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HomeMy WebLinkAboutL 12207 P 433~tAID MAD£LtNE t,1. re~idi~.g oJ 893 Ga_.ri. inet Drive. ii, fy ~ iVY I 17~ sim~e. ~yin~ in I1~ Town SUBJECT TO I:~e i~ov~ ora ~ion ~,',',.,.orded in ol'SulTo~kon Jun~ I L 1975 ~b~r 78~i~ nt p~ 0~. ~s~ by~l~r 7~14~d p~ 27-'L of~u~ i S~ of~ I0. 19~ in Lib~ 7279m ~. ~of~ ~m~ upd~ ~veloper, its h~rs or ~ ,~ ~ Duper has any ial~ i~ ~ i~o11~"',0' ~ ~ ~ ~ ~ ~ATE 01;' NEW YO~ COUNTY OF which the ~ u~o~ ~f of ~ ~-~--,~d STATE OF NEW Y~ COUNTY OF On~ dayof ~99,befo~mmepen~onal~ycamc ~o me k~owr~ ~ ~ depo~ and s~y ~ ~ of , th~ ~ e~ the knows t~ ~1, ~ h taunt thcrcto by like NOTARY STATE OF NEW YORK, ~NTY OF SS: NOTARY PUBUC Block: 02.00 Lo~ 063.000 S~ Add..~s: 893 ~L,~r D~ve ~URN BY MAIL Bay S~ NY Ii~ ti i ,Sab Tota3 _ GRAND.AL T01~ M:'T~ TAX 020~ ~ooo o~ o2oo o630oo SZB£N & SZBEN, LLP. CPF Tax Due S . ~ga~n 6 Saie Oecd T~e ~ ~n isd~ in TO ,,, ~DELI NI~ LI TAX ~: 02-05427 0~0. O0 0~.00 $7S, 000.00 07~48~ AM 0~S3. OOO ~ $5.00 WA*~ $5.00 ~-se4 $5.00 /~"'~ $~0.00 'Priz~£e= t&~ $300.00 '~KAII~"'t~ TA3~ ~: G2-GS427 ~ P~ XS ~0 HO A P~ OF ~ SS,GO ~ $~S.00 ~ $25.00 ~ $0.00 ~ $0.00 SO $0.00 ~0 $3~.00 Cou~ Clerk, Mfolk C~U PLEASE TYPE OR,Pt~ INSTRUCTIONS: http://www,orps.state.n¥.us or PHONE (518) 473-7222 REAL PROPERTY TRANSFER REPORT STATE OF NEW YORK STATE BOARD OF REAL PROPERTY SERVICES RP -5217 1. Property 1,1 3. Tax n~icat~vhere future Tax Bills are to be sent~ Biffing if othe~thar ouyer addreSS (at bottom of form Address FIRST NAME L~ST NAME COMPANY STRE ET NUMBER AND STREET NAME 4. Indicate the number of Assessment Roll par~els transferred on the deed 5. Deed Prope~. I I X Size ;RONT FEET DEPTH CI3W OR TOWN ~ # of Parcels OR [--~ Part of a Parce STATE Zip CODE (Only if Part of a Parcel] Check as they apply'. 4A. Planning Board with Subd~ws~on Author ty Exists [] 4B. Subdivismn ~pproval was Reauired for Transfer [] 4C. Parcel AnDroved for Subdivision with Map Provided [] 6. Seller FIRST NAME MADELI NE LAS3 NAME / COMPANY FIRST NAME 7. Check the box below which most accurately describes the use of the proper~ at the time of sale: Residential Vacant Lano Aoartment Public Service Non*Residential VaCant Lan(] Entertainment Amusement Forest 11. Sale Contra~ Date 12. Date of Sale / T~anstor Morffh Day Year' 13. Pull Sale Price , 7, 5, 0, 0, 0, 0 , 0 I Full Sale Price is the total amount paid for the ~roperty ~ncluCi~ng personal properly. This paymen~ may De ir the form of casn. o~ner prope~y or ~oods. or the assumotion of moffgages or otner OOl gallons P/ease round to the neares~ wtlole dollar amount. 14. Indicate the value of personal ,0 , 0 I prop~ inciuded in the sale i j D E F G H ] J Bel~Beb, v~en Rel~Uves er Fo~rrper F~latives ~al~tw~en Related ~omeanies or~Partnet~ 'in Business One{gf the Bu~ers is also a Seller Buyer or Seller is Government Agency or Lending Institution Deed Type rmt Warrarr~, or Bargain and Sale {Speci~ Below) Sale of Fractional or Less than Fee Interest ISpecify Below) Significant Change in Property Between Taxable Status and Sale Dates Sale of Business is I~clu~eo in Sale Price Other Unusual Factors Affecting Sale Price (Specify Belowl None 16. Year of Assessment Roll from which information taken t . 18. Property Class , i t 'l--I 20. Tax Map Identifier{s) / Roll Identifier{s) (R more than tour, altach sheet with additional identifier(sD I Dist: 1000 Sect: Block :! 02.00 ~ LO%: 17. Total Assessed Value tof all parcels I 19. School District Name · 030.00 [ certify that ati'of the items of information entered, on this '{orm are tto the best of my knowledg~md la~lef} and I understand that the nmking of any widful false statement of material fact he. in wifl subject me to the provisions of the penal law relative to the making and ffl~g of false instruments, BUYER t. ' BUYER'S AI'rORNEY BUYER SIGNA'~U~E ' DATE LAST NAME F~RST i~AME Lot 90 631 665-3400 Soutnold I NY I 11971 SELLER SELLER SIGNATURE