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CaTn. OF.F~L
Affidavit
C~fled Copy
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GRAND TOTAL
2002 00~0 0400 ~4000
P.O. ~ 177
~ ~t 29 09~23~14 ~
Ecn~or~ P. Rmaifle
DJFF~ ~TV
DT~ 0~13074
I. bsic Tsx
2. Additional Tax
~. M~.. TAX
Dutl Town · i~.~1
Held fl~r A~~t,
T~ T~ ~/~
d
will h lmprov~ by 8 one or two Fsmil~
d~ ~ly.
6 ~un,ty ~,~,vat,m~ Fund
Conside~flon Am~nt
TD
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TTpo o£ ~t~t~ I)BB~S/I:JlX)
leumber of P~e~ 3
~FER TAX ~n: 02-13074
1001
heal Auount t
002.00 04.00
$99,900.00
D00012217
283
oo4. oo0
TAX W~: 02-13074
PAGE iS A PART OF ~ ~TRUMENT
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~~ P.~ne
CounL-y Clerk, ~££olk County
FOR COUNTY USE ONLY
Cl, SWIS Code
C2. Date Deed Recorded
I~LI:~,~I: I Vl'~ UH I'~H~:~ I'IHMLY WHI:IN WHIIlINtJ UI~f-UHIV~
INSTRUCTIONS: http://www.orps.state.n¥.us or PHONE (518) 473-7222
· Month DSy' Year
C4. Page
Jnhn~on Court-.
STREET NAME
REAL PROPERTY TRANSFER REPORT
STATE OF NEW YORK
STATE BOARD OF REAL PROPERTY SERVICES
RP - 5217
RP-5217 Rev 3/97
I 11944
ZIP CODE
PROPERTY INFORMATION I
1. PropertyI q lJ-4
Location STREET NUMBER
Southold
I Greenport
CITY OR TOWN VILLAGE
2. BuyerI Zingone I Lorne
Name LAST NAME t COMPANY FIRST NAME
I
3, Tax
.~illing
Address
LAST NAME f COMPANY
Indicate where future Tax Bills are to be sent
if other than buyer address (at bottom of form)
FIRST NAME
I
LAST NAME COMPANY
FIRST NAME
I
STREET NUMBER AND STREET NAME
CITY OR TOWN
I , I
STATE
ZIP CODE
4. Indicate the number of Assessment
Roll parcels transferred on the deed
, 1 I #of Parcels OR ~-] Part of a Parcel
5. Deed
Property I I xl I ORI .... 0 o6 ,0 I
Size FRONT FEET DEPTH ACRES
6. Seller [ Stinky And Wife, Inc. I
(Only if Part of a Parcel) Check as they apply:
4A. Planning Board with Subdivision Authority Exists []
4B. Subdivision Approval was Required for Transfer []
4C. Parcel Approved for Subdivision with Map Provided []
Name LAST NAME ~ COMPANY FIRST NAME
I
LAST NAME COMPANY FIRST NAME
7. Check the box below which most accurately describes the use of the property at the time of sale:
i: One Family Residentia, E: Agricultural i: Communit~Service
2 or 3 Family Residential F Commercial Industrial
Residential Vacant Land G Apartment Public Service
Non-Residential Vacant Land H Entertainment / Amusement Forest
Check the boxes below as they apply:
8. Ownership Type is Condominium []
9. New Construction on Vacant Land []
10A. Property Located within an Agricultural District []
10B. Buyer received a disclosure notice indicating []
that the property is in an Agricultural District
! ,SALE INFORMATION I '"
11. Sale Contract Date [ 2 / 28 / 02 I A
Month Day Year B
C
12. Date of Sale / Transfer 10 / !8 / 02 I D
Month Day Year E
F
9 9 9 0 0 G
13. Full Sale Price [ , ~ ~ ~ ~ , ~ I I 0 ~ 0 I H
'-. (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 J
mortgages or other obligations.) P/ease round to the nearest whole dollar amount.
14. Indicate the value of personal
property included in the sale
~ t ~ ~ ) ~ 0 ~ 0 I
~ ·
Check one or more of these conditions as applicable to transfer:
Sale Between Relatives or Former Relatives
SaFe Between Related Compames 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
Other Unusual Factors Affecting Sale Price (Specify Below)
None
I ASSESSMENT INFORMATION - Data should refleCt the latest Final Assessment Roll and Tax Bill
16. Year of Assessment Roll from I 0 2 I 17. Total Assessed Value (of all parcels in transfer) I
which information taken t '
/
20. Tax Map Identifier(s] I Roll Identifier(s) (If,l~p_~re than'fO(iL attach sheet with additional identifier(s))
I 1001-002.00-04.00-004.000 I I
I ~ ~, I I .; , '~ I
! certify that all of the items of information entered on this form are true a[~d,~correct (to the best of ~ay knowledge and belief) and I understand that the making
of any willful false statement of material fact herein will subject me to the prows~ons of the l~?~l~tW relative to the~making and filing of false instruments.
BUYER
CITY OR TOWN
STREET NUMBER STREET NAME (AFTER SALE)
STATE
SELLER
DATE
ZIP CODE
BUYER'S ATTORNEY
Gould
Jennifer
LAST NAME
(631)
477-8607
FIRST NAME
AREA CODE TELEPHONE NUMBER