HomeMy WebLinkAboutL 12206 P 887THIS I~DE, NTURE, madcm~ .'~/
d~y of Ju L y . in thc yca~ 2002
~w~ a~ ~a~ as ~ions o~ ~ N~. 29, 30 ar~ ~ l, on a ~ ~p ~ 'M~ of
May ~, ~96~, a~ r~ bn ih~ Off~¢ ~ LE~ C~ ~ ~ C~nty of SuE~k ~ ~ ~ ~y o[
LOT 023.00!
Cu£cho~ue~ ~Y ]~935
d
__ Sub IO~J
F~IES
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02032)07 ~ooo ossoo o4~.o o2~02
L
Suffolk Cout
rD ~
Title Com~uy Information
CO. Name
& Endo~emmt
TO
..... ~L, ":'
In t~ Vl~ t,AGE
ar ! IAMLEF o~
t:IOXI~ ~; 'I14.RU 9 MU.~r I11~ i¥?ED OR iq~l~ IN ttL&CK iNK Ca'~LY Iq~lOR*lO RFZ~1JRDING OR HUNG,
RECORDS 0FFI~
P~CO~ING PAG8
~ of ~:~Ut;: DEEDS/DDD
TR~SF~ TA~ NUi.'~BER: 02-04983
Sect:ton ~ Block:
055,00 04.00
gX~J~II, rgD AND ~G~D AS
;50.00
LIBERt
~ $5,00 ~0 NY8 S~C~G
TP'SSt $5,00 NO Cer:.C0p~e~
~PT $30.00 NO scrM
Trane£er tax ~0.00 N0 C~,~rea
~FER TAX NUMBER~ 02-04383
THIS P~ IS
A PART O~1' T~ ZN8TR~
County Clerk, Su£folk Cou.n~y
09/0~/2002
D00012206
887
023. 002
$S.00 ~
$15.00 NO
$25.00 NO
$0.00 NO
$0.00 NO
$0.00 ~
$102.00
PLI=ASb I Y{"E OH FI'iES~ FIRMLY WHEN WRITING ON FORM
INSTRUCTION~ http://www, orps.state.ny.us or PHONE (518) 473-7222
STATE OF NEW YO~K
STATE BOARD OF R~AL PROPERTY SERVICES
RP - 5217
1. Property
Loca'don
400 { Long Creek D{ive
Southold ] Suuthold ]11971
[ Johnson ~l~'I Todd
] $~erliq~., ~ ~ ", ~ r~s~,~M~P~achel
Indi~te where future Tax ~lls am t0 ~ ~nt ? ) ~
if mher than buyer addr~s (~ ~om ~ ~) ~ ~
2. Buyer
Name
3. Tax
Billing
Address
I
STREET NUMBER AND STREET NAME
4. Indicate the number of A~s~mmtt
Roll parcels transferred on the deed [
CITY OR TOWN
Deed
Prope. I I xl Ioml
6. Seller I, Mosher
Name La~T NAME / COMPANY
I , I
STATE ZIP CODE
(Only if Part of a Parcel) Check as they ap~y:
4A. Planning Board with Subdivision Authority Exists []
4B. Subdivision Approval was Required for Transfer []
·, ~ [ 4C. Pamal Approved for Subdivision with Map Provided []
{ Mosher
William
FIRST NAME
Ella H.
RRSTNAME
7. Check the box below which most a~uratoly describes the use of the property at the time of ~ele:
2 or 3 Family Residential
Residential Vacant Land
Non-Residential Vacant Land
I SA E I
11. Sale Com%'agt Date
12, Date of Sale / Transfer
Che~k the boxes below as they apph~.
8. Ownership Type is Condominium []
9. New Construction on Vacant Land []
10A. Property Located within an Agricultural District
1OB. Buyer received a disclosure notice indicating
that the property is in an Agricultural Distric~
15. Check o~e or more of theee conditions as applicable to transfer,
Sale Between Relatives or Former Salst[vas
Sal~i~stween.~er~ed ~ompames~or Pa{tne~ m Bus ness
One of the Buyers is also a Seller
E Deed Type not Warranty or Bargain and Sa)e (Specify Below)
F Sale of Fractional or Less then Fee Interest ISpecify Below)
Significant Change in Propert~ Between Taxable Status and Sale Dates
Bale of Business is Included in Sale Price
Other Unusual Factors Affecting Sale Price (Specify Below)
J None
Agricultural I [] Community Service
Commercial J ~_~ Industrial
Apartment K[~ Public Service
Entertainmenl Amusement LU Forest
I 07 / 29 / 02. I
Month Day Year
13. Full Sale Price
Full Sale Price ia the total amount paid for the property including personal property.
This payment may be in the form of cash, otbdf property or goods, or the assumption of
mortgages or other obligctionsJ Please round to the nearest whole dollar amount.
14.1ndicate the value of pereonal I , ~, 0 , 0 I
property Induded in the sale ·
16.
0
2
½ ½ ,5,'7 ,o ,o I
18. Prope,'tyCla,p, { 2, l, q-[__J 19. SohoolDistristName L Southold
20. Tax Map Identifie~(a) / Roll IdenBfieHs) (ff mo~e than four, attach ~h~et with addl'donal ide~ithw(s))
I lOO0-055.00-04.00-part of 023.001
I certify that all e~ Ifle items of infommttoa e~tered on this form are true and correet (to the best of my knowledge and belie~ and I undersfand that the making
of any wlllfol false statement of material fact herein wtB subject me to the prov~ons of the penal law relative to the making and filing ~ false iustmment~
BUYER'S A'ITORNEY
SELLER
Olsen
David Worthington
L~T NAME
FIRST NAME
631 I 734-7666