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L 12723 P 370
SUFFOLK COUNTY CLERK RECORDS OFFICE RECORDING PAGE Type of Instrument: DEED WITH LIFE ESTATE Number of Pages: 4 Receipt Number : 13-0029111 TRANSFER TAX NUMBER: 12-17726 District: 1000 Deed Amount: Recorded: At: LIBER: PAGE: Section: Block: 080.00 04.00 EXAMINED AND CHARGED AS FOLLOWS $0.00 Received the Following Fees For Above Instrument Exempt Page/Filing $20.00 NO Handling COE $5.00 NO NfS SRCHG EA-CTY $5.00 NO EA-STATE TP-584 $5.00 NO Notation Cert. Copies $0.00 NO RPT Transfer tax $0.00 NO Comm. Pres Fees Paid TRANSFER TAX NUMBER: 12-17726 THIS PAGE IS A PART OF THE INSTRUMENT THIS IS NOT A BILL JUDITH A. PASCALE County Clerk, Suffolk County 03/13/2013 10:31:41 AM D00012723 370 Lot: 004. 000 $20.00 $15.00 $125.00 $o.oo $60.00 $o.oo $255.00 Exempt NO NO NO NO NO NO Number of pages This document will be public record. Please remove all Social Security Numbers prior to recording. RECORDED 2013 Mar i3 JO:3i:41 JUDITH R. PRSCRLE CLERK OF SUFFOLK COUNTY L D00012723 P 570 DT~ 12-i7726 Deed / Mortgage Instrument Deed I Mortgage Tax Stamp Reco[ding / Filing Stamps 3 I ~ES ' Page / Filing Fee b~f,,/__ Handling 20~ 00 TV-584 .~ Notation EA-52 17 (County) ~ EA-5217 (State) /~*'-9 __ 60.00 Comm. of Ed. 5. 00 Affidavit Certified Copy NYS Surcharge 15. 00 Other 4 I Dik9.°° Real Property Tax Service Agency Verification Sub Total Sub Total Grand Total 13000334 xooo o8ooo 0400 004000 Mortgage Amt. 1. Basic Tax 2. Additional Tax Sub Total Spec./Assit. or Spec./Add. __ TOT. MTG. TAX Dual Town __. Dual County___ Held for Appointmen2~r- 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. / Community Preservation Fund Consideration Amount CPF Tax Due $ ~ Improved 1 Satisfactions/Discharges/Releases List Property Owners Mailing Address RECORD & RETURN TO: Vacant Land I RICHARD W. VANDENBURGH, ESQ. TD I FOSTER, VANDENBURGH & RIYAZ, LLP -- I 4 Montauk Highway TD__ Westhampton, NY 11977 TD I I IMail to: Judith A. Pascals, Suffolk County Clerk 171 Title Company Information I 310 Center Drive, Riverhead, NY 11901 In N " ' I www.suffolkcou ntyny, gov/clerk I T~i~ie ~ams . Suffolk County Recording & Endorsement Page, This page forms part of the attached DEED with Retained Life Estate made by:' (SPECIFY TYPE OF INSTRUMENT) GUS L. MUELLER and The premises herein is situated in E L I Z A B E T H A. M O E L L E R SUFFOLK COUNTY. NEW YORK. TO In the TOWN of Sm,Vhcfl d DAVID MUELLER, DONNA MAGILL, In thc VILLAGE and KENNETH MUELLER or HAMLETof Southold BOXES 6 THRU 8 MUST BE TYPED OR PRINTED IN BLACK INK ONLY PRIOR TO RECORDING OR FILING. (over) BARGAIN AND SALE DEED WITH COVENANT AGAINST GRANTORS'S ACTS (INDIVIDUAL OR CORPORATION) FORM 8002 (short version), FORM 8007 (long version) CAUTION: THIS AGREEMENT SHOULD BE PREPARED BY AN ATTORNEY AND REVIEWED BY ATTORNEYS FOR SELLER AND PURCHASER BEFORE SIGNING. THIS INDENTURE, made the clay of .~"fzj~g~'0lFd'(., 2012, BETWEEN GUS L. MUELLER and ELIZABETH A. MUELLER, of 390 Lake Drive, Southold, New York 11971, party of the first part, and DAVID MUELLER of 4 Russell Terrace, Wayne, NJ 07470, DONNA MAGILL of 25 Victory Knoll Path, Miller Place, NY 11764, and KENNETH MUELLER of 214 Pomander Road, Mineola, NY 11501 party of the second part; o WITNESSETH, that the party of the first part, in consideration of Ten Dollars and No Cents ($10.00), 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, the heirs or successors and assigns of the party 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 in the Town of Southold, County of Suffolk, State of New York, known and designated as and by Lot No. 3, Block G, on a certain map entitled "Map of Re~/don Shores", and filed in the Office of the Suffolk County Clerk on July 2, 1931, as Map No. 63t. BEING AND INTENDED TO 'BE the same premises conveyed to the parties of the first part by Deed, dated May 11, 1978, and recorded in the Office of the Clerk of Suffolk County on May 16, 1978, in Liber 8428, Page 409. PREMISES KNOWN AS: 390 LAKE DRIVE, SOUTHOLD, NY 11971 THIS DEED IS SUBJECT TO GUS L MUELLER AND ELIZABETH A. MUELLER, THE PARTIES OF THE FIRST PART, RETAINING A LIFE ESTATE. Section: 080.00 Block: 04.00 Lot: 004.000 NYSBA's Residential Real Estate Forms (9/00) O 20t2 Matthew Bender & Co,, a member of thc LcxisNcxis Group. The grantors, GUS L. MUELLER AND ELIZABETH A. MUELLER, reserve the power to appoint their remainder interest in the premises, or any portion thereof, outright or upon trusts, conditions and limitations, to or among any one or more members of a class consisting of the now living issue of said grantors and the issue of said grantors born hereafter but during their lifetime, in such proportions and amounts, without regard to equality, as said grantors may appoint during their lifetime by a deed, in proper form for recording, making express reference to this power and executed and recorded prior to their death. No exercise of this power of appointment shall be deemed to release any other interest of the grantors, including any retained life estate, unless such a release is explicitly made. The exercise of this power shall not exhaust it and the Deed recorded last shall control as to any ambiguities or inconsistencies. No exercise of this power of appointment shall be effective against or constitute notice to any bona fide purchaser or mortgagee unless the deed purporting to effect such exercise of this power is executed and recorded as provided for herein. This power shall not be exercisable by the grantors, GUS L. MUELLER AND ELIZABETH A. MUELLER, to appoint their remainder interest in the premises, or any portion thereof, to themselves their estate, their creditors or the creditors of their estate, under any circumstances. The death of either party of the first part will not affect the remaining party's right to the life estate or their ability to exercise the aforementioned special power of appointment. TOGETTHEIR 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, TOGETTHEIR with the 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, 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. NYSBA's Residential Real Estate Forms (9t00) © 2012 Matthew Bender & Co., a member oftbe LexisNexis Group. The word "party" shall be construed as if it read "parties" whenever the sense of this indenture so requires. IN WITNESS WTHEIREOF, the party of the first part has duly executed this deed the day and year first above written. IN PRESENCE OF: GUS L. MUELLER ELIZABI~'I~ A. MUELLER Acknowledgment by a Person Within New York State (RPL § 309-a) STATE OF NEW YORK COUNTY OF SUFFOLK ) ) SS.; ) On the i'L- day of ~t~'~¢'~"~dT--in the year 2012, before me, the undersigned, personally appeared GUS L. MUELLER and ELIZABETH A. MUELLER, 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 instf~ent and acknowledged to me that he executed the same in his capacity(les), and that by hi~ ~ignature(s) on the instrument, the individual(s), or the person upon behalf of which th..e ind V~iual(s) act~'dj, executed the inst~[nent, (sig~ ~ture and,office of ind!vidual takin~acknowledgment) ~,, RICHARD W. VANDENBURGH Nota~ Public, State of New York No. 2VA5027629 - Suffolk Co,.~. Commission Expires May 16, ~ ~ NYSBA's Residential Real Estate Forms (9/00) © 2012 Matthew Bender & Co., a member of the LexisNexis Group. -3- PLEASE TYPE OR PRES8 FIRMLY WHEN WRITING ON FORM INSTRUCTIONS (RP-S217-1N$): www. orps.state.ny.us FOR COUNTY USE ONLY c,...Bco.. , 7.3. g.5.% Taxation and Finance C,.Da.,,..e.,.,. IO t,.3 I O~c, of RealProper~yTax$.wices "'"" ~" " RP- 5217 C3. B.okII.A.-"t'A.~ IC4..a..[ . 37q , PROPERTY INFORMATION 1. Propady I 390 LooM[On [ MOU/~OLD 2. au~r ~ MUSLLER SOU'~iOr. D I 11971 I DAVID I ~/. 390 Lake Drive 4, Indicate'the number of Assessment Roll parGels transferred on the deed J , . 5. Deed [ MuEr. LF_~R I KENNETH 3. T~ I~i~ ~m futura TBX Biffs am ~ ~ ~nt Sl:ll~ il ~r ~. ~r address (ct ~ ~ ~) [ M~LL~ I O~~u'g I Southold [ ~ { 11971 ~ { M ~ls OR P~ M 7. G~k ~e box bel~ ~iGh most ~Gura~ de~dbeB the use M the ~ it the its 8. ~e~hip Ty~ is ~nd~in.um ~ ~ 2 ~ 3 Fami~ R~s~o~al F I I CommG~.a ~ ~ I ndust~l 1~. I)~NomRes~n~slVa~nlLa~ }]QEnl~alnme~l~use~nl ].~ Fams~ that~ep~s~isinen~cul~mlDis~ SALE INFORMATION i tl. 8ele Contraet Dm N/A i / / I " " : '/ lZDetaofDeislTre.efmr I ~ 17 I 13. FuIIDeisPd~ I , , {, , . '~ O - · § ,(J I C FuU Bale Pdc~ is tho tolal amount paid fro' the prope~y m~ludlng persorml pmpe~y. This paylm~n[ may be in lbo fom~ Of c~sh. ether properly or §(~ds. or the ~ssumptJon of m0dgage$ or oU~er a~ligalions.) Ple,'~seroundtolhoae~m~wholodoflarcmount. 14, lndtcatathevMueofpamonal -- 0 --· 0 0 i propMty Included In tho sale [~ ~ ; '- ~~ -- 15. Check one or more of these conditions as eppllcable to transfer. A [] Sale Between Reis[ives or Foe[ar Roistivac ~ ~J Dele Between Related Compames of Pa~tnem in Bus[nasa C .__J Offs MUle Buyer's Is also a Seller D .~J Buyer m' Seller Is Govemmem Agency m' Len~mg Insti~utk)n F. ~J Deed Type oM Warranty or Dergain arid Dele (Sl~ci[y Below ) I" .__J Sale Of FraGlionsI or Less Ihsn Foe Inloms! ( Bpacit'y Below } 0 / Bignif~.nt ChanGe in Peps/fy Delween Texabio Status end Sale Ds~es H ~ Dais Of Bus[nasa is lncluded in Sale Price [ .~ Other Unus~l Factors Affecting Bale Price C Bpadfy Below ) J ,__J None ConYeyzmce with ~et~ined 'li~:e e.~t.a~e & limited pow. er of appointment to change ASSESSMENT INFORMATION - Data should reflect the latest Final Assessment Roll and Tax Bill lS. Year of Asalllmeot R~il ~ which Iltfofmetlon taken J .~J 17. Total A~seesad Value (of etl parcols in trensfer~ 20. Tm( Map IdenUDerjs) I Roll Idontitior(s) ( If mom than four, attach sheet with additional Identifier(s) ) I SC~ # 1000 - 080.00 - 04.00 -004.000 I I I I I J CERTIFICATION J i c~-J-12. DATE FOSTER, VANDENIBURGH & RIYAZ~ LiP 631] 288-5550 %. NEW YORK STATE COPY BUYER CONTACT INFORMATION Mueller I Gus t. 631 I 765-3106 390 j Sako Drive $outhold NY 11971 I I