HomeMy WebLinkAboutL 12690 P 489SUFFOLK COUNTY CLERK
RECORDS OFFICE
RECORDING PAGE
Type of Instrument: DEED
Number of Pages: 5
Receipt N~.~m~er : 12-0042120
TRANSFER TAX NUMBER: 11-18261
District:
1000
Deed Amount:
Recorded:
At:
LIBER:
PAGE:
Section: Block:
108.00 04.00
EXAMINED AND CHARGED AS FOLLOWS
$0.00
Received the Following Fees For Above Instrument
Exempt
Page/Filing
COE
EA-CTY
TP-584
Cert. Copies
Transfer tax
$25 00
$5 00
$5 oo
$5 oo
$6 25
$0 oo
TRANSFER TAX NUMBER: 11-18261
NO Handling
NO NYS SRCHG
NO EA-STATE
NO Notation
NO RPT
NO Comm. Pres
Fees Paid
THIS PAGE IS A PART OF THE INSTRUMENT
THIS IS NOT A BILL
JUDITH A. PASC~?.~
County Clerk, Suffolk County
04/19/2012
09:52:48
D00012690
489
Lot:
007.045
$20 00
$15 0o
$i25 O0
80 oo
$60 oo
$0 00
$266 25
Exempt
NO
NO
NO
NO
NO
NO
umber of pages ~"
This document will be public
record. Please remove all
Social Security Numbers
prior to recording.
RECORDED
2012 ~pr t3 09:52:48
JUDITH fl. PflSCflLE
CLERK OF
SUFFOLK COUNTV
L D00012690
P 489
DT# 11-18261
Deed / Mortgage Instrument Deed / Mortgage Tax Stamp [ Recording / Filing Stamps
3 I FEES
Page / Filing Fee t~N __
Handling 20. '00
TP-584 ,~__
Notation
EA-52 17 (County) ~__
EA-5217 (State) I.C~,~
R.P.T.S.A. ~ ~
Comm. of Ed. 5. O0
Affidavit
Certified Copy~''~ .~-
NYS Surcharge 15. 00
Other
Sub Total
SubTotal (~x tI ''~' family dwelling only.
_ ~ -- YES or NO
Grand Total (~9 . /~If
NO, see appropriate tax clalase el
~ ~age ~ ~. of ~is ins~entl .~
~ 12008011 ~000 20800 0~00 00~045 ommuni~
TaXAgen(Ser
Vedfica _
61,~~ ~~RECORD&~TO: I 7 ~~d '-
I Mail to: Oudith A. Pascale,.Su,olk County Olerk ~ Title Information
I al0 Oonter Drive, ~iverhead, NY 11901
] m. suflolkcou ntyny, gov/clerk Title~ame
Mortgage Amt.
1. Basic Tax
2, Additional Tax
Sub Total
SpecJAssit.
or
Spec./Add,
TOT. MTG. TAX
Dual Town __ Dual County.__
Held for Appointment ~
Transfer Tax ~
Mansion Tax
The property covered by this mortgage is
or will be improved by a one or two
81 Suffolk County Recording &_Endorsement Page
This page forms part of the attached ~)~9~(~ made by:
(SPECIFY TYPE OF INSTRUMENT)
The premises herein is situated in
SUFFOLK COUNTY, NEW YORK.
In the TOWN of ~'~4 ~
In the VILLAGE
or HAMLET of J~. ~ .~!
BOXES 6 THRU 8 MUST BE TYPED OR PRINTED IN BLACK INK ONLY PRIOR TO RECORDiNG OR FILiNG.
(over)
Recording requested by:
When recorded, mail to:
Name:
Space above reserved for use by Recorder's Office
Document prepared by:
Name
Address: Address
City/State/Zip:
Property Tax Parcel/Account Number:
City/State/Zip
Quitclaim Deed
This Quitclaim Deed is made on
and
, between
__,Cityof ~o-.21][~ '~e.._.~ ,Stateof ~ ]~c~t~'rl lo/') e 'x/" , Grantee, of
, City of ~ ~~1~~..~~ , State of
For valuable consideration, the Grantor hereby quitclaims and transfers all right, title, and interest held by~
the Grantor in the following described real estate and improvements to the Grantee, and his orarl~er heirs
and assigns, to have and hold forever, located at ~ ~_~ O~.x_k, ~__Q~
, City of /'~:. '[,J~-~ , State of ~:_:r.~ c/tO f"LL~__
Subject to all easements, rights of way, protective covenants, and mineral reservations of record, if any.
Taxes for the tax year of shall be prorated between the Grantor and Grantee as of the date of
recording of this deed.
~'NOVA Quitclaim Deed Pg.1 (07-09)
Dated:
Signature of Grantor
Name of Grantor
Signature of Witness #1
Printed Name of Wimess #1
Signature of Witness #2 Printed Name of Wimess #2
Stateof, fq~/~ ~('~/~ Countyof
personally'came before me ~d, being duly sworn, did state ~d prove ~at he/she is the person described
ent~d ~at he/sh~ si~ed the abow document in my presence.
Notary Public,
In and for the County of
My commission expires:
Seal
Send all tax statements to Grantee.
DEBORAH A. WOJCIg
Notary Public, State of New York
No. 4990159
Qualified in Suffolk County ).~
Commissio~ Expires Dec. 30, 20
· ~'NOVA Quitclaim Deed Pg.2 (07-09)
Uniform Form Certificate of Acknowledgment
State of New_York
undersigned, personalize appeared
Chri hn
personally known to me or proved to me on the basis of satistactory evidence to
be the individual (s) whose name (s) is/are subscribed to the within instrument
and acknowledged to me that he/she/they executed the same tn his/her/their
capacity (ies), and that by his/her/their signature (s) on the instrument, the
individual (s), or the person upon behalf of which the individual (s) acted,
executed the instrument
~'qotary Public
Notary Pu.b. ltc, .S.l,~le.,~ Near.York
NO. 6~o~ztu
Qualified in Suffolk County.__. ~
~mmi~ion~~~
$ohedule A De~rlptlon
ALL THAT CERTIAN PLOT, PIECE OR PARCEL OF rAND 81TUATE LYING
AND BEING IN THE TOWN OF $OUTHOLD, COUNTY OF SUFFOLK AND
STATE OF NEWYORK, BOUNDED AND DESCRIBED AS FOLLOWS:
BEGINNING AT A POINT ON THE SOUTHERLY $1DEOF RACHAEL~ ROAD,
DISTANT 432.67 FEET SOUTHWESTERLY AND WESTERLY AS MEASURED
ALONG THE SOUTHEASTERLY AND SOUTHERLY 81DE OF RACHAEL~
ROAD FROM THE SOUTHWESllERLY END OF THE ARC OF A C~JRVE
CONNECTING THE SOUTHEASTERLY SIDE OF RACHAEL'$ ROAD WITH
THE SOUTHWESTERLY SIDE OF ELIJAI~S LANE;
RUNNING THENCE SOUTH 02 DEGREES 31 MINUTE8 43 SECONDS EAST,
285.77 FEET TO A MONUMENT;
THENCE SOUTH 17 DEGREES 49 MINUI--r.S 50 8ECONDS EAST, 125 FEET
TO THE NORTHERLY 81DE OF MAiN STREET (NY8 ROUTE 25);
THENCE ALONG THE NORTHERLY SIDE OF MAIN ROAD, SOUTH 80
.
DEGREES 27 MINUTES 47 SECOND8 WEST. 50.61 FEET TO A MONUMENT;
THENCE NORTH 17 DEGREES 49 MINUTES 50 SECONDS WEST, 222.97
THENCE SOUTH 68 DEGREES 15 MINUTES 10 SECONDS WEST AND
THROUGH A MONUMENT, 112.57 FEET;
THENCE NORTH 25 DEGREES $5 MINUTES 47 SECONDS EAST, 265.67
FEET TO THE SOUTHERLY SIDE OF RACHAEL'S ROAD;
THENCE EASTERLY AND NORTHEASTERLY ALONG THE SOUTHERLY AND
SOUI~F_ASTERLY SIDES OF RACHAEL'S ROAD ALONG THE ARC OF A
CURVE BEARING TO THE LEFT, HAVING A RADIUS OF 175 FEET, A
DISTANCE OF 45.20 FEET TO THE POINT OR PLACE OF BEGINNING.
PLEASE TYPE OR PRESS FIRMLY WHEN WRITING ON FORM
INSTRUCTIONS (RP-E217-1NS): www.orps.state, ny. us
Billing if ofher ~sn bwer address (at bottom of from) L~
Address
4. Indicate the number of Assessment I'~
Roll parcels trans~efTed on the dNd I , , I # of Pc~c~.~ ORI I Part of · Parcel
5. Deed
Size
I. Check the box below which molt IP~urntMy dolcrtbol the ale of tho properLy.mt the time of sale:
.~"~'One Family Residential
RLI2or 3FamUynes, denbal F LiJC~mme,-~al 1 Iii Industrml
c !__l ~.id.es.. v,~., '-nd O
D L/N°"-nseiden"'~ v.=m'~nd ;t I I;~t'r=inr~nt/~mu~m~l LI _~ Far.,
New York 8tats Del~rtment M
Taxation and Finance
Office of Real Property Tax Sewices
RP- 5217
Real Property Transfer Report (~/10)
I
(Ofll~ ff Pa. of n Parcel) Ch~k sm ~ey apply:
aA. Planning B~ with Subcli~ AuUtmtty Ex~sts []
48. Subdivision Appro,ml was Required for Transbr []
., ~1 4C. percelAplxovedfQrSulodivi$iortwhhMapPro',~ded []
Check the boise below as tlmy appty:
5. Ownemh[p Typa ~ ~minium ~
10~ ~ ~ ~ln an ~ral DI~ ~
SALE INFORMATION i
11. ~fo Gontmct Date
12. Date of $sle I Transfer
I / / ..]
Mot, fl1 Day Year
t3. FullSalaPdcn I , , ~ , , , , ,.~.0 0_i
( Fldl Sale Price Is the total nnmunt paid fat' the p~opmly including p~rs~lal I~QpartY-
1~i$ payment may bo In the form of cash. Mher properly or goods, or the ascampUon of
fl~ages (x other obligatiMt$.) Please round to the nearest who~ dollar amount.
14, IndlGate thI value of par&ooel 0 ,0I
propedy Included Iff the olle ~ ~ ' , , , n
15. C heCr~.~y(XlS M more, of th(lc condlthme ne al~k'.aMe to ~nlhc
A I ~ b~ ~n R~s or F~er ~
~ ~ ~ ~n RMa~ ~m~n~ w Pa~ ~ Bu~ne~
(: ~ O~ ~ t~ B~m is al~ a ~1~
D ~ B~ or ~ller is ~mmem ~e~ ~ ~i~ In~
F ~ Sale ~ F~al ~ L~ss ~n F~ th~ ( S~ ~1~ )
(; ~ Slgn~ C~n~ in ~ ~n Ta~ S~s a~ Sale
~ ~ ~le ~ Buslm~ ~ Ind~ in Sale ~m
I ~ ~r U~s~l Fa~ A~ ~b ~ ( S~ ~l~ )
J ~ None
I ASSESSMENT INFORMATION - Data should reflect the latest Final Assessment Roll and Tax Bill I
IL Lleag°~n~l~a~fom~r~t klReofn fromI , , 1,.TotalAasolaedVMu, (ofnlipamelethtraolfer)I , , ;i , , ,' , , z '- ' ~
15. Tee ~ Idant51e~s) I Rs5 Identlfle~(e) ( If mnm than four, attach sholt ~ addlSe~el I'~entifia~el I
, oco -lo .oo-o'-l. oo--ez .c j' ,
I.__ __I I I
I CERTIFICATION I
SELLER alGHATURE
BUYER 81GNATURE
BUYER'S A"R'ORN E¥
BUYER CONTACT INFORMATION
117_ 2