HomeMy WebLinkAboutL 12112 P 904
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AOS-r rCIC"1':51 Inc.
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1000
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143.00
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02.00
LDI('l
022.002
SC Real Propert~
531 8:;.2 155tl
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CON'SOI.TYQUR lAWVER.II...:nI~SlGHlNc.'ITD81."lf5I'l:Y1MJln'_TlImDlnau.M.ll"""SHOllLD B.R USJl:b BY' I.,\wvrt$t:i ONJ.V
....,...
THIS lNDENniBE. DlQdc Ihe -.. d:a)' uC Oecembr:r
BETWEEN
lJ[ANA GUN1HER NOLAN. n.>sJdin,g a.t 4111 Crr.uvlcw Drive.. Vai::l.'Yillc, ClilltClmia 956RJ1. nnd DIANA HYNDS
STOWE., rc:tldin.g at 207 High St.. Nuday-. Naw Jency 07110, 1UI J(ljnt le:nontJI with RigbL1 of Sutvi.\"I.'I~hip
. inrtJe:!fCiJI" ~OOO
llntyorthc:finll!'4".8llQ
'l!o..."I "'C..lCUm:lMHOMES. INC.
23 Wood A'IIa\l.lo, Albcrt:actn, N'a\l,I York
party or Lhc M:toM p:tl"l'.
W'lTNESSlt1'fI, lhuUIll JUriy oflba ftntp:in_ tucomidmdonofTcn Ovll;qs Ollld oUwrvOllu.1ble C%lMldl!ll':lllon p;lld by tb:-
p;uty of ~ sc~ p:ln., does hell!lby gral ..nd rdeue Unm the piInJ' oflta;> 'CC(,\II(! p::lJ1. Ih(l !lei'" nrlluCCl!!I:!OD tIIld :lMI$lll!: of
the pnr.ty ofdll:' ~d plD'T ran:vcr,
AJ.L mOlt mulO Jllnt... plca or pa.ru.J qf!OIn&!. ",jdt the builtJlltP and inlfl"'Y~ra rhE:~on ft'tCtt.d. s,UulUc. lyirigUlJ trlng in tb~
SEE SCflIlDULE 'A' A'ITAOIE!> RERoro AND MADE A PART HEIl.EOF
The gr-Bn~OrloJ hUl!in Rt:'6 the 8aDle persons ,u the. gr,antees in :)eed c1a.ted 12/6/94
reGorded 12/12/94 ~n LLber 11106 cp 175.
TOGElBE.R with all rl~l, lill.::md InlC:t'C',/ot, if .ll1.:r. MUle (ll:lrty of the RI'llr p:lrtQ1.1n Indroany lI(C'C:i:l.l/ IInd n,'!.'\l.l:a;. tll'luUlng tht
:l.oolleo.d.ei'cribftd prcrnlt<s It) the- ~r1fU Iin~ Gl.em)f: TOGETIIIR wM tt\o Olppllrlc:n..nl.'Y:IIind. 011 J.he n111lli:! and ri.eh~of'ho
putty of the tine p:ut: in and (0 aa.id premiBCa: TO HA. VEANO'ro BOl.D the prcmis~.!I harein gr:l.1li:e\f unto the J":l.".\' (Irlhl!
~ond p;l.rt, tho hL'irs 01" IlUCCCSSolm And UlllpJ of llIe plrI)! of thesc.:ond POlIt (clever,
AND lhe pan)' (If" Ihe linn,pan' covn:m" mtt Ib.!I pary af me fllU. p::m has net \k)ru; ur ollufft'ft!iJ llnylhing ..h.;r~i:ly the ~.id
premI.:,t. have ~ incu~ in .D)' "'"Y llIh:atcYcr, Q'ce(C:I& afol'l!'$ilid.
ANDthr Nrty ('fthe n~51 pelt\. In (l,)fI'\plilUlC'D With SccIioo J~ (lftbt Ll", Ul.W, COVe!nlnc/! lbat tbI:. p.3tly oftf\e fjT'\lt pun wi!1
~vc: Ihr a:JOlidcrudQn rlJf lllili NOvt!yancc:.nd will ~Id Ihe ri&htln n!ni'n' l'Ue'h (:Df\lid~I~~" OIlrll::t1 fund ec. k= Jpplil!'d
first fur lh~' pllrpwio: (Ie ~ing IIYl can or the i~yerntllt and ~n DPPlY me' UIJ'll;l am b:I the ~lUymcnt Qr Il1e ...'OIJ. nr lhc
impn~....."ml:n~ b~r.,..", uNnc :IVY part nf 1M Iml ofdle.me far,,~ l,ldlcr purpOSl;.'.
'I'htl wonJ "fIOJ1t" ~Ilnll he construl:!d QI ifir. rQd "parti~.." whe.tlcYr;r lhe '-'1151.' orlhlll indcnllln=: ~(I, l'!'qui~l;,
IN WITNESS W'El';EItItOI!', dl~ par\)' of the rrl'lll pun: tUIS dilly eI('eQled [hIs deed IhP day And }'C~(' nl':'it ubon: written,
IN PRv..sJl!!lfa: OF:
./ &u~/L_.T.h.;)'7f1~:.-/
DIANA G ER NOl.All
ikA~~_ ~"'A~~;;';_
DIANA IlYNDS STO
v
'.:......
P.04/0S
06/06/2001 WED 10:13
[TX/RX NO 6070] [{lj004
. TUN-OE.-2D01 11: 29 __m~C Real Property
- ~f.N;~-York---
531 852 1566
P.D5/06
;;
SCHEmi~ A (Descriplion)
TITL& i; 12-71990
All that oertain -plot. piece or parcel of land, \~ith tile builclinss md improvements thereon
eroctc:d, situat-e" lying &Dd being near Mattituck, in the To,",n of Southold ,
County of suffol~ and State of New York, known and designated as
and by Lot No. 27 on .a cert.ain map entitled "Amended Map of
Mattituck Park E'roperties, Inc., Mattituek, New 'fork", said map
being made by Daniel R- Young, P.E. ~nd L.S. from ac~ual survey
completed ,July 11,1924 and filed in the Office of the Clerk of
the County of Suffolk on the 12th day of January, 1926 as and by
Map No. 801 (Abstrac~ No. 36B) and more particularly bounded and
described as follows:
6EGINNING at a point on the wElsterly line of Marlene Lane.
518.36 feet sout.herly along said westerly- line from the
southerly line of the Main Roacl (Route 25); and running along
~aid westerly line of M...nlene I,ane., S. 20 degrees 39 minutes 50
seconds W. 75.0 feet;
tHENCE along land no!oll' or form8:z~ly of Abitz on a line at right
anglt:!s to said westerly line oj: Marlene Lane, S. 69 degrees 20
minutes 50 seconds W. 145.0 feet to land now or formerly of
Masti~ic Park Properties, Inc.. Thence along said land no~ or
forme:rly of Mattituck Par}:; propert:1es Inc. N. 20 degrees 39
minut.es 10 seconds W. 7S. 0 feet~ thenc@ along othf!.r land of the
part:'1' of the first part on a ltne at. right angles to aaid
w~3ttlrly lin~ of Ma~lene Lane, N. 69 degrees 20 minutes 50
secoTlds E. 145.0 feet to t.he pClint of BEGINNING.
TOGE1'HER with an ea.5ement for passage between I?econic Bay
BoulE!vaJ:d and fecQI"L.ic Bay over .! certain 10 foot ri9ht. of 'ioIay,
in CClmDlOn with all othera now having such right of ~ay and thosiIiII:
to whom hereatt.er such rig-he oj: way a.nd easement maybe granted,
whic!, right of way h more particularly described as follows,
ALL 1:~h.!.t parcel of land si tuatl~ near Mattituck. Southold Town,
Suffolk County, New York, bounded and d.@scribed as follows: The
east"rly line of the sobject 1,Il foot right of way i. described
a~ f~dlo'WB
BEGIUNING a.t a point on tn@ southerly line of peconic Bay
Boulovard, ~OO.20 feet westerly along said line from the
northea~terly corner of land o:f Haggerty Estate; and .running
alonq said land of Haggerty Estate on aline p.!lral1el 't.o the
eastl;,rly lin@ of sa1d land of Haggerty Estate and 200.0 feet
\
"~'--r~""""Y;'-~~ ._"
\
W'eSI~er.l.y therefxom, South 20 de!qreee 23 m1nut.8S 00 seconds East.
500 f7et1 more ox less to the ordinary high water mark of Great
Peocmlc Bay; t.h@ westerly linEr of said 10 foot right of way is
par(ll~81 to lIIna 10.0 feet westerly from the easterly line herein
desGr~be~, and rQns frOln Pecordc Bay Boulevard to Great l?econic
Bay., ~ai.d eCllsl!ment is sl.1bjed: to the following covenantB and
cond~tJ.Qn3:
1. said eaSBment. is for foot t;ravel only.
2. Jt shall not be obstruct@d in any-~ay and the mAintenance
tJ:@rl!"lof shall be joint reSt:,onsibility of all tho.se having 8.
J:'~ght t.o Lise said right of ",ay for ~he time being
3. said easl!!Ilnent shall hI! per&:'etual and shall run with the land
~ht no easement or rig-hts in said right of way shall vest in
e qen@r~l public. It shall remain a private right of ~ay.
06/06/2001 WED 10: 1.1 [TXiRX "i0 6070] I4i 005
. JLN-06-2cl01
11:29
SC Real Propert~
631 852 1566
P.06/06
;.. .....
tJSI;4crN1J1T"~\IlE7\'TFf:IIUIIlU/JW"il1ll1NNlMrQB!'rA1'lro~;
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bc~l'M,lh.:umJ~.~L\y.~
~~glIy kl!cl""n 10 me or pIUYCd 10 me tJn tlID b;Ws. or 511i~
~vld~1'\I.:t' w bt Ih:: 1IldIvid"",,ts',...nCl:'ic' II!lmI!l.lIl ;. l=) sub:itrlbal Iltllt10
Within 1II41fWt.c'l1f ud :a.cknowkod~ 1(1 rtit' IMt beI~ ClCI:urad
rhe ume in hi~r (,1I~InJ, .wi tlwt ~ ~i\bdr
~lgn3.l\Jp\:(t1) 011 th~ i~(, dr indlvidtl:lkil.. or ~ ~ upm
brhalr o1whic~ lhe Indiv.wu~I1~) .3Ctrd, c,lJ:allcd the.lnSUllnrot.
Ar..'AMJlWJU;lt;,tUCNT "'t,-", POll UK Wl7ll,N N1;WYQa'S7AniO/'iU:
IN""I',oJ"i:~,.wIl$WIr"I'.J.r~"'C'c"I/hJf"
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Onthc d;lyor j.athc:~
txnJl'tIl1\C, tht undC'T":lISna1 pc'm'1Uwly,l(~
11'10 ';\lb!ll:'rlb!nl:: WiLnL'U to d:u: fOft';olng I~tn.lmr:nf. 'q'i1h \J/hurrll ilm
FtWn3.lIy q:c:alNCd, who, ~IJl! ~ me duly ~ did cieP'lSll".:!oftL!
SI.)'rh:1th.I!I"'lll'lb~ro<ide(sl;n
(!Jth... plaL~tifl'C$fd~"a: Is In tJ .;lQ', i"dllde ,ht; ,SII'C('I rlM,Utter I/Jl.fltbt""
1/ !1l1_~~ ilJ,."ttf'l': !:bat hl!/.she/\hey mllW(lI)
w ta.. tl:I~ iodi,MolI] ~t'libcd in Ilnd U1nl,) l;'.let,.'U1ed ftlI! rClrl.'l!~
instrunu:nt: thllllllid 'lIba:T1.tHng ...11laJ w.., ~ s:nd mw we
('lICI.:UIc ~ l'lII'nC'; :md thut ~ wilncSll :1f. the- SOWI!l c:imc .!iublcrltm
I'lL"'hcrltbc-1r Mm-:(Il) 1m ~ wlmess~.
B4AuAbas.A.I..i:InM
wn"cvn:lVIlttt..w,!1'$T1;lILl,..-rolI."I'IL'fil
TmJ!No. 12-rlc:jCfO
....:'OlAN AND STOWE
TO
Wte!tUSTOM FlOMES. lNe
FlDltUT'~ N^ TION.t.L Tm...INSt!JlANC.
ACOMr^,,",O~N~YOJU<
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lJ$BA.Cif/r1mn~"0IUIBEU.m'VlTn"NN6tn'ORKS7Am()NI.r..
Slalecl'NetrVorl!..Counryor
JlIS.,
0rI11I: dJy or In Ih~ yc;1r
h."fi;;lrt- ~ the uml~'n;Igm:d. FCnWn;.ll~ APpeDm.l
~Iy Jakawn W me or pn'lv..'d lD rile: on ih~' busi1 of .5Dil#'a<.1u';
tvidcDt:c b:J he'heindivldulll{~) UI'~nDr'rlC'(,;J iM (~)sub..'IQ"it:..'\IItITtu:
\lIIilbin U\mamL'ftt and .eknowI~ to JM &hut bd5h~ "'~=ucd
lhc: ~ in hillha,:dJhdr cqpa..il~l. IIld lkit by hitJhcrftta=ir
lipItwl!ll) on !be imuvmmt., ~be indi\'idll&l(!l). fI\' Ihe fCl':5W1 upl."ln
bcb~lt nrUlhlal tbe- indiilidulll($)~. ~C'Cu.lI,:d t~ in~t.runu:JJt.
AOM7'tt.lill1\IBN7'POIm HJR W'Jl()II1fJIM!NBlrYOfl'~S7":t'IfONU"
.ltiD~~~,~~~'~~~~~:~~,~~.~.~~.I.Z:_ }a.;
(C'....,oIr'.. hllw whir Sur. v:::J'f'j, ,II'>W,.....Jl, M1IIlfro1]l.Wll:rI
On Ihc1..CJlIYol ~.cnlbc:r In tbl:::Y'!3f ~O()O
beJ'tn, r1I(.', the:' W1dmiSfle.d. penooalty "'l"f'C'B"!I:l
nUl.DA GUIl~' NQIII" UltI Diana Hynds Stol&rc '
~I,. )(n~'ft ~ me or poml to ~c on 111" bo:u;i!l of 1>:lli.!~{0I)"
"1dcrta:llObi:-d1sjndl\1Idu:.lIIIJW~ narn&::(e:1 b:(llR')5u~lJ ~lhl:
within iMlnlTnr'nl ~ ~led",,-d lo me Nt ~Qllhcy CICC\)tl:d
rhClliBlrinh]~lf(apud"lfcj;).IiuD. b1hi~d\htiTlA!UI:.llUn:h)
on the- i.l'urrumenl., Ita.: indlvidag](.... ortho pl!n<In upon ben~t afwhkh
lhP mdrotid~lr&}~. ~>>.!1:1a'd R m\l'\lll'lo.!nl. and thai slJchll'ltlividu:ol
rrIlXkm;:b..lI~JI.'\:bl:'fimth!U~fJetlin!h~ AJ
. ' J f#- - ///~{>'.ed..
(1 !:rl rutnrf' illM,",&4h'i.ti""Cl.lldthr:'~1tluor~l:iJ"')
tlllir tltI!L'I: /ftlll:IlrWtl..1 Il'l -
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CoUI\;n" ()fI. TOWN
IIlr{lfff)IU) IiTlfEr/11E..'T or
li1deIiIy NIId~ '11111II rllllll~ CIIMPDnY 4l'Ncw York
F:mVllN BYM.tlL 10
BERNARD H, COHEN, ESQ,
99 TULIP AVE.
FLORAL p~.. NY 11001
~~
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06/06/2001 WED 10:13
TClTRL P.06
[TX;RX NO 6070] I4J 006
. TUN-01'.-20m
J,;
\:;
11:2E:
SC Real Property
I i= 2
,
Number of pagl.!;:\
TO~nENS
&rj;tIH
Cc-rrificar.e fI
PrlorCI(. I'-
Oeed , MDnl;lJg~ IIlSU\1menl
Oer:d I M:on~f T;l~ Sll.mp
FEES
2)
Paf.c I Filing Fe'!:'
Handling
'Il'-58J
Notll.livn
!:.A-52 17 t Crlllnl} J
Sub Total
~.~::17(Slatd
R.P-T.S.A
/0-
Comm. or Ed_
'Q2--
AmtJlvjl
Cl:I1ined Copy
Reg. C Clpy
Orller
SubTotal
I);) -
G~^ND TOTAl.
M.C'1I1 f)rapeny Ta."i. Servi"" I\gmcy Vcorifi,t.:ariQ1
Dlsl. Section n lQl'k
1,(\1
1Il00
143.00
0.2.00
022.002
110(')/
~
SulisfacLions/Dischl!l.rges/RolflB$QS List Proporty O\Ync:rs Mailiug Addrc
RECORD & RE'rVltN TO:
j
.~
BJnlNAE~n fl. COHEN~ ESQ.
99 TUl,IP AVE.
FLORAl, PARK, NY 11001
1'.31 852 151'.1'.
P.03/01'.
~
a2l1 ..,. 1,1; 1l8:.5~ IlI'l
I ;\,;',J,uj';.. I'. ):,:,''!<iI~: I~
clJ;;illI. OF
51JfFOuc. CIlIIll~
1- OO3O:l2J.l2.
P ;D4
PT~ QIJ-~
Recording I Filing SI11l\1P'
Mgn.~c: AmL
I. Bui('T<lX'
:!. AdJitil'lnlll'lx
Sub T of81
SFC./Ault.
Dr
Spec./Add.
TOT. MY". TAX
Duall'()Wn_Dui1.1 CUUIIIJr'_
Ildd rurA~partjo"ml,."l" ~
Trnn:'ir..::rTu 07o~ --
Man"lon Tax ,_,_ _
Th~ rm."f'l~"Y co....Clt'J b)' (hJs 1II(I"~g(: i, gr
""ill be improved by D ~1MC or (\YO fJmily
uw('lIillll.onIJ"
YES_Of NO_.
If NO. see appropriRff' rnlo: dnuse 011 P~l;lO!' II
_,)rthis ins1rl.lmenL
It Conununity Prcsct"VmiOIl Fund
CO"8iU~rl:lli,m AIr1()Ulll $
Cl~r" Tax Cue
s
Impro....C\I
Vncanrl.lJl'ld ~
Id
TO
TO
TlJ
~
· Title Company Information
Ca. Natne
12-71990
Suffolk County Recording & Endorsement Page
Tltl~#
This page forms pan offill: alr.:u:ho:i
DF.Rn
(SPECll-YWPI!OF INSfRUMENr)
madt:bv:
DLAWA GUN'~ NOLAN AND
nTAUA tJY'"IJ"~ <::..,......Ull'
The prelt1i~ herein is situnted in
SUWOLK OJUNIY. NEW YORK.
SOOTBOLD
TO
~\l\",.JCIJgTOM HOMES. INC.
In the T""nlhip of
In I"" V1LlJ\GE
or Hl\MLEl nf
i.J\Q11\ 1Uc:.l-
UOXES 5 'n IRU 9 MlIST Dr. TYPED OR PRINTEIl IN 8lJ'.CIi.INK ONLY PRIOR TO IlECORDfNG OR l'JUI'<G,
COVEll)
06/06/2001 WED 10: 1.1 [TX/RX NO 6070] [4]003
.JUN-06-2D01 11: 28
SC Rea. Property
631 852 1~66 P.02/06
.
111111111111 111111111111111 1111111111111111111111111111
1111111111111111111111111
SUP FOLK COUNTY CLERK
RECORDS OFFICE
RECORDING PAGE
'I)1pe of Instrument: DB2DS/DDIl
NwIlber .,f Pages, 4
TRANSF:B:R TAX NUMBER: OO-B853
ReCorded,
At,
LIBRR:
PAGE:
04/12/2001
08:35,20 AM
D000121l2
904
Distric1: ,
1000
Section:
143.00
BlU\IlIJ:!llro llND
$50,?50.00
Block:
02.00
C'BARGED AS
Lot:
022.002
Deed Amount,
FOLLOWS
Received the Following Peea p'or Above Instrument
ExEllllp t Bxtillllpt
Page/Filing ~12.00 NO Handling $5.00 NO
COE $5.00 NO ltA-cn $5,00 NO
BA-S'I'ATE: $25.00 NO 'I'P-584 $5.00 NO
Cert. COI,ies $0.00 NO RPT $15.00 NO
SC'I'M $0.00 NO Tran.,.t..r tlUC $204.00 NO
Comm.Pro'a $0.00 NO
Fe..s Paid $276.00
TRANSFER TAX NUMBER: 00-33853
THIS PAGB IS A PART OP THE INSTRUMENT
Bdward P.Romaine
County Clerk, SUffolk county
06/06/2001 WED 10: 1.1 [TXiRX NO 6070] 141002
PLEASE TYPE OR PRESS FIRDlfI!'V WHEN WRITING ON FORM
....= INSTRUCTIONS: http:// www.erps.state.ny.us or PHONE (518) 473-7222
"Fgl COl,INTY USE .ONlY { 1- () Q ('
j1:1.SWis code I / 7 ,/ ,II I-l ./ L
C2.~':'DMII!econ1ed I 111/ c1 10/ I
_ . Mont" Day YeaI'
~.-L6]) I dlc,voll"19n V,
"
.;.
PROPERTY INFORMATION
REAL PROPERTY TRANSFER REPORT
STATE OF NEW YORK
STATE BOARO P!'1RIiil'I<;1'IlOPERTY SERVICES
""f,tP' '~~~if7 "'J
""
7 Re,
': hi
1. Property L-----
Location STFlEEU NUMBER
Marlene Lane
STREET NAME
,'f.!
~nllf"hold
CITY O~ TOWN
Mattituck
VILLAGE
11952
ZIPeODE
2. Buyer
Name
I '-'...........; I')ohi 11 C'.nq,t"orn H()mp~, Tnj~
~IAi\A'i;'ICOMPANY
FIRST NAME
L----- I
LAST ~IAME I COMPANY . FIRST NAME C
3,Tax 'od"a"w'""M,,,TaxBd'sacetobeseot 16a'~ \j\t'W WSTC:Xn }1~'~ 16
Billing If other than buyer address (at bottom of form) _ ~
Address LAS lAME! COMPANY FIRST NAME
I 20 \\j(joq \Qn.:':: A\~n-00h
STREET NUMBER AND STREET NAME CITY OR TOWN
R \c..I'~YQ
ZCllhycq I
I ~,;j I ;,:c~1
4. Indicate the number of Assessment
Roll parcels transfl!rred on the deed
, I # ot Parcels OR D
Part of a Parcel
5. Deed
Property
Size
L-
FRONT FEET
Ixl
IORL
'ACRES
.2SI
(Only if Part of a Parcell Check as they apply:
4A. Planning Board with Subdivision Authority Exists D
48. Subdivision Approval was Required for Transfer D
4C. Parcel Approved for Subdivision with Map Prp,~ideQ n
1.~t"""~""
\'. i
Gunther I
DEPTH
~
6. SeUer,
Name
I !.olan
LAST flAME / COMPANY
Diana
FIRST NAME
I St01.e
LAST t,AME / COMPANY
Diana Hynds
FIRST NAME
A~ One Family Residential
B 2 or 3 Family Residential
C X Residential '/acant 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
lOA. Property Located within an Agricultural District
lOB. Buyer received a disclosure notice indicating
that the property is in an Agricultural District
D
D
D
D
7. Check the box belc)w which most accurately describes the use of the property at the time of sale:
I SAtE'INI'ORMATIONl
11. Sale Contract Oaite
'j'"
r
12. Date of Sale I Transfer
9 / 27 I 99
Month D,y Year
12 / / 00
Month D,y Year
15. Check one or more of these conditions as applicable to transfer:
13. Full Sale Price
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
,5,0,7,5,0, ,0,01
, , .
(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. Indicate the valuel of personal I I ~) I 0 I 0 1
property included in the sale, , .
I ASSESSMENT INFORMATION - Data should reflect the latest Final Assessment Roll and Tax Bill I t/
16. Vear of Assessment Roll from 1 0 \ 1 1 ).3 -
h' h 'n! t' t k ,17. Total Assessed Value (of all parcels In transfer) "
w IC I ormalOll a en ,
Other Unusual Factors Affecting Sale Price (Specify Below)
None
;J
,
:2::<' I'~OI
; ,
18. Property Class
1~1, \
1- U 19. School District Nam. 1
mulT J C U TC \-\ 1 LD '--\
20. Tax Map Identifiertsll Rollldentifier(sl (If more than four. 'attach sheet with additional identifier(s))
1000-143.00-0:<.00-022.002
I
-
"!~=oft~e itelIlll of information ~;;'..,.tonthis form are true and correct (to'the best of.;.~Lwledge and belief) an~ I nn\lerstand that lbe j~g
of any willful false statement of/Jliaterial fact herein will subjed me to the Drovisions of the uenallaw relative to the making and filing of false instmments.
'~i ,~U\~~Rn rt:5. \ t:c. BUYER'S ATTORNEY
- . ..._-----------,-
2- )2310\
C()\ten
LAST NAME
E;S;QI: ger rk.Jnq
f!RST"NAW:
DATE
\>1 00 d
lone
( E>) b ')
AREA CODE
488 -?(fJj
TELEPHONE NUMBER
REET NUMBER
STREET NAME (AFTER SALEI
^ i\}C \ t-,:::70n
\\,1701
CITY OR TOWN
ZIP CODE
CITY rrOWN IASSESSOR
COpy
<< I .'
c.,,!//,.((l._ c,'l
SELLER SIGNATURE
'ILl.
.4:-
"--~;{.tl-(,IC Ci