HomeMy WebLinkAboutL 12215 P 3668PY~ KOUZIO~ & LIETTA KOUZK~, I!~ ~
~ ~NE~8 & DANlaLA ~ hhl ~
/
~ ~ THREE H~~~D ~
way ~ partly ~ons ~ boundary betwee~ had now or formm4y of~ and ]and of
~ L. Dayton, ~ pa~tiy over ~ I~d of'~ L. Day, on ~ ~ al~ the boundary
~ ~ land ofM~ L. Dayton a~d 1~ o£How~d A. Toe&er.
d~ted 8/22/97, n~ord~d 9/03/97, ~ l~er 11~9, psp 64L
W ~ENCE OF:
BARC-~N ~ S~ DEED
TO
~it 4304?e0 * FAX; ~'W 13~4~1'~
OISTI~CT
BLOCK
L.O~ 4
TC',.,WN $OUTHOJ_D
~SS 2600 TAKA~ RO~.D
RETURN BY ~ TO:
N~m~ or pa&es
TORRI~NS
Tax St~
GRAND ~TAL
RRCOR~ & RETURN TO:
~ ~y Tax ~i~ A~ Verifi~on
0~~ looo oe?oo 0600 004000
Mailin{
REC0~
Oct, 17 i2=09=2~ PH
E~rd
CLEPf< OF
SUFFOL~ C.(~.'T'?
L
P
{)TI{ 02.-i l~i
Recordin~ / Filing
Tax
2. Addil~l Tax
Sub To~
Or
TOT. MTG. 'FAX _
t~l Town ~ Coaniy
Held for Ap~rtion~t
lime pro, ny cov~ by this moriga~ is ot
wlll be improved by a one or two famiiy
Y~ or NO,,,
if NO. see appropriate tax {:}muse on ~ #
ofthis insinment.
Commur Fq'e~rvation Fund
Considcralion Amount $..
CPF Tax Due $
TD
lnformaimn
Lan~
~ ~ Tour, ship of
M t~he VILLAGE
or H/UViLET of
made by:
~SPECIFY TriPE OF iNS].RLFivIENF)
~ ~ ~n is sii~ in
SUFFOLK COUNTY, N~ YORK.
I i111111 il IIII Iii IIIII II IIiii iii Iliii iiii iiii
S~FOLK COUNTY
~CORDS OFFi~
~-ECORDING :PAGE
~of instant; DEEDS/DDD
~er o£ Pagees 3
T~%NS~R TAX NUMBER: 02-11601
D~s:trict~
1000
Recorded
At ..
LIBER:
PAGe:
087.00 06,00
~ ~ CHA~GED ~ FOLL~B
$300,000.00
10/17/2002
12=09;28 ~
D00012215
366
L~t ~
004. 000
Received the Fo11~ing Fees For ~ Inst~t
Page/F/ling $9.00 ~ Handl~
eSE $5.00 NO NYe
~'~ $5.00 NO EA-STATE
TP-584 $5.00 NO Cart. Copies
aPT $30.00
Transfer ~ $1,:200.00 NO ~.~res
T~J~NBF~R TAX NIF~ER: 02-11601
FeesP&~d
THIS PAGE IS A PART OF THE ~NBTItUMENT
Exempt
SS.00
$15.00 NO
$25.00 NO
$0.00 NO
$0.00 NO
$3,000.00 NO
$4,299.00
Edward
County Clerk, Suffo~ County
INSTRUCTIONS: http://www.orps.state.ny.us or PHONE (518) 473-7222
~FOI~eOUNTY USE ONLY
.CI.~NIS Code
/D
I Moah / % Yea,
C2. Date Deed Recorded
REAL PROPERTYSTATE OF TRANSFER NEW YORK REPORT
STATE BOARD OF REAL PROPERTY SERVICES
PROPERTY ~NFORMATION I
~' P~P~I ~ ~ ~ I I
Location STREET NUMBER . - .... STREET NAME
CITY OR TOWN VILLAGE ZIP CODE
2. Buyer I V~'/,./t- -'~-,'~ I ~ I
Name LAST NAME / COMPANY FIRST NAME
LAST NAME I ANY FIRST NAME
3. Tax Indicate where future Tax Bills are to be sent
Billing if other than buyer address (at bottom of form) I
Address LAST NAME ~ COMPANY
FIRST NAME
I I
I STREET NUMBER AND STREET NAME I CITY OR TOWN STATE ZIP CODE
I
4. Indicate the number of Assessment
Roll parcels transferred on the deed
I ,, / I Ct of Parcels OR
5. Deed
Property I ORI , ,
Size
6, Seller
E (Only if Part of a Parcel} Check as they apply:
Pad( of a Parcel 4A. Planning Board with Subdivision Authority Exists []
4B. Subdivision Approval was Required for Transfer []
I I X I .... (-~1 4C. Parcel Approved for Subdivision with Map Provided []
FRONT FEET DEPTH ACRES
"-:'/?V , ,'po ,,4
LAST NAME! 7CO ANY. FIRST NAME
Name
LAST NAME ! COMPANY FIRST NAME
7. Check the box below which most accurately describes the use of the property at the time of sale:
2 or 3 Family Residential
Residential Vacant Land
Non-Residential Vacant Land
Agricultural I[~ Community Service
Commercial !~ Industrial
Apartment Public Service
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
I SALE INFORMATION I
11SaleContractDate I ~' / /'"~/ U~
M~nth Day Year
12. Date of Sale / Transfer I c~ / ?~/, / P' '~' I
Month Day Year
15. Check one or more of these conditions as applicable to transfer:
A
B
C
D
E
F
G
H
I
J
13. Full Sale Price I , , , ~-'~1 , I O, ~1 O, 0 , 0 I
(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 assure ption of
reD,gages or other obligations.) Please round to the nearest whole dollar amount.
14. Indi~te the value of pemonal I i i i i i ~ , 0 , 0 I
prope~ in~ud~ in the ,lo ~ ~ ·
ASSESSMENT INFORMATION - Da~ ~ould ~e~ the late~ Rnal A~ssmem Rbll and Tax Bill
16. Year of ~ment Roll from ~ ~ ~ ~ 17. To~I As~ Value (of all parcels in tran~er)
which information taken ~ '
Sale Between Relatives or Former Relatives
Sale Betwben 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 ~ot Warranty or Bargain and Sale [Specify Below)
Sale of Fractional or Less than Fee Interest (Specify Below)
Significant Change in ProperW Between Taxable Status and Sale Dates
Sale of Business is Included in Sale Price
Other Unusual Factors Affecting Sale Price (Specify Below)
None
19. School District Name I
20. Tax Map Identifier(s) / Roll Identifier(s) {If more than four, attach sheet with additional identifier(s))
I
"' ...... I cErTiFiCATION' '
I I I
I
I certif3' that all of the items of information entered on this form are true and correct (to the best of my knowledge and belief) and I understand that the making
of any willfult false statement of material fact herein will subject me~ ~9'' the provisions of the penal law relative to the making and filinoo of false instruments.
:'iNi!'[: I,~' . / BUYER//// ,.~' ? //
BUYER!SIGNATURE ~ DATE
STREET NUMBER STREET NAME (AFTER SALE)
......... ~
I
CITY OR TOWN ZIP CODE
SELLER /
,-- ., ,
~" .......- :- -'"' ":::" "' I' '/ ~
SELLER SIGNATURE DATE
BUYER'S ATTORNEY
LAST NAME FIRST NAME
/: -777-
AREA CODE I TELEPHONE NUMBER
f ~