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L 12708 P 583
III SUFFOLK COUNTY CLERK RECORDS OFFICE RECORDING PAGE Type of Instrument: DEED N~m~er of Pages: 9 Receipt N~m~er : 12-0119200 TRANSFER TAX NUMBER: 12-06092 District: 1000 Deed Amount: Recorded: At: LIBER: PAGE: Section: Block: 055.00 01.00 EXAMINED AND CHARGED AS FOLLOWS $0.00 Received the Following Fees For Above Instrument Exempt Page/Filing $45.00 NO Handling COE $5.00 NO NYS SRCHG EA-CTY $5.00 NO EA-STATE TP-584 $5.00 NO Notation Cert.Copies $5.85 NO RPT Transfer tax $0.00 NO Comm. Pres Fees Paid TRANSFER TAX NUMBER: 12-06092 THIS PAGE IS A PART OF THE INSTRUMENT THIS IS NOT A BILL JUDITH A. PASCALE County Clerk, Suffolk County 10/16/2012 04:19:58 PM D00012708 583 Lot: 005.003 $20 00 $15 00 $125 00 $0 $60 $0 $285 Exempt NO NO NO 00 NO 00 NO 00 NO 85- Number of pages This document will be public record. Please remove all Social Security Numbers prior to recording. RECOROED 2012 Oct i6 04:19:58 PH JUDITH R, PASCRLE CLERK OF SUFFOLK COUNTY L D00012708 P 583 DT~ 12-06092 Deed / Mo~gage Instrument Deed / Mo~gage Tax Stamp [ Recording / Filing Stamps FEES Page / Filing Fee Handling 20, 00 TP-584 Notation EA-52 17 (County) < __ EA-S217 (State) ..P.T.S.A. Comm. of Ed. S, O0 Affidavit Sub Total NYS Surcharge 15. O0 Sub Total Other .Grand Total v'4 ~ 12022035 ~ooo ossoo ozoo Real Property~ Tax Service Agency Verification Satisfactions/Discharges/Releases List Property Owners Mailing Address RECORD & RETURN TO: TOWN OF SOUTHOLD · PO BOX l 179 SOUTHOLD, NY 11971-O?-7~? Mortgage Amt. 1. Basic Tax 2. Additional Tax Sub Total Spec./Assit. or Spec./Add. TOT. MTG. TAX Dual Town __ Dual County __ Held for Appointmer~k/ Transfer Tax Mansion Tax The property covered by this mortgage is or will be improved by a one or two family dwelling only. YES or NO If NO, see appropriate tax clause on page #_ of this instrument. I Community Preservation Fund Consideration Amount $ CPF Tax Due $ Improved__ Vacant Land TD TD TD Mail to: Judith310 CenterA' Pascale,Drive,SUffOlkRiverhead,County NyClerk11901 ;o. !ame Title Company Information www.suffolkcountyny.gov/clerk T tie # Suffolk County Recording & Fn. dorsement Page This page forms part of the attached by: HAMAN, SMITH, CARRIG, PIERSON, LAIBLE, PIERSON AND PIERSON DEED (SPECIFY TYPE OF INSTRUMENT) The premises herein is situated in SUFFOLK COUNTY, NEW YORK. made TO IntheTOWN of SOUTHOLD TOWN OF SOUTHOLD In the VILLAGE or HAMLETof SOUTHOLD BOXES 6 THRU 8 MUST BE TYPED OR PRINTED IN BLACK INK ONLY PRIOR TO RECORDING OR FILING. (over~ Tax Map Designation District I ooo Section 05-~ O0 Block 0[.oo Form 8002* - Bargain and Sale Deed. with Covenants against Grantor's Acts - Individual or Corporation. (single sheet) CONSIJLT YOUR LAWYER BEFORE SIGNING TItlS INSTRI..IMENT - THIS 1N.qTRI ;MENT SHOULD BE USED BY LAWYERS ONLY. THIS INDENTURE, made the ¢ , day of ~ 66 t,~ , two thousand and //~&aa.'2 v,~ BETWEEN Carolyn Haman residing at 1020 Old North }toad, Southold, New York t 197l; Annette Smith residing at 2531 Pole Bridge: Road, Avon, Ncxv York 14414; Audrey Carrig, residing at 840 Greenwood Drive, Ballston Spa, New York 12020; Richard Pierson, Sr., residing at 5245 North Bayview Road, Southold, New York 11971; Elizabeth Ann Laible t/k/a/ Elizabeth Ann Pierson, residing at 3 Bailey Farm Road. ?it,stown, New Jersey 08861; Jean Marie Pierson, residing at 2 Halstead Street, Clinton, New Jersey 08809 and Richard Pierson, Jr., residing at 6637 Radcliffe Lane, Woodbridge, Virginia 22191 party of the first part, and Town of Southold, residing at 54375 State Route 25, Soulhold, New York 11971 party of the second part, WITNESSETH, that the party of the lirst part, in consideration ofTen Dollars and other 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 second part forever, ALL that certain plot, piece or parcel of land, with the buildings and improvements thereon erected, situate, lying and being at the Hamlet of Southold, Town of Southold, County of Suffolk, State of New York bound and designated as follows: BEGINNING at a point on the westerly side of Youngs Avenue (f/k/a Railroad Avenue) distant 70.00 feet southerly from the intersection of the southeasterly side of the Old North Road with the westerly side of Youngs Avenue (17k/a Railroad Avenue): RUNNING THENCE along the westerly side of Youngs Avenue South 15 degrees 15 minutes 00 seconds East 148.53 feet to a point; THENCE South 65 degrees 3 t minutes 20 seconds West 303.64 feet to a point on the southeasterly side of the Old North Road; THENCE along the southeasterly ~ide of the Old North Road, North 33 degrees 01 minutes 50 seconds East 303.64 feet to land now or fbrmerly of The Town of Southold~" THENCE along land now or formerly of The Town of Southold, North 74 degrees 45 minutes 00 seconds East 78.51 feet to the point or place of BEGINNING. TOGETHER with all the 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 appurtenances and all the estate and rights of the party of the first part 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 party 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" whenever 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: ANNETTE SMITH ~' RICHARD PIERSO'N, SR. ELizaBETH ANN LAIBL~ ///~- JE,~ MARIE PIERSON RICHARD PIERSON} JR. TO BE USED WHEN THE AC,KNOWLEDGMENT IS MADE IN NEW YORK STATE STATE OF NEW YORK, COUNTY OF _~'~~ SS: On the O . day of Iv \ ~"-t~ , in the year ~ rO ! before me, the undersigned, personally appeared RICHARD PIERSON, SR. personally known to me or proved to me on the basis of satisfactory evidence to be the individual(~0 whose name~ is ~) subscribed to the within instrument and acknowledged to me that he/~l~/t~'9 executed the same in his/l~/t~r capaci .b'. ~), and that by his/l~/t~r signature(.~, on the instrument, the individuaI0(b, or the p- "erson upon behalf of which the in' "dividual(3,) acted, executed the instrument. (signature an--d office of indix{idu'al ~aking acknowledgment) CAROL HYDELL NOTARY PUBLIC - STATE OF NL=W YORK NO. 01HY6189695 QUALIFti=D IN SUFFOLK COI.JNT~,,.~ COMMISSION EXPIRES 06/30120.~/N il STATE OF NEW YORK, COUNTY OF ~ ss: Onthe dayof ~¢ ,intheyear ~0 ] q. before me, the undersigned, personally ~ppeared CAROLYN HAMAN personally known to me or proved to me on the basis of satisfactory evidence to be the individual0~ whose namet4) is subscribed to the within instrument and acknowledged to me that bd'/she/t.~executed the same in hid/her/tl:0~ capacityfi~, and ....... that by ~5~//her/th~stgnature0tkon the ,nstrument, the ,nd,v,dua'0~: or the person upon behalf of which the individual0(J acted, executed the instrument. ^ (signature and office ofindividul~i ta~kiatg acknowledgment) CAROL HYDELL NOTARY PUBLIC - STATE OF NEW' YORK NO. 01HY6189695 QUAlIFiED IN SUFFOLK COUNT~, COMMISSION EXPIRES TO BE USED WHEN THE ACKNOWLEDGMENT IS MADE IN NEW YORK STATE STATE OF NEW YORK, COUNTY OF ~t~."~a~_ ss: Onthe \ "-']'~'~ dayof ~(h O,~-n , in the year before me, the undersigned, personally appeared AUDREY CARRIG 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 behalf of which the individual(s) acted, executed the instrument. (signature and office of individual takifi'g acknowledgment N!.AR,1LY N E HO'GAN N,qtt~ry Public, State of New York Reg. No. 01H06200852 Qualified in Saratoga County, ~t..,~, rnlssion Expires 02-09-2 ~ TO BE USED WHEN THE ACKNOWLEDGMENT IS MADE IN NEW YORK STATE STATE NEW YOm<, COUNTY ,-, Onthe I -I /q% day of , in the year ss: before me, the undersigned, personally appeared ANNETTE SMITH 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 behalf of which the individual(s) acted, executed the instrument. ~f~ce~o; in~ki~knowledgment) MIA A. KELLOGG NO. 4838320 Notary Public, State of New York Qualified in Livingston County "~',, ~ My Commission Expires November $0, l~J'_.~.TM 3 TO BE USED WHEN THE ACKNOWLEDGMENT IS MADE IN NEW YORK STATE STATE OF NEW YORK, COUNTY OF _[s~ [~[~o \t 0 [-/-~ ss: On the 2 q ~ day of ~ ~xt , in the year ~- ©l ~-. before me, the undersigned, personally appeared JEAN MARIE PIERSON 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 behalf of which the individual(s) acted, executed the instrument. (signature and office of individua[~aking acl~wledgement) SANDY COLLAZO ~ Notary PuDllc - State of New York ~ NO. 01C06168289 [ Quolilled In Bronx County, _[ ACKNOWLEDGMENT FORM FOR USE OUTSIDE NEW YORK STATE ONLY: (Out of Stare'or Foreign General Acknowledgment Certificate) i&;,~;l;,';/4;;; ;;;;; ~;,;t~i ;;g;;;e'; ;; ;b;;~;~;,;l;',k) ....... .. _~...~ SS.: On the day of ~year before me, the undersigned, (Insert N~ry) personally appeared ANNff. A~TE SMITH fl,~rt ?me os si?~, tory; personally known to.. m,,~f..proved }o m.e o.n the basis of satisfactory evidence to be the individual(s) whose name(s) is (are) subscribed to t~..n i.nstmmen, t.and a, ck.nowledged to me that he/she/they executed the same in his/her/their capacity(les), and that by hi~l~~(,s),on the }n,stm..ment, the individual(s), or the person upon behalf of which the individual(s) acted, ex~omed the instrument, and that such individual made such appearance before the undersigned in the (Insert the city or other political subdivision and the state or country or other place the acknowledgment was taken) (signature and office of individual taking acknowledgment) ACKNOWLEDGMENT FORM FOR USE OUTSIDE NEW YORK STATE ONLY: (Out of State or Foreign General Acknowledgment Certificate) .~..o.u~.o...~...~! .~..~..¥.,.~.~., ~ ~ 9.....¢.~. ,..~.~.. ~.,.,).,~....G. ~9.~.: (Complete Venue with State, Province or Municipalily) Onthe ~V,, dayof ,.).U-nC (lnsert Name ~_~ary) personally appeared RICHARD PIERSON, JR (Insert Name of Signatoryj , in the year o~l o~ before me, the undersigned, 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 behalf of which the individual(s) acted, executed the instrument, and that such individual made such appearance before the undersigned in the (stgnamre and office ofmd~wdual takin~a~owledgment) ~ ~" ~'.I", '"~/~ * A ACKNOWLEDGMENT FORM FOR USE OUTSIDE NEW YORK STATE ONLY: (Out of State or Foreign General Acknowledgment Certificate) ......................................................................... } SS.: (Complete Venue with State. Province or Municipality) On the 02 t day of ~,ff~/~,~t' , in the year O (Insert Name of Notary) before me, the undersigned, personally appeared ELIZABETH ANN LAIBLE (Insert Name of Signatory) 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 behalf of which the individual(s) acted, executed the instrument, and that such individual made such appearance before the undersigned in the .... (Insert the city or other political subdivision and the state or country or other place the ackno~vledgment was taken) (signature and ¢ce of individual t~ind a~'~knowledgment) MARY4.EE GAGE NOTARY PUSMC STATE Of: NEW JERSEY ACKNOWLEDGMENT FORM FOR USE OUTSIDE NEW YORK STATE ONLY: (Out of State or Foreign General Acknowledgment Certificate) (Complete Venue with State, Province or Municipality) On the day of , in the · .} SS.: before me, the undersigned, (Insert Name of Notary) personally appeared JEAN MARIE (Insert Name personally known to me or proved on the basis of satisfactory evidence to be the individual(s) whose name(s) is (are) subscribed to the within instrum acknowledged to me that he/she/they executed the same in his/her/their capacity(les), and that by his/her/their si on the instrument, the individual(s), or the person upon behalf of which the individual(s) acted, executed the and that such individual made such appearance before the undersigned in the (Insert the state or country or other place the acknowledgment was taken) (signature and office of individual taking acknowledgment) SCHEDULE A ALL that certain plot, piece or parcel of land, with the buildings and improvements .thereon erected, situate, tying and being at the Hamlet of Southold, Town of Southold, County of Suffolk, State of New York, bound and designated as follows: BEGINNING at a point on the westerly side of Youngs Avenue (f/k/a Railroad Avenue) distant 70.00 feet southerly from the intersection of the southeasterly side of the Old North Road with the westerly side of Youngs Avenue (f/k/a Railroad Avenue); RUNNING THENCE along the westerly side of Youngs Avenue South 15 degrees 15 minutes 00 seconds East 148.53 feet to a point; THENCE South 65 degrees 31 minutes 20 seconds West 303.64 feet to a point on the southeasterly side of the Old North Road; THENCE along the southeasterly side of the Old North Road, North 33 degrees 01 minutes 50 seconds East 303.64 feet to land now or formerly of the Town of Southold; THENCE along land now or formerly of the Town of Southold, North 74 degrees 45 minutes 00 seconds East 78.51 feet to the point or place of BEGINNING. PLEASE TYPE OR PRESS FIRMLY WHEN WRITING ON FORM INSTRUCTIONS: http:/! www.orps.state.ny, us or PHONE (518) 473-7222 FOR COUNTY USE ONLY I ~ C1. SWlS Code ' ~-~ -~, ~ ~, ~,91 REAL PROPERTY TRANSFER REPORT -- I STATE OF NEW YORK ~. Dat. Deed R~eord,d ~ /~'~ [5 / /~ STATE ,OARDOP,ALPROPERTVSEI~ICE, . RP- 5217 C3. Book . Page SL,.~n R~, ~ PROPERTY INFORMATION ~ ' [ I I 3. Tax Indicate where future Tax BUM em 10 be sent Bmi:ng if other' than buyer address let bottom of fom~l Ad~'e~ 4. Indlcme the number of A~eesment Roll. persMa trenM~rrnd on the deed I , S. D~ · .s.,~ i ,~ ~L~ I I # of Parcels OR F----I Pert of a Pete, el JORI .... I ~ or 3 Family Residential F I~ Commercial Industrial Residential Vacant LandC]I~I Apartment Public Bowke Non-ResidentiaIVKam Land HI I Entenainmem/Amusemem Forest I (Only if Part of · PamrelJ Check. es they ~ 4A. Ptaflfling Board with Subclavian1 Audlorlty Exists [] ~ Subdivlslon Approval was Required fM Transfer [] 4C. Parcel Approved fo~ SubdMslon wltl~ Map Provided [] & Ownership Type ia Condominium [] 9. New Construction off Yecem Land[] 10A. Property Located with[n an Agricultural District [] I~B. Buyer received a disclosure notice i~clicating [] that the pmp0rty ia in an A~riQuI~urBI Dialriot SALE INFORMATION 11. Sm. Contra. Da. · , 13. Full ~1* ~ I , , I ' ' : ' modgages or ~her obll~fion..l ~. rou~ ~ ibc nesr~ ~ ~1~ 0 I ASSESSMENT INFORMA~ON - Oat8 should reflect the lat.t Final ~se;smem Roll and Tax Bill I 15. C~esk ore m mine of these ~ma~mtiom es epplk~Me m ~: A ~ gale ~en Bolali~S or Former ~lat~a ~ ~ Sale B~en Rel~ Compan~ or Pa~nem in Busi~ C ~ O~ of t~ B~rs is al~ a ~ller D ~ Burr or Seller is O~mment ~e~ or Lending In~[~tion ~ ~ ~ T~ ~ Warran~ or Bargain and ~lo (S~i~ ~1~) F ~ ~le of F~ional or ~a than Fee In~ IS~ei~ BOI~) ~ ~ ~gnifl~nt Change in Pro~ ~n Ta~Mo S~tus and ~le ~ H ~Sale of Busings is Inclu~ in ~le ~ [ ~her Ueusual F~mm A~i~ ~le Pri~ (S~iN ~) J ~None Year of .~Nammtt Roll from i~>.lt. ~1~ which iofommtiml 1akin . TOtal Aeseesed Ve~ul &of ell t~reofs in transfm') ~ ~ 20. TLY Map Idm~lBm(al / Roll IdemRtm(a) (ff mom than four, altash sheet with eddiifoml iden~flm(s)) I I I I CERTIFICATION I I curtal)' ~mt ~dl at' the Ltem~ M' Inrunimdea ememJ un thb lam are true an~ cerm~'l. Itu Ibc bee d' m~ kmm'[edRe and bt4k~ and ] uuacrr, tond dmt the malda8 el' an.v willful rab, e ~totemeat el' material I'~t herein will rmb. kd me to the pnvflsiom ar the penal law' relethe lo the makiuR end fiBnR ar fal*e Irmnmmeat~. BUYER BUYER'S A'ITORNEY ,,1,~P~,,~ ,,q I NEW YORK STATE COPY %�2 70k ,p 593 ADDENDUM TO PECONIC BAY REGIONCOMMUNITY PRESERVATION FUND FORM SCHEDULE A GRANTORS NAME ADDRESS HAMAN,CAROLYN 1020 OLD NORTH ROAD, SOUTHOLD,NY 11971 SMITH,ANNETTE 2531 POLE BRIDGE ROAD,AVON,NY 14414 CARRIG,AUDREY 840 GREENWOOD DR., BALLSTON SPA,NY 12020 PJERSON SR., RICHARD 5245 N. 13AYVIEW ROAD, SOUTHOLD,NY 11971 llu4zAAd:Z2==-- I:AIBLE, ELIZABETH ANN 313AILY FARM ROAD,PI'1TSTOWN, NJ 08861 PIERSON,JEAN MARIE 2 HALSTEAD STREET,CLINTON,NJ 08809 PIERSON JR.,RICHARD 6637 RADCLIFFE LANE, WOODBRIDGE, VA 22191 I�