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SUFFOLK COUNTY CLERK
RECORDS OFFICE
RECORDING PAGE
Type of Instrument: DEED Recorded: 05/20/2013
Number of~Pages: 5 At: 11:32:40 AM
Receipt Number 13-0059957
TRANSFER TAX NLJMSER: 12-23041 LIBER: D00012'730
PAGE: 237
District: Section: Block: Lot:
1000 106.00 11.00 015.000
EXAMINED AND CHARGED AS FOLLOWS
Deed Amount: $169,000.00
Received the Following Fees For Above Instrument
Exempt Exempt
Page/Filing $25.00 NO Handling $20.00 NO
COE $5.00 NO NYS SRCHG $15.00 NO
EA-CTY $5.00 NO EA-STATE $125.00 NO
TP-584 $5.00 NO Notation $0.00 NO
Cert.Copies $0.00 NO RPT $60.00 NO
Transfer tax $676.00 NO Comm.Pres $380.00 NO
Fees Paid $1,316.00
TRANSFER TAX NUMBER: 12-23041
THIS PAGE IS A PART OF THE INSTRUMENT '
THIS IS NOT A BILL
JUDITH A. PASCALE
County Clerk, Suffolk County
?1 2? .
Number of pages ~ RECORDED
2Oi3 hi.ay 2ii iL3~[:4O GM
_fl1C3ITH R. PRSr_.gLE
This document will be public CLER~I: of
record: Please remove all ~-[~~f-aL~ c~~F~rtr~r
L DOOOIZF3C~
Socia! Security Numbers P 23f
prior to recording. DT# 12-23Ci41
Dccd /Mortgage Instrument Deed /Mortgage Tax Stamp Recording /Filing Stamps
3 FEES
Page / Filing Fee ~ l Mortgage Amt.
1. Basic Tax
Handling 20. 00
2. Additional Tax _
TP-584 Sub Total
Notation SpecJAssit.
~ Or
EA-52 17 (County) S Sub Total Spec. /Add.
EA-5217 (State) TOT. MTG. TAX
Dual Town Dual County
R.P.T.S.A. Held for Appointment
Comm. of Ed. 5. 00
~a ' ~ Transfer Tax
Affidavit yy~ Mansion Tax
`~~tj
The property covered by this mortgage is
Certified Copy or will be improved by a one or two
NYS Surcharge l5. 00 Sub Total ~Q~ family dwelling only.
YES or NO
Other
G ~ Grand Total t~~o If NO, see appropriate tax clause on
~ , ~ ~ page # of this instrument.
ds-
4 Dist./000 13012629 iooo io6oo uoo oi5ooo ~~'O 5 Community Preservatio`npFtind
Tax Service R V1T A 1
ReaE Property P T S l~~,IIIIIIIII~~IIIl~I~I~III~IIl~Ill~~llllillll~l ~ Consideration Amount $ ~U 7/~
Agency 13-MAY-1 CPF Tax Due $ 3
Verification
- - - - - - Improved
6 Satisfactions/Discharges/Releases List Property Owners Mailing Address
~i RECORD & RETURN TO: Vacant Lan//d~~
~'e'~",1~N, /~•Qsq~v~ ~l.aS.T ~ ~~3dae ~ LCP TD I V
~o. 3Jk lye 3 TD
rJTL~TT':T(.tGK, Ny /I$.5~. TD
Mail to: Judith A. Pascale, Suffolk County Clerk 7 Title Com an Information
310 Cen#er Drive, Riverhead, NY 11901 C .Name
www.suffolkcountyny.gov/clerk Title # /3 - o - y
g Suffolk Count l~ecordin & Endorsement Pa e
This page forms part of the attached ~ made by:
(SPECIFY TYPE OF INSTRUMENT)
I o /!'(e T+~ The premises herein is situated in
SUFFOLK COUNTY, NEW YORK. ~ hh
/ n TO In the TOWN of / °C
./7 A ee ~fL~/o In the VILLAGE
or HAMLET of i'Tc.~ c
BOXES 6 THRU 8 MUST BE TYPED OR PRINTED IN BLACK INK ONLY PRIOR TO RECORDING OR FILING.
iz-mw..~aioeklc (rlverl
• v • CONSULT YOUR LAWYER BEFORE SIGNING THIS INSTRUMENT-THIS INSTRUMENT SHOULD BE USED BY LAWYERS ONLY
THIS INDENTURE, made the ~ 7~ day of ,~r; ~ , 2013
BETWEEN DOROTHY R. UHLEMANN, alkla DOROTHY G. UHLEMANN, as surviving Trustee of THE
UHLEMANN FAMILY 2007 TRUST, residing,at_5~11 Oy reenter Street, Valley Village. CA 91fi07
rncc,~o ipt~r-'/
party of the first part, and CHAD~4EI_~, residing a 3030 Ole Jule Lane, Mattituck, NY 11952
party of the second part,
WITNESSETH, that the party of the first part, in consideration of ONE HUNDRED SIXTY-NINE THOUSAND
the party0oftte(second pa
~ the the ~spor su cessorsrtand assigns ofdthe party oft erseconrd part foreverse unto
SEE SCHEDULE "A" ANNEXED HERETO AND MADE A PART }iEREOF
BEING AND INTENDED TO BE the same premises conveyed to the Ernest G. Uhlemann and Dorothy G.
Uhlemann, as Trustees of THE UHLEMANN FAMILY 2007 TRUST by deed made by Ernest Uhlemann dated
March 28, 2007 and recorded in the Suffolk County Clerk's Office on May 17, 2007 in Liber 12505 Page 760.
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 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 tots{ of the same for any other
purpose. The word "part' 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: " ~/t7t~JLJ2i'
DOROTHY UHLEMANN, alkla DOROTHY G.
UHLEMAN
Fidelity National Title insurance Company
' TITLE NO. F13-74Q489743SUFF
.r - SCHEDULE A-1 (Description)
ALL that certain plot, piece ar parcel of land, situate, lying and being in the Hamlet of Mattituck, Town of Southold,
County of Suffolk and State of New York, shows and designated as Lot Nos. 1 S and 16 on a certain map entitled, "Map
of Shore Acres, situate Mattituck, Town of Southold, Suffolk County, New York, surveyed December, 1913, by Roswell
S. Baylis, C.E., Huntington, L.L", which map was filed in the Officc of the Clerk of the County of Suffolk, New York, on
or about Janua 3rd ]914, as Ma No. 41.
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THE PDI.lCY TO BE ISSUED under this commitment will insure the title to such buildings and improvements on the premises which
by law constitute real property.
ri ht title and interest o the ar of the first part, of in and to the land lying
V YANCING ONL Y: To ether with all the g ,r p
FOR CONE S
in the street in front of and adjoining said premises,
SCN1rDULEA-I (Descri cion)
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TO BE USED ONLY WHEN THE ACKNOWLEDGMENT IS MADE IN NEW YORK STATE
ss: State of New York, County of ss:
State of New York, County of Suffolk
On the day of in the year
On•the, day of September in the year
before me, the undersigned, personally appeared 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 personally known to me or proved to me on the basis of
(are) subscribed to the within instrument and acknowledged to satisfactory evidence to be the individual(s) whose name(s) is
me that helshelthey executed the same in hislherltheir (are) subscribed to the exe utedtRthe nsarneacnn hislher/the
capacity(ies}, and that by hislherltheir signature(s) on the me that he/she(they
instrument, the individual(s), or the person upon behalf of which capacity(ies), and that by hislherltheir signature(s) on the
the individual(s) acted, executed the instrument. instrument, the individual(s), or the person upon behalf of which
the individual(s) acted, executed the instrument.
(signature and office of individual taking acknowledgment)
(signature and office of individual taking acknowledgment)
TO BE USED ONLY WHEN THE ACKNOWLEDGMENT IS MADE OUTSIDE NEW YORK STATE
State (or District of Columbia, Territory, or Foreign Country) of California ss:
On the day of in the year 2013 before me, the undersigned, personaAy appeared
DOROTHY R. UHLEh~NN, alkla DOROTHY G. UHLEMANN
personally known to roved to me on the basis of satisfactory evidence to be the individual(s) whose name(s) is (are)
subscribed to the within i~tfup~ and acknowledged to me that helshelthey executed the same in hislherltheir capacity(ies), and
'nstrument the individual(s), or the person upon behalf of which the individual(s) acted,
that by hislherltheir signature(s~~ ,
executed the instrument. and that suc ~lal made such appearance before the undersigned in the
0
C(~ ~ ornia
(insert the City or other political subdivision) sert the State or Country or other place the acknowledgment was taken)
(signature and office of individual taking acknowledgment)
DISTRICT 1000
BARGAIN AND SALE DEED SECTION 106.00
WITH COVENANT AGAINST GRANTO 'S ACTS BLOCK 11.00
. 1 n m~ ~Lt'i- L.OT 015.000
Title No. / lX COUNTY OR TOWN
DOROTHY R. U LEMANN, as Trustee STREET ADDRESS
TO
CHAD M£-f.~6 Recorded at Request of
~e-~\ ~ COMMONWEALTH LAND TITLE INSURANCE COMPANY
R B IL
STANDARD FORM OF NEW YORK BOARD OF TITLE UNDERWRITERS
DANIEL C. ROSS, ESQ.
Distributed by Q.O. Box 146
Commonwealth Mattituck, NY 11952
n L+~oAHeaucn courn.~~'
COMMONWEALTH LANDTTCLE INSURANCE COMPANY
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CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT cmL cooE ~ iia9
State of Calif "a
County o
r
On ~ before me, t ,
Date Here Insert Name nd Title of the Offi r
personal) appeared
j Names} of Signers}
who proved to me on the basis of satisfactory
evidence to be the person) whose name(s) isk~re
subscribed to the within instrument and acknowledged
to that he/~e hey executed the same in
hi eir authorized capacity), and that by
hi heir signatures) on the instrument the
JULIET E. WHITE person(sjj, or the entity upon behalf of which the
I ~ Commission ~ 1922854 personO acted, executed the instrument.
z • kotary Public -California Z
a
Las Angeles County I certify under PENAE_TY OF PERJURY under the
M Comm, Expires Feb ]8, 24]5 ~
laws of the State of California that the foregoing
paragraph is true and correct.
WITNESS m and official seal. .
r
Signatur ~ '
Place Notary Seal Above gnature of N ary ublic
OPTIONAL p
Though the information below is not requr'red by law, it may prove vatuabt pesons~Felying
on the document
and could prevent fraudulent remove! and reattachment of this form to another document.
k Description of Attached Document ~
y Title or Type of Document:
Document Date: Number of Pages: 'I
Signer(s) Other Than Named Above:
Capacity{ies} Claimed by Signer(s) ~
Signer's Name: Signer's Name:
? Corporate Officer -Title(s): ? Corporate Officer -Title(s):
? Individual - ~ ? Individual ~
? Partner - ? Limited ? General Top of thumb here ? Partner - ? Limited ? General Tap of thumb here
? Attorney in Fact ? Attorney in Fact
? Trustee ? Trustee ,
? Guardian or Conservator ? Guardian or Conservator
? Other: ? Other:
Signer is Representing: Signer Is Representing:
® 2010 National Notary Association'NationalNotary.org • 1-B00-US NOTAFIY (1-8p0-87$-6827) Item X5907
- - ~ -
INSTRUCTIONS(RP-5217-PDF-INS): www.orps.stale.rry.us
FOR COUNTY USE ONLY New York Stale Department of
.ct sNns cD~ I ?J ~ rg ~ I Taxation and Finance
0lfice of Real Properly Tax Services
cz. oate,Daea Recorded I S / ZO / I ~ J RP- 5217-PDF
~7- Book L~[~ I~~J C4. Pape Real Property TranaNr Report (8110)
PROPERTY INFORMATION
Sayview Avenue
7. Propetry 13 3 0 '
Loraaon •a19EET N1rBER •e[pEEr egME
/Southold Mattituck _ 11952
c vauaE • ~ ~
•r:r.nR[owx
Buyer Fiche fy)t ~ Chad
Name ~rrAUE~W1f
ANV FrpST wWE
FRiSr MlE
4aT y1MFJf>DYPANI'
Taa Indleare wham hduro Tax BBa era to be saM
Bllllnp uW[sr than dryer addroeslet bosom 0l(arm) usr Nw°~001rPANr Fest NSUE
pddnss
s[ne mcoaE
a[REETHMaER AraNxYE 411108 i0WN
(Onry D Parl m • pareeq check ss IIwY aPPH~
4. Indtcats d1e numMr of AfaeaameM 1 e 01 Pareale OR ? Part of a Parcel 4A. PIanM eoaro with Subdivrspn Auagdry Fxlsls ?
Roll panNs Inrlshwed on the deed nB
5. Dead QIj 0 - 91 4B. SuhdWtslon Approval was Roqulred Apr Trarlakr ? !
Property -FRaerrEEr •oEFrN •"°8s ?
g~ IC. Pereol APProved for guhdivisbn vRh MaP Provided
Dorothy R r ~ 1')'tlxt I
Uhlelnann _
nRai NAY
8. SeIMr ~
use xwE,cawur. ~ ~ -
Nams~A uh1~
_ 1V FF45r n1YE
u8T NAIa:lOD11PAM' I
Cheek the hoaas below as they aPPIY: ?
•7. S¦Ncl the desedpgon vrhkh moat aecunnly daacdtlaa the a.Ownenhip Typa is Contlomintum
use of the property st tM lima of Bah: ?
e. New (:On61N4310n Or10 VeCaM Lond
A. Ont•. C:hmlly Rcstdorntal ?
7gA. PmPeny Laeatad wahln an ApriWtwral DL4riCt
seB. Boyar reulvld a dNcloeuro nWiCe rnticetlnp dot the ProPedY is in an ?
AykvlWtal DisVicl
SALE INFORMATION 7S. Check ens or etas or Uwsa eordMbna as applkahle ro Vamler:
A. gala BetWnren Relatives or Farmer Relaltvos
0 2 ~ 2 0 ~ 2 013 e. Sab hotvroen Related Compsnlas or canners in Busi[eas
77. Sale ConVad Dsu C. One of the Buyeq is also 0 SaMr
D. Buyer or Srakr le GovammoM Agon4Y ar Landing InsgWlton
72. Date o1 SddTnm6r .T'.3' ~ 3 E. Deed Type not Warrony ar Barpatn and gala (gpeciy BNOw)
F. Seta of Frxlbnal or Lase autn Fee Imcrost (Spscity Below)
16q, 000 ,QQ G Sipndicam Change in Property Between Ta:ada Slaws and Sale Dates
'1a. Full SaM Prke H. Sato W Buslnasa b Included in Sak Prise
( Full Sale Puce lathe total amount gala for the OroPeRY 1nClWinp personal property. 1 OUler Unuwal Faclma AflecGng Sak Prise lgpeeity Below)
Thin payment may b! W the ham of cash. cater PropMY sx goods, or Na a66umptipn of J. Noss
mortgages or other ohllgatiom) Pkex rountl ro the nearsat whale donor amount Comment(s) on Condhlon:
74. IndkatOlM value of personal 0 .OQ
propergl included In the sent
ASSESSMENT INFORMATION -Data should re0ecl the latest Final Assessment Roll and Tex Bill I
td. Year o/ Asxssment Roll tram whkb Inbrmapen takenlYY) 12 '7T. Total Asxssed Value 3 , 2 0 0
'ta.Propsrry Clax 210 _ '1a.9eheol OFSWeI Name Mattituck/Cut drogue
'2a. Tax Map IdeMiflar(sMRoll IdeMiflel(a) (II moro Than lour, aDach sheet wah addllbnal k1aMMarlsl)
1000-106-00-11.00-015.000
CERTIFICATION
1 CeNy chat ill d the Meets o1 Inbrmatbn enhrad on thN form an true and eorreetryy
~Oe
~ ~ ~ Iny
end Iplllna of
lalsa inritldru
~ird~.
d~ ~t ~ maklnp of arty witnul
lalaa alatemellt o! material feel Mreln aub)eel ma to IMpfeYlt(OM.aLIM.alM IaMI. BUYER CONTACT_INE9RMAT~N
QFI 1 FQ $IC.~~~
- (FiVersaaaeewr Irr sr dlYar. Nee n alrrar s LLC,aspsly, aAS[oxae. mP01n0a. pnl wore earrsarN• OW1a v
emrry sal is sal an rtlrdral pwlt aradruwy, elan a rWrw am sOnlid HprraPwn ol~lsxetlrowerParaaae
r) aalrywro ePwr arwwa 9uR~wraWdrq an mnalermel ba Belted TYW///1~P~ wy7
SCLLERSIOrU aA7E ' V I I O ~ ~V
w~IVER SIGNATI,($~ ~'71 x. .~11_ ~51~
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•Of.YW TOWN 'SrA[L .IDCaOL
BUYE(~,gATSQRNEY
Ross Daniel
usr NANE Fa6r NAVE
(631) 298-1200
ataACapE iElERlOEraamERdir atlaatr)
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