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SUFFOLK COUNTY CLERK RECORDS OFFICE RECORDING PAGE Type of Instrument: DEED Number of Pages: 4 Receipt Number : 12-0110151 TRANSFER TAX NUMBER: 12-04292 District: 1000 Deed Amount: Recorded: At: LIBER: PAGE: Section: Block: 052.00 02.00 EXAMINED AND CHARGED AS FOLLOWS $320,000.00 09/24/2012 04:10:57 PM D00012706 203 Lot: 018.000 Received the Following Fees For Above Instrument Exempt Page/Filing $20.00 NO Handling COE $5.00 NO N¥S SRCHG EA-CTY $5.00 NO EA-STATE TP-584 $5.00 NO Notation Cert. Copies $0.00 NO RPT Transfer tax $1,280.00 NO Comm. Pres Fees Paid TRANSFER TAX NUMBER: 12-04292 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 $3,400.00 NO $4,935.00 JUDITH A. PASCALE County Clerk, Suffolk County Number of pages This document will be public record. Please remove all Social Security Numbers prior to recording. RECORDEO 2012 Sep 24 04:10:57 PM JUDITH fl. PflSCflLE CLERK OF SUFFOLK COUNTY L 000012?06 ? 203 DT~ 12-04292 Deed / Mortgage Instrument Deed / Mortgage Tax Stamp I Recording / Filing Stamps 31 Page / Filing Fee Handting 5. 00 TP-584 Notation EA-52 17 (County) EA-52t7 (State) R.P.T.S.A. t.~~'j '~' Comm. of Ed, 5. 00 Affidavit ..Certified Copy NYS' Surcharge 15. 00 Sub Total Mortgage Amt. 1. Basic Tax 2. Additional Tax Sub Total Spec./Assit. or Spec./Add. TOT. MTG. TAX Dual Town __ Dual County __ Held for Appointment/~ Transfer Tax I /2~/hi ] '/~' Mansion Tax The property covered by this mortgage is or will be improved by a one or two family dwelling only. Sub Total YES or NO Other GrandTotal /~)~ ~ lpSgNeO~°oP~/t~ies~ii/~ · . ,._ I imPrOve~l '[/~/k~) 6 Isatisfacti°nsmischargesl~Er~celoe~S~s&Lis~t~,~°~ert~YTOoW..UerS Mailing AddressI / ]VacantLa.nd-~ Mail to: Judith A. Pascalo, Suffolk Oounty OIork 7 Title Company Information I 310 81 Suffolk County Recording & Endorsement Page This page forms pa~ of the attached ~ made by: TO (SPECIFY TYPE OF INSTRUMENT) The premises herein is situated in SUFFOLK COUNTY, NEW YORK. In the TOWN of .-(",,dr'~4/ In the VILLAGE or HAMLET of BOXES 6 TH 8 MUST BE TYPED OR PRINTED IN BLACK INK ONLY PRIOR TO RECORDING OR FILING. (over) BARGAIN AND SALE DEED WITH COVENANT AGAINST GRANTOR 0NO U ) STATUTORY FORM C THIS IS A LEGALLY BINDING INSTRUMENT. IF NOT FULLY UNDERSTOOD, WE RECOMMEND ALL PARTIES TO THE INSTRUMENT CONSULT AN ATI'ORNEY BEFORE SIGNING. THIS INDENTURE, made the SEPTEMBER, Between JAMES P. PROVENCHER and KAREN S. PROVENCHER, of 1 t BARNES ROAD, WADING RIVER, New York 11792, party of the first part, and PETER PERRONE and ROSEMAI~-PERRONE, AS HUSBAND AND WIFE, whose address is 50 WENDOVER ROAD, YONKERS, New York 10705, party of the second part: WITNESSETH, that the party of the first part, in consideration of one dollar and other good and valuable consideration, lawful money of the United States, paid by the party of the second part, does hereby grant and release unto the party of the second part, their heirs, successors and assigns forever, all of the fight, title and interest to 53 830 ROUTE 48, TOWN OF SOUTHOLD, COUNTY OF SUFFOLK, STATE OF NEW YORK as more particularly described in Schedule A attached hereto; Subject to all covenants, easements and restrictions of record, ifa_ny, affecting said premises; Being and hereby intending to convey the same premises as conveyed to the parties of the first part by Deed dated January 5, 2003, and recorded in the Suffolk County Clerk's Office on November 21, 2003, in Liber/Reel 12285 at page 62; TOGETttER with the appurtenances and all the estate and rights of the party of the first part in and to said premises; TOHAVEAND TOHOLD the premises herein granted unto the party of the second part, their heirs, successors and assigns forever. And the party of the first part covenants that he has not done or suffered anything whereby the said premises have been encumbered in any way whatever. IN WITNESS Fe'HEREOF, the party of the first part has hereunto set his hand and seal the day and year first above written. d,/'~ P. PROVENCHER, Seller K)kREN- S ~-PRoV ENC-HER, Seller NYSBA's Residmfial Real Estate Forms (9/00) O 2012 Mallhew Bend~ & Co., a member oft. he t_~xisNexis Group. Acknowledgment by a Person Within New York State (RPL § 309-a) STATE OF NEW YORK ) ) SS.: COUNTY OF SUFFOLK ) On the /~)T/'t day of ~"EtOt'~,'n~ in the year20 t;2--, before me, the undersigned, personally appeared JAMES P. PROVENCHER and KAREN S. PROVENCHER, 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 they executed the same in their capacity(ies), and that by their signature(s) on the instrument, the individual(s), or the pers~~~ecuted the instrument. (signature and office of individUaI taking acknOWledgment) NYSBA's Residential Real Estate Forms (9/00) © 2012 Matlhew Bender ,& .Co., a member ofttte LexisNexis Group. -2- SCHEDULE A ALL that certain plot piece or parcel of land, with the buildings and improvements thereon erected, situate, lying and being in the Hamfet of Arshamomaque, Town of Southold, County of Suffolk and State of New York, bounded and described as follows: BEGINNING at a point on the southerly line of North Road distant along said line 49.33 feet westedy from the northwest comer of land of Ruch (which point of beginning is atso the northwesterly comer of land of Richard and Carcte Gibb); RUNNING THENCE along the southerly line of North Road South 61 degrees 59 minutes 10 seconds West, 50 feet to a point; THENCE South 31 degrees 40 minutes 50 seconds East, 90.18 feet to a point in the center line of Old Cove Boulevard; THENCE along the center line of Old Cove Boulevard North 61 degrees 59 minutes 10 seconds East, 50 feet to a point; THENCE North 31 degrees 40 minutes 50 seconds West, 90.18 feet to the point or place of BEGINNING. For Clearance click: Cl~earance~,MadisonAbstract.com T~tle Number:. S 12 15906 PLEASE TYPE OR PRESS FIRMLY WHEN WRITING ON FORM INSTRUCTIONS (RP-5217-1NS): www.orps.state.n¥.us FOR COUNTY USE ONLY ,3 .~ ~ fl ~/~ New York Slate Department of RP- 5217 C3. Book' I, ~,'~ ,(~D 'C4. P'9'~ I ~ I(~11 I RealPropel~tTransferRepo¢(efl0) PROPERTY INFORMATION Billing if ~er men burr ad,mss (at ~ ~ ~1 ~d~s I 4. Indieafe the number of Assessment Roll gareele tranefermd on the deed I , I I #ofPar~els OR x I ?. Cheuk the bed bel~'t ~'alah m~t e~a~l~ ~One Family Residential ~ ~neu~ral J ~ C ..... i~wi~ R ~2~3FamiNR~M~t~I F ~al J ~ Indus~l C ~ RssWnfial V~nI L,~ O ~,nl E~ PU~IG ~M D ~ ~n-R~tial Vaunt La~ I I ~ End.mmpi I ~me~ L ~ Forest CIIYOHIOWN IPaIt of a Parcel (Only g Pad of a Parcel) Chock as they apply: 4A, Planning Board with Subdiv~on Authodly Exists [] 4B. SulxJ~sion A4~r~wl wss Required for Tre. nefer [] 4C. Parcel Approved fer SubdMskxt with Map Provided [] Cheek the boxes below ae they apply: B, Own~hip TWa id Condominium [] 9. New Constru~on on Vaunt La~ ~ lOA. P~e~ ~d ~in an ~dcu~ml DisM~ ~ 1OB. Burr ~i~ 8 diem n~i~ i~i~ting ~ ~t the ~y is in an ~l~ml Dis~ ,,.F.,,S.,,,. o. o.o; o.o , Full Sal8 Pl~ce i$ t~ ~1 amoant ~id ~r t~ ~m~y i~uding ~BI ~. ~is ~ymont ~y ~ in the ro~ ~ Msh. ~her p~e~ or g~s, 0r the a~mp~n d ~a~ or ~her obligors,) ~e~the~t~ra~nt. pmF.~ Indud.d In tho.lo ' ~ ~ 15. Check one or more of ~ese r. ofldltlons as appllcabfe to transfer: A ~ Sale Belween Relatives er Former Relatives ~ ~J Sale Between Related companies er Peffmer~ in BusinaM C .~J One of the Bu~m lae]~a Seller D .~ Buyer of Sellm is Oovemmeof AgeKy or Lof~ding Inslitulkm ]~ .~J Deed Typenot WarrantyorBargalnandSalo(SpecilyBelow) F ,~ Safe of FrK~iof'lal or Less then Fee Infemst ( SI~ly Below ) (~ .~ Signirlcant Changein Properly satwesn Taxabb Slatueond SuieDates H .~ Sale o! Business is Includ~l in Sale PHce I / Other Unusual Factors Affe~bng Sale PHce ( Speory Below ) J ~" N~'~O ASSESSMENT INFORMATION · Data should reflect the latest Rnal Assessment Roll and Tax Bill ~0. Tax Map fosntitie,'(s) I Roll Identifisds) ( If mom then four, ktteok Shem wRh addlfl~al Identifiers) ) , , CERTIFICATION SELLER SIGNATURE -~~~BUYER SIGNATURE BUYER'S ATTORNEY C NEW YORK STATE COPY BUYER CONTACT INFORMATION ,