HomeMy WebLinkAboutL 12160 P 548NSTRUCTIONS: http://www.orps.state.ny.us or PHONE (518) 473-7222
REAL PROPERTY TRANSFER REPORT
STATE QE NEW YORK
STATE BOARD OF REAL PROPERTY SERVICES
RP -5217
1, Property;
Locatlen[
Z Buyer
985
STREET NUMBER
Southold
Holley
Bay Shore Road
STREET NAME
I Greenport
Robert E. /
i 11944
~PCODE
Name
Billing
Address
LAST NAME COMPANY
Holley
LAST N~ME COMPANY
indicate where f~tum Tax Bills are to be sent
if other than buyer addres~ {at bottom of form)
4. Iddicnte the nu~hber of Assessment
~t~ll parcels transferred on the dee~
FIRST NAME
I Barbara
FIRST NAME
LAST NAME COMPANY
CI~P*' OR TOWN
]] #ofPercels OR ~] Part of a Parcel
(Only B Part of a Parcel) Che~ as they apply:
4A. Planning 3oard with Subdivision Authority ~Exiats []
5. Deed
Property I I X.
6. Seller I Groppe
IoRI 4 5
, , 'ACRES' ~
4B, Subdivision Approval was Required for ~'ransfer
4C. Parcel Approved for Subdivision with Map Provided
Ellen
FIRST NAME
* 7, Check the box below which most accurately
describes the use of the property at the time of sake:
2 or 3 Family Residentia
Residential Vacant Lane
Non-Residential Vacant Land
I I
11. Sale Contract Date
12. Date of Sale / Transfer
Commercial
Entertainment Amusement
10 /4 ! .01 I
Month Day Year
I/ Ol
Moflth Day Year
1
13. Full Sale P.ce I , , ,, , , , , ~ 0,0t
(Full Sale Price is the total amount paid for the property including bersonal probeny.
This payment may be in the form of cash. other 0robeny or gooos, or the assumption of
mortgages or other obligations.) Please round to the nearest whole dollar amount.
14. lndlente the value of personal I q , 0 . 0 .
Community Service
Industrial
Public Service
Forest
16. Year of As~essme~t Roll fTOm [ O~ 0 I 17. Totel Assessed Value (of eg 0areelsinl~ansfer) l
which informntJon taken
Cbe~k the boxes below as they apply:
8. Ownership Type-is Co~dominium
9. New Constructi~ on Vacant Land
10A~.Pmbefly Located within an Agdcuitursi Distdct
10B. Buyer received a disclosure notice indicating
that the proper:y is in an Agriouitural District
15. Cbe~k one or more of these con~rrtidns as applicable to
A Sale Between Relatives or Former Relatives ~
B Sale Between Related Companies or Par[ners in B-usir~
C One of the Buyers is also a Seller
D Buyer or Seller is Government Agency or Lendin;~ t~'stit~n /
E Deed Type not Warranty or Bargain and Sale (S~c.i~y Below),
F Sale of Fractional or Less than Fee Interest (Specify~B%lowl
Significant Change in Property Between Taxable Status and Sale Dates
Sa~e of Business is Included in Sale Price , - - -
Other Unusual Factors Affecting Sale Price ~Speci6/Below)
None
18. Property Class I 3 1, ll-I 19. SdToolOiatdctName. Greenport ,
20. Tax Map klentifieds) I Roil Identifier{s} (If more than fora, attach sheet with additional identifier(s))
1000-053.00-03.00-012. 000
I ce~ify that all of the items ofinformaffon eotered on this form are true and correct Lto the best of my knowledge and beite~ and I undenmmd that t~e making
of any willful false (mtement of material fact herein will subject ii~ to the pro,~siom of the penol law relative to the makiTl~ ~Jld illin(, Ot
BUY_ER
BUYER'S
AI'rORNE¥
Rob'err E. Ho].lev
Barbara Holley v
1085 I BaY Shore Road
Greenpor t NY 11944
I
SELLER
Gould Jennifer
631 477-8607
I \