBralhm for lhle conyeyance and will hold Iha right 10 racalve such conaldaraUon
es e trust fund to be appllad first for Iha purpoaa of paying lhe cost of the Improvement and wUI apply the same
first 10 the paymanl of the cost of Ille fmprovamanl before using any part of the 'total of the sama for any other
PUlp088. Tha word "party" shell be construed es If II read 'parlias' when eyar Ihe sense of Ihla Indenture so
requires.
IN 'WITNESS WHEREOF, tha party of lha first part has duly execuled Ihls daed the day and yaar flrsl eboys
wrllten.
IN PRESENCE OF;
~~~-
~,~ 1:. ~<4~~
Eu ne R. Puskarz. 8S T tee
~r~~
"
SI_...'.rd N.Y.B.T.U. Form 8002 - BIIrgaJn end Sal. Deed. wllh Cowen.nl avalna. Or.nlo,', AcIII- Uniform I\cknowlltdgm.nt
F=nr,n 329n .
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SCHEDULE A
to
~
Party of the First Part: Puskarz Family living Trust
Party of the Second Part: Walsh Park Benevolent Corporation
Deed Dated: September I"t.., 2003
All that certain plot, piece or parcel of land, with the buildings and i~rovements thereon
ereded, situate, lying and being at Fishers Island, in the Town of Southold, County of
SuiFfolk and State of New York, being bounded and described as follows:
BEGINNING at a stone monument set in the northwesterly line of Madeline Avenue, said
pOint of beginning being North 4363.45 feet of a point which is West 412.04 feet from
another monument marking thE' United Stales Coast and Geodetic Survey Triangulation
Station .PROS";
RUNNING THENCE North 09 degrees 05 minutes 45 seconds West along land now or
formerly of Jessica Delius Doy"~, 150.00 feet to another stone monument on the westerly
linE' of the land now or formerly of said Jessica Delius Doyle;
THlENCE continuing North 09 degrees 05 mnutes 45 seconds West, 261.56 feet along
said land now or formerly of J~lSica Delius Doyle to the northeast comer of the premises
herein and to lhe southerly line of land now or formerly of Alfred R. Grebe. Jr.;
THENCE westerly along said land now or formerly of Alfred R. Grebe, Jr. South 86
de"rees 44 minutes 40 secondll West, 124.61 feet to the northeast comer of land now or
formerly of lois E. Derderian;
THI:NCE southerly along the easterly line of said land now or formerly of Lois E. Derderian
South 14 degrees 04 minutes 50 seconds East, 363.31 feet to a point;
THENCE continuing southerly lltill along the easterly line of land now or foimerly of Lois
E. Derderian South 10 degrees; 28 minutes East, 82.00 feet to the northwesterly line of
Madeline Avenue;
THENCE northeasterly along thl~ northwesterly line of Madeline Avenue North 68 degrees
50 minutes 00 seconds East, 912.64 feel to the stone monument at the point or place of
BEGINNING.
f
..
[i[i]
RECORDED
2003 Oct 21 11:26:04 RM
Edward P.Romaine
CLERK OF
SUFFOLK COUNT\'
L 000012279
P086
OTt 03-11632
. .
~
N umber of pages
TORRENS
Serial #
Ccnificatc #
Prior Clf. #
2J
Deed I l\1ongagc Inslrumt:nl
Otted , M<>rtgage lax Slwnp
I
Recording' Filing Slamps
FEES
Page I Filing Fl.."e
Handling
-Comm. of Ed.
5. 00
Mortgage AmI.
I. Bask-Tax
2. AdeJiliunal Tax
Sub Total
Spcc.lA"sil.
or
Spec. 'Add.
TOT. MTG. TAX
Dual Town _ Dual County
He'd fur Appllinlmenl
Transfer Tax II 0 ()
Mansion Tax
5. ....QQ...
TP-584
Notatiun
EA-52 17 (Col.nly)
EA-52 17 (Slale!
IU'.T.S.A.
Sub TOIal
.3000
Al1iduvil
Ceniticd Copy
Reg.. Copy
Dlher
Sub TOL:l1
Grand Total /87
The property o,"ered by Ihis mortgage is
or will be i proved by a one or two
family .lwei ng only.
YES or NO
1000 ] 006.00
4 Dislricl Seclion
Real
Property
Tax Sen.'ice
Agency
Verification
~IOCk
~
If NO. see a pn)pri~le lax clause un
page # of this. imnrumenl.
~ SUlisfal'liunslDi~chargesIRelC'usc:s List Prupeny Owner~ I\rlailing Addn..'Ss
~ RECORD & RETU:RN TO:
Stephen L.. Ham, 1:11. Esq.
Matthews & Ham
45:::..:Hampcon Road
Southampton. NY 11968
1000 0061)0 0700 009000
CPF Tax Due
275.000
2.500
5 CommUDity
Improved
Vucant I ~and
TO /000
",
'.
TO
TO
7
Title Com
Infonnation
Co. Name Commonwea1th Land T~tle Ins. Co.
Ti,le II RH80031405
~ Suffolk CountY..B.ecording & Endorsement Page
This page fnnns pan uf the allachf..~ __
Deed
(SPECIFY TYPE OF INSTRUMENT!
made by:
EUGENE R. PUSKARZ and
GENEV:[EVE PUSKARZ. as Trustees
The premises herein is silualm in
SUFFOLK COUNTY. NEW YORK.
TO
WALSH PARK BENEVOLENT CORPORATION
In the Township of
In lhe VILLAGE
<>r HAMLET of FISHERS ISLAND
BOXES 6 THRU 8 MUST BE TYPED OR PRINTED IN BLACK INK ONLY PRIOR TO RECORDING OR FILING.
..~~~ (over)
f-~ :... "
SOUTHOLD
--" -::_---" "
111111111111 111111111111111111111111111111111111111 I11I
1111111111111111111111111
St'll'l'OLK COUNTY CLERK
RECORDS OFl'ICE
RECORDING PAGE
Type of Instrument: DEEDS/DDD
NWIlber c)f Pages: 4
TRANSFIER TAX NUMBER: 03-11632
Recorcled:
At:
LIBBR:
PAGE:
10/21/2003
11:26:04 AM
D00012279
086
POSMJlZ FlNILY LIVING T1U1S'l'
WALSH PARK BBNIWOLIDrl CORPORA'l'ION
Districl:: Section: Block:
1000 006.00 07 .00
BXANDlED AHD CD'D13!n AS FOLLOWS
Deed Amclunt: $275,000.00
Received the Following Fe.s :I!'or Above Instrument
ExMlpt
NO
NO
NO
NO
NO
NO
Page/Pi. ling
COB
!:A-Cn
'l'P-584
RPT
'l'ransf.,r tax
$12.00
$5.00
$5.00
$5.00
$30.00
$1,100.00
Handling
NYS SllCHG
BA-S'l'A'l'B
Cart.Copi.s
SC'l'M
CGIIIIII.Pre.
'.e. Paid
'l'RAHSI'D. TAX NtJNBBR: 03-1163:~
THIS PAGZ IS A PART OP 'l'IIIi: INS'1'1WHBN'1'
'l'HIS IS NOT A BILL
Lot:
009.000
$5.00
$15.00
$50.00
$0.00
$0.00
$2,500.00
$3,727.00
Exlllllpt
NO
NO
NO
NO
NO
NO
Bdward P.RoIIIaine
County C1.rk, Suffolk County
.
fOR COUNTY USE ONLY
PLEASE TYPE OR PIRESS FIRMLY WHEN WRITING ON FORM
INSTRUCTIONS: http://www.orps.state.ny.us or PHONE (5181 473-7222
REAL PROPERTY TRANSFER REPORT
C1. SWIS Code
~
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1. Property ~.O If)
Location STREET NUMBER
Madeline Avenue
STREETNAMF
Fishers Island
VH.LAGE
NY
ZIP CODE
~uthold
CIlYORTOWN
2. Buyer LWALSH PARK BENEVOLENT CORPORATION
Name LAST NAME I COMf'ANY
FIIlSTNAME
~
LAST NAME I COMPA~'Y
-i'!8STNAME
-,
3 Tal(
BiUing
Address
WALSH PARK
I BENEVOLENT CORPORATION
lll,STN....MEICOMPANV
Incicate where future Tax Bills arato be sent
if other than buyer address lat bonom of form)
~o. Box 684
STflEET IIIUMll'ER AND STREE', NAME
Fishers Island
CITY OR TOWN
4 Indicate the number of A.sessment
Roll parcels tren'Jferred on the deed
~__.L.JJ # of P,ucals OR 0 Part of a Parcel
5 Deed
Property
Size
L_~xL
""0NTFE'ET
10RL
P.CIlES
1 . 0 2
OEPTH
6. Seller
Name
L-.!'USKARZ
LASfNIIME/COMPAf\Y
STATE OF NEW VORk
STATE BOARD OF REAL PROPERTY SERVICES
RP - 5217
RP-5211Rcv3I'n
FIRST'JAME
INY
S"'A1E
I 06390
ZIP CODE
(Only if Part of a Pare.1I Check as they apply
oIA. Planning Board with Subdivision Authority Exists
4B. Subdivision Approva! was Required for T'ansfcr
4C. Parcel Approved for Subdivision with Mdp P'ovided
o
o
D
EUGENE R. and GENEVIEVE, as Trustees
FII'ISTNAME
~
lASfNAME/CUMPANV
FtFlSTN.o.ME
7. Check the box blllow whieh most accuratelv doll'SCl'ibes the use ,~f the property at the tlm. of ~Ie:
A~ Ono Family Re$;dent,ai
H 2 or 3 Far'iiy Residentiili
C Re5idential Vacantl..and
o Non-Residential Vacant Land
I SALE \NFORMA TI'9.!:LI
11. SlIle Contract Date
~~
G
H
~~
Agricultural
Commercial
Apartment
EntenainmBnt/An'lusement
Community SeNice
Industrial
PublicSeNice
Forest
Chttek the bO)(BS below M they appJy:
8. Ownership Type is Condominium
9. New Construction on Vacant land
lOA. Property located within an AgriCultural District
10B. Buyer received a disclosure notice indicating
that the property is in an Agricuttural District
o
D
D
D
15. Check one or more of thlltS8 conditions., 3'Pplicable to tranfler"
06 / 16 /03
Mo~!t1 D', Year
to / I / 03
M<>r!t1 0" Year
A
B
C
D
E
F
G
H
1
J
12. Dilte of Sale I Transfer
13. Full Sale Price
2
o
7
5
o
o ,0,01
, , .
iFul! Sale Price is the total amount paid for the property including personal property.
This payment ma.,. be in the forlT of cash, other property or goods, c" the assumption 01
mortgages or other obligiltions.) PleasL' round to the neBrBSr whole dolfar amount.
Bargain sale
x
Sale Between Relatives or Former Relatives
Sale Between Related Companies or Partners in BUSiness
01'18 of the Buyers is also a Seller
Buyer or Seller is Government Agency or lending Institu:ion
Deed Type not Warranty or Bargain and Sale (Specify Belowl
Sale of Fractionill or Leu. than Fee lntefi'.st (Specify Be\owl
Significant Change in Property Setween Taxable Status and Sale Dates
SOlie of Busi~ess is fnclLlded in Sille Pri<.:e
Other UfllJsual Factors Affecting Sale Price (Specify Below)
None
14. Indicate the value of personal , 0 . 0 . 0 1
property Included In the sale, , .
I ASSESSMENT INFORMATION - Data should reflect the latest Final Assessment Roll and Tax Bill I
16. Vear of Assessment Roll from I 0
which informati"n taken
3 I 17. Total Assessed Value lot all parcels In tranflerll
18. Property ClaSti
~.....Qj-LJ 19. School District rJame I
Fisbers Island
20. Tax Map Identmer(llll Rollldentlfler{sl (If mora than fOLlr, attacl'l sheet with addltionalldsntifi"'(sll
1000-006.00-07.00-009.000
L-
--------l~ 7
,
o .0 1
I CERTIFICATION J
I certify that all of the items of information entered on this form lire true and correct (to the best of my knowledge and belief) and J understand that the making
of any willful false :'italement of material faet hermn win subject me to the orovisions of the oenal law relatjn to the makinll and rding of fabe instruments.
BUYER
WALSH PARK BENEVOLENT CORPORATION
1lY
BJYEA IGNATUIU,
Frank w.
It... l(). 6.....M...--
lAST NAME
09/10/03
Ham
DArE
Burr) President p 'D., 8
-0. "c::l,~ t) "--
Madeline Avenue 1
(no II)
(631)
STR"HfIlUMfl"R
STREET "AME (;\FTEA SALEI
"'RE"'COOE
Fishers Island
NY---L 06390
STATE ZIPCOOE
CITY OR TOWN
r
SELLER
~, d!~v'J--
PUSKarz, .as Trustee
oo:~ Ii /03
--'"
BUYER'S AnORNEY
Stephen L.,
FIRSTNA""E
III
283-2400
TElEPl-lONENUt,48€R
NEW YORK STATE
COpy J