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STATUTORY FnRM C
CONSULT YOUR LAWYER BEFORE SIGNING - THIS INSTRUMENT SHOULD BE USED BY LAWYERS ONLY
MOORE'S LANE HOLDING CORP., a domestic corporation with offices at
c/o Sarisohn, Sarisohn, Carner, LeBow, Braun & Shiebler,
3510 Veterans Memorial Highway, Commack, New York 11725,
party of thc first part, and
NANETTE~. YAVEL, residing at 200-14 Hilton Avenue, Hempstead, New York 11550,
party of the second part:
WITNE$SETH, that the party of the first part, in consideration ofTen Dollars and other good and
valuable consideration paid by the party of the second part, does hereby grant and release unto thc party of thc
second part, his heirs, succcssors and assigns of thc party of thc sccoud part forever,
ALL that ccrtain plot, piece or parcel of laud, with thc buildings and improvclncl]ts thcrcou crcctcd, situate,
lying and being in the Town of Southold, County of Suffolk, and State of New York, known and
designated when taken together are bounded and described as follows:
DISTRICT:
1000
SECTION:
040.01
BLOCK:
01.00
LOT:
042.000
ALL that certain plot, piece or parcel of land, with the buildings and improvements thereon
erected, situate, lying and being in the Town of Southold, County of Suffolk and State of New
York, being known as Unit No. 42 as shown on Condominium Plan entitled, "Pheasant Run
Estates Condominium I' filed in the Suffolk County Clerk's Office as Map No. 257 on 6-13-96
together with a 5% interest in the commo,, elements of the Condominium described in the
Declaration of Condominium entitled "Declaration of Pheasant Run Estates Condominium I'
recorded in the Suffolk County Clerk's Office in Liber 11707 page 628 as amended.
This; conveyance is made in the regular course of business conducted by the party of the first part.
The Grantor herein is the same entity as the Grantee entity in deed from DIANE CARROLL and
DONALD BLACKEN dated 6-30-93, recorded 8-20-93 in ~iber 11640, Page 929.
TOGETHER with all right, title and interest, if any, of the party of the first part in mid to any streets and roads
abutting the above described premises to the center liucs thcrcof; TOGETHER with thc appurtenances and
all the estate and rights of the party of the first part in and to said premises; TO HAVE AND TO HOLD
the premises herein granted unto the party of the second part, his heirs, successors and assigns of the party of the
sccend part forcvcr.
AND the party of the first part covenants that he has not done or suffered anything whereby the said premises
haw: been encumbered in any wa,, whatever.
AND the party of the first pagj4 c~g£/(a~tce, ,~,,~ ~'0~)13 of the Lien Law, covenants that the party of the
first part will recetve the D,~R~r~.d~ ~ ~./g_~a, ~u~ and will hold the right to receive such considcratmn
as a trust fund to be applied first for~ ./~,/~, ~/',~y/~)g the cost of the improvement and xvill apply the same
first to the payment of the cost of the improvement before using any part of the total of the same for any other
purpose. The word "party" shall be construed as if it read "parties" whenever the sense of this indenture so
requires.
IN WITNESS WHEREOF, the party of the first part has hereunto set his hand and seal the day
and year first above written.
MOORE'S LANE HOLDING CORP.
~q WI~SER, President
Number of pages
TORRENS
Serial #
Certificate #
Prior Cfi. #
Deed / Mortgage Instrmneot
Page / Filing Fee
Handling
TP-584
Notation
EA-52 17 (County)
EA-5217 (State)
ILP.T.S.A.
Comm. of Ed.
Affidavit
Certitied Copy
Reg. Copy
Other
500
Deed / Mortgage Tax Stamp
FEES
__ Sub Total
Sub Total
Recording/Filiug Stamps
Mortgage Amt.
1. Basic Tax
2. Additional 'Fax
Sub Total
Spec./Assit.
Or
Spec./Add.
TOT. MTG. TAX
__ Dual County -tionment
covered by this morlgage is or
by a ouc or two Ihmily
orNO
>fthis instrument.
page #
,I
Real Property Tax Service Agency Verification
Dist. Section B lock Lot
/ ~r,~ ~ t co/ , ~,~,a
nity Presetwation Fund
hnproved ~-,/
Vacant Land
'rD /0
Satisfactions/Discharges/Releases List Property Owners Mailing Addres~
RECORD & RETURN TO:
/~O ,5~ ~/~, ~' {8 I Tit~Companylnfon~ation / j
Suffolk Co ty Recording & Endorsement Page
~6s page tbrnu pm~ o[the attached ~- t.~ ~' m~do by:
(SPEOFY ~PE OF ~S~{~ )
SUFFOLK CO~X, NEW YO~
~4 ~-~ ~ ~/~ Z ~ the VILLAGE
~ or ~ET of
BOXES 5 TI4RIJ 9 MUST BE TYPED OR PRINTED IN BLACK INK ONLY PRIOR TO RECORDING OR FIL1NG.
SUFFOLK COUNTY CLERK
RECORDS OFFICE
RECORDING PAGE
Type of Instrument: DEEDS/DDD
N~mher ¢)f Pages: 3
TRANSFER TAX NUMBER: 00-38121
District:
1000
Deed Amount:
Recorded:
At:
LIBER:
PAGE:
Section: Block:
040.01 01.00
EXAMINED AND CHARGED AS FOLLOWS
$179,900.00
05/17/2001
10:32:04 AM
D00012118
970
Lot:
042. 000
Received the Following Fees For
Page/Filing $9.00
COE $5.00
EA-STAT~I $25.00
Cert. Copies $0.00
SCTM $0.00
Comm. Pres $598.00
TRANSFER TAX NUMBER: 00-38121
THIS PAGE IS
Above Instrument
Exempt
NO Handling
NO ~EA-CTY
NO TP-584
NO RPT
NO Transfer tax
NO
Fees Paid
A PART OF THE INSTRUMENT
Exempt
$5.00 NO
$5.00 NO
$5.00 NO
$15.00 NO
$720.00 NO
$1,387.00
Edward P.Romaine
County Clerk, Suffolk County
PLEASE TYPE OR PRESS FIRMLY WHEN WRITING ON FORM
INSTRUCTION,S: http://www.orps.state.ny.us or PHONE (518) 473-7222
REAL PROPERTY TRANSFER REPORT
STATE OF NEW YORK
STATE BOARD OF REAL PROPERTY SERVICES
RP- 5217
LAS] NAME/COMPANY
3. Tax Indicate where future Tax Bills are to be sent
Billing if other than buyer address (at bosom of form) I
Address LASTNAME/COMRANY
I
STREET NUMBER AND STREET NAME
Indicate the number of Assessment
Roll parcels transferred on the deed I
5. Deed
Property [ J x l
L~.S1 NAME / COMPANY
I
FIRST NAME
IORI · I
I
FIRST NAME
I , I
STATE ZIP CODE
(Only if Part of a Purcell Check as they apply:
4A. Planning Board with Subdivision Authority Exists []
4B. Subdivision Approva~ was Required for Transfer []
4C. Parcel Approved for Subdivision with Map Provided []
7. Check the box below which most accurately describes the use of the property at the time of sale:
A D One Family Residential
B J__.] 2 or 3 Family Residential
C J~ Residential Vacant Land
D L._J Non-Residential Vacant [.and
11. Sale Contra~ Date
12. Date of Sale / Transfer
Commercial
Apar[ment
Entertainment ! Amusement
Month Day Year
Month Day Year
Community Service
Industrial
Public Service
Forest
Che~k 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
15. Check one or more of these conditions as applicable to transfer:
A Sale Between Relatives or Former Relatives
D
E
Sale Between 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 not Warranty or Bargain and Sale (Specify Below(
Sale of Fractional or Less than Fee Interest (Specify Below(
,g. Pu,,S.,ePr,.
(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
mortgages or other obligations.( Please round to the nearest whole dollar amount.
14. Indicate the value of personal I , , , , , , i 0 , 0 I
property included in the sale ·
I A~MENT t~[~N ~ ~h°uld refle~' t~ ~t F~ Asses~ R°ll and TaX Bii~'
16. Year of Assessment Rog from
which informatie,n taken I ~ , 0 1 17. Total Assessed Value (of all par. Is in transfer)
18. Property Class ~, /, / '-~ 'g, School District Name' ~g~:~'~
20. Tax Map Identifier(si / Roll Ident~fier($l {If more than four, at~ach sheet with additional identifier{s))
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 I I I
1 cerifl'y that all of the items of information entered on this form are true and correct (to the best of my knowledge and belled and l understand lhat the malting
of any willful false ~,~tatement of material fact herein will subject me to the provisions of the penal law relative to the making and filing of false instruments.
BUYER
STREET NUMBER STREET NAME (AFTER SALE)
CI~ ~ TOWN ~ . STA~ ZIp CODE
BUYER'S ATrORNEY
LAST NAME FIRST NAME
AREA CODE TELEPHONE NUMBER