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Home My WebLink AboutL 12698 P 463SUFFOLK COUNTY CLERK RECORDS OFFICE RECORDING PAGE Type of Instrument: DEED Number of Pages: 3 Receipt Number : 12-0076678 TRANSFER TAX NUMBER: 11-24395 District: 1000 Deed Amount: Recorded: At: LIBER: PAGE: Section: Block: 113.00 04.00 EXAMINED AND CHARGED AS FOLLOWS $350,000.O0 07/o6/2o12 11:24:30 AM D00012698 463 Lot: 005.000 Received the Following Fees For Above Instrument Exempt Page/Filing COE EA-CTY TP-584 Cert. Copies Transfer tax $15 O0 $5 oo $5 oo $5 oo $0 O0 $1,400 00 TRANSFER TAX NUMBER: 11-24395 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 Exempt $20.00 NO $15.00 NO $125.00 NO $0.00 NO $60.00 NO $4,000.00 NO $5,650.00 JUDITH A. PASCALE County Clerk, Suffolk County Number of pages S This document will be public record. Please remove all Social Security Numbers prior to recording. RECORDED 2012 Jul 06 t!:24:30 AM JUDITH ~.~P~SC~LE CLERK OF SUFFOLK COUNTY L D00012698 P 463 DT~ I!-24395 DeedlMortgageln~rument Deed/MortgageTaxStamp I Recording/FilingStamps 3 I FEES Page / Fil!ng Fee Handling TP-$8~, Notation EA-$217 (County) EA-$2~7 (State) R.P,T.S.A. Comm. of Ed. Affidavit Certified Copy NYS Surcharge Other :~0. 0__90. SubTotal ~;. oo 15. o__~o Sub Total Grand Total Real Property Tax Service Agency Verification 6 Sati~action 8 12015728 zooo zz3oo 0400 005000 Wickham, Bressler, Gordon & Geasa P, O. Box 1424 13015 Main Road Mattftuck, NY 11952 Mail to: Judith A. Pascale, Suffolk County Clerk 3~o Center Drive, Riverhead~ NYz~9o~ www.suffolkcou ntyny.govlclerk Mortgage Amt. __ z. Basic Tax ~. Additionat Tax Sub Total Spec./Assit. or Spec/Add, TOT. MTG. TAX Dual Town Dual County__ Held for Appointment ~ TransferTax /c/i(~O ~ Mansion Tax The property covered by this mortgage is or will be improved by a one or two family dwellin~ only... YES~_orNO~ If NO, see appropriate tax clause on parle # of this instrument. $ Community Preservation Fund Consideration Amount $ -~0 oC;C). ~ Improved Vacant Laad r~ rD FD t? I Title Company Information Co. Name Suffolk County Recording & Endorsement Page This page forms part of the attached by; TO made (SPECIFY TYPE OF INSTRUMENT) The premises herein is situated in SUFFOLK COUNTY, NEW YORK. In the TOWN of ~ c~ In the VILLAGE Or 'HAM LET of BOXES 6 THRU ~ MUST BE TYPED OR PRINTED IN BLACK INK ONLY PRIOR TO RECORDING OR FILING. (over) Standard N.Y.B.T.U. Form 8002 - Bargain and Sale Deed, with Covenant against Grantor's Acts - Uniform Acknowledgment Form 3290 CONSULT YOUR LAWYER BEFORE SIG~ING THIS INSTRUMENT.THIS INSTRUMENT SHOULD BE USED BY LAWYERS ONLY THIS INDENTURE, made the,/~day of ,2012 BETWEEN HARRIET G. THEUER, as surviving tenant by the entirety of Henry G. Theuer who died a resident of Suffolk County on November 7, 1996 Surrogates file #494S96, residing at 300 Jackson Landing Road, Mattituck, New York 11952, party of the first part, and JANE A. PETERSON, residing at 1771 Old Welsh Road, Huntingdon Valley, PA 19006, party of the second part, WlTNESSETH, that the party of the first part, in consideration of Ten and 00/100--($10~00)--dollars, and other good and valuable consideration paid by the party of the second part, does hereby grant and release unto the party of the second part, the heirs or successors and assigns of the party of the second pad forever his life estate interest in: ALL that certain plot, piece or parcel of land, situate, lying and being in the Town of Southold, County of Suffolk and State of New York, known and designated as Lot No. 3 on a certain map entitled "Map of Jackson Landing", and filed in the office of the Clerk, of the County of Suffolk on March 28, 1969 as Map No. 5280. SUBJECT to covenants, restrictions, easements, reservations and agreements of record. BEING AND INTENDED TO BE the same premises conveyed to the party of the first part by deed dated September 11, 1986, recorded November 18, 1986 in the Office of the Clerk of the County of Suffolk in Liber 10171 Page 123. TOGETHER with all right, title and interest, if any, of the party of the first part in and to any streets and roads abutting the above described premises to the center lines thereof; TOGETHER with the appudenances 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, the heirs or successors and assigns of the pady of the second part forever. AND the party of the first part covenants that the party of the first part has not done or suffered anything whereby the said premises have been encumbered in any way whatever, except as aforesaid. AND the party of the first part, in compliance with Section 13 of the Lien Law, covenants that the party of the first part will receive the consideration for this conveyance and will hold the right to receive such consideration as a trust fund to be applied first for the purpose of paying the cost of the improvement and will 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" when ever the sense of this indenture so requires. IN WITNESS WHEREOF, the party of the first part has duly executed this deed the day and year first above written. IN PRESENCE OF: f/deedTheuer BE USED ONLY WHEN THE ACKNOWLEDGMENT IS MADE IN New York STATE State of New York, County of , SS', State of New York, County of SS~ . On the day of in the year before me, the undersigned, personally appeared On the day of , in the year before me, the undersigned, personally appeared personally known to me or proved to me on the basis of satisfactory 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 in 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. personally known to me or proved to me on the basis of satisfactory 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 in his/her/their capacity(les), and that by his/her/their signature(s) on the instrument, the individual(s), or the person upon behatf of which the individual(s) acted, executed the instrument. (signature and office of individuat taking acknowledgment) Notary Public (signature and office of individual taking acknowledgment) Notary Public TO BE USED ONLY WHEN THE ACKNOWLEDGMENT IS MADE OUTSIDE NEW YORK STATE State (or District of Columbia, Territory, or Foreign Country)of PENNSYLVANIA County of ,,.2(Y~I~.,:~/F/~/F~ ,~' ss: On the /~ ~ day of r,//~1,t~- , in the year 2012, before me, the undersigned, personally appeared HARRIET G. THEUER personally known to me or proved to me on the basis of satisfactory evidence to be the individual(s) whose name(s) is (are) subscribed to the within instrument and acknowledged to me that he/she,ffhey executed the same in his/her/their capacity(les), 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, and that such individual made such appearance before the undersigned in the (inser~he City or~o~her political subriivision) Co~T~ i0F ~NNSYLVANL~ ~ Notadal Seal I ~ Dlpanwita Namboodtd, Notary Public I | seu~te~on Bero, Montaome'Y Count,/ ] L ~ Commission rr_xplres March 39, 20~6 J in (and insert tt'~State or Country or other place the acknowledgment was taken) (signa(ure and office of individual taking acknowledgement) Notary Public BARGAIN AND SALE DEED WITH COVENANT AGAINST GRANTOR'S ACTS Title No. HARRIET G. THEUER SECTION BLOCK LOT COUNTY OR TOWN Southold TO JANE A. PETERSON STANDARD FORM OF NE1N YORK BOARD OF TITLE UNDERWRITERS Dist'ributed by Commonwealth COMMONWEALTH LAND TITLE INSURANCE COMPANY Recorded at Request of COMMONWEALTH LAND TITLE INSURANCE COMPANY RETURN BY MAiL TO: Wickham Bressler Gordon & Geasa, P.C. P.O. Box 1424 lMatt tuck, New York 11952 PLEASE TYPE OR PRESS FIRMLY WHEN WRITING ON FORM INSTRUCTIONS: http~/www.orps.state.ny.us or PHONE (518) 473-7222 FO,R COUNTY USE ONLY I~~-~ Cl. aWlS Cod. ' %.~7.3 ,~ .~ ,~ I REAL PROPERTY TRANSFER REPORT STATE OF NEW YORK .... . RP- 5217 , . ...,...... PROPERTY INFORMATION 1. hopmy 300 [ Jackson Landing Road I Southold I Ymt tttuck I 11952 z.a.~ [ Peterson I Jane A. I I I 3. Tax Indicate whe~a future Tax Bille sro to be cent Billing if other 1hen buyer addmas (et bottom of form) st,. .... ,,.., ..... 4. lode, ate the number of Acesosowgt I~ IOdy ff Pwt d a Pmcd) Chcek as they apply: ~oll pmcels wndmlred on the dead I , , [ I IOt Ps,cats OR Pert of · Pen;el 4A. Pfonnlng Board Mth Subdivision Authority Exists amid 48. Subclivisiofl Apixl)vsl was Required for Trsnsb~ Ss,h~'~' I ~C)HT FEET I X J 0EPTH I OR · ' ' '~'nE5' ' ~,. 9 I 4C. parcel Approved for Subdivisioo with Map Provided I I 7, Cheek the box below ythlrJt m~t 1~;41retlly d~odl)~ tho un ~ t~ p~.~ ~ tho time ~ One Fami~ R~idential ~ ~ ~ri~ltural ~ .... i~ Basics 9. N~ Con~r~i .... V~nt ~ D 2 or 3 Family R~ide~iM Ceremonial IMbmfial Basldential V~ant ~nd ~Hmeot Public S~e 1Ga. B~ Non. Residential Vacaot ~nd End.inmont ~ Amu~ment Forest ~ ~ pm~ b in an ~r~u~ural ~i~ I SALE INFORMATION I 11.81fo Co~tri~t Dire I ~"~ / I (Furl Sale Price is die total amount paid For the property including personal property, This payment may I~ in the form of cash. other property or goods, or the assumption of marlgags8 0r Other obligetien..l I~eacerouqd~othene~Motv~ofodelJaramount. 14. lndir, ate the value of pof~i1BIL , , ~ o, o I property included in the ~te ~ ~ ' ' ASSESSMENT INFORMATION - Data should reflect the latest Final Assessment Roll and Tax Bill 16. Year of ~ RMI From ~ l 1/~ i 2 I 17. Total A~e~ed Value (of all peceds in Iranderl I wM~h Mhm~mt]~t tal~n . 18. PropedyClace I 2, 1. 0I-U 19.$ehoolObtHetName L ~tCttuck iSale Baeween Relatives or Former Relatives (~ Sale Between Related Companies or Parmem in Business One of ~he Buyem is also a Seller Buyer or Solar is GOv~nment Agency or lending Institution · Deed Type sol WananW or Bargain and ,Sale (Spa¢ify Below) Sale of Fractional or Less than Fee Intemet (Speci(y Below) Sale of Buaineas is Included in Sale Price Other Unusual Factors Affecting Bale Price (Spacifi/Below) ,7.7.0.01 Map IdeIT~ieds) I Roll Idemlllw(a) (ff more then roar, attach sheet with additional identiflerlall L 1000-113.00-04.00-005.000 I L I I I I I CERTIFICATION I I cerd~- thai oll of (he items el' iofomlation tmten'd mi (hbi fMTO are true and emil'1 (to the ~ of my knockers and bdJof) and I u~ thai (he makinN id' an)' wolf,d fnlhe .Moltment of m~ml ~ ht~4n will .~ltJect me to the p~wL, dolt,, M' the p~nol ]ow relative to the makill~ and rdin~ oF raL~ imlrum~. BUYER t"--~R;4GW'TU~EJaRS A. Pet:erson L'~71 [ Old Velsh Road HunCtnsdon Valle]~ I PA I 19006 SELLER Harriet G. Theuer BUYER'S ATTORNEY I NEW YORK STATE COPY