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IIIIIII IIII IIIII Illlf Illli IIIII IIIII 11111 IIIII IIII IIII
111111 IIIII IIIII IIII IIII
SUFFOLK COUNTY CLERK
RECORDS OFFICE
RECORDING PAGE
Type of Instrument: DEED Recorded: 12/27/2013
Number of Pages: 3 At: 02:31:33 PM
Receipt Number : 13-0166157
TRANSFER TAX NUMBER: 13-14627 LIBER: D00012758
PAGE: 202
District: Section: Block: Lot:
1000 113.00 11.00 004.001
EXAMINED AND CHARGED AS FOLLOWS
Deed Amount: $0.00
Received the Following Fees For Above Instrument
Exempt Exempt
Page/Filing $15.00 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 $0.00 NO Comm.Pres $0.00 NO
Fees Paid $250.00
TRANSFER TAX NUMBER: 13-14627
THIS PAGE IS A PART OF THE INSTRUMENT
THIS IS NOT A BILL
JUDITH A. PASCALE
County Clerk, Suffolk County
Y€"
Er 91 RECORDED
2013 Dec 7 02,31:33 PM
JUDITH F'ASCALE
Number of pages 3 , CLERK OF
SUFFOLK C0UflW
L D00012755
P 201
This documentVill_be public Dry 13-14n17
record. Please remove_all
Social Securty-Numbers
prior t6fecording.
Deed /Mortgage Instrument Deed / Mortgage Tax Stamp Recording / Filing Stamps
3 FEES
Page / Filing Fee ' Mortgage Amt.
i„ 00 1. Basic Tax
Handling ~ 2. Additional Tax
TP-584 r _ Sub Total
Spec./Assit.
Notation _
EA-52 17 (County) Sub Total or
j Spec. /Add.
EA-5217 (State) t R.~ TOT. MTG. TAX
Dual Town Dual County
R.P.T.S.A. Held for Appointment
Comm. of Ed. 5. 00
Transfer Tax
Affidavit Gal Mansion Tax
The property covered by this mortgage is
Certified Copy or will be imprixed by. a one or two
NYS Surcharge 15. 00 ` Sub Total d family dwelling only.
S
Other YES or NO
`
Grand Total A Jo If NO; see appiapnatetax clause oa
d dV l
4 Dist. t 13035871 1000 11300 1100 004001 5 Community Preservation Fund
Tax Service R DHO A
Real Property IIIIIIif~IIIIIIIIIIIIIIIIIIIIIIIIIIII IIIIIIIIII Consideration Amount S
Agency 7-DEC1 CPF Tax Due S
Verification-
Improved
6 Satisfactions/Discharges/Releases List Property Owners Mailing Address
RECORD & RETURN TO: Vacant Land
A t TD /0
3A5 W9_S+_(~;kPkLPk e TD rlpo 3ox k L~c
hr1 P --1 k C, cL , v \ 1 t Q -2 TD
Mail to: Judith A. Pascale, Suffolk County Clerk 7 Title Company Information
310 Center Drive, Riverhead, NY 11901 Co. Name N
www.suffo[kcountyny.gov/clerk Title #
8 Suffolk Count Recordin & Endorsement Pau
This page forms part of the attached Q•flll~t a-- c.u~ by;
lam. 4"S 5
(SPECIFY TYPE OF INSTRUME
,Ran PA. S c~ny~ IR t5 fi,, t u-W CAJ-, C-0- The premises herein is situated in
SUFFOLK COUNTY, NEW YORK.
TO In the TOWN of
• S~OI~R 15 ~-Cl~ In the VILLAGE u /
~•r~~U or HAMLET of Ac
BOXES 6 THRU 8 MUST BE TYPED OR, PRINTED IN BLACK INK ONLY PRIOR TO RECORDING OR FILING.
CONSULT YOUR LAWYER BEFORE SIGNING THIS INSTRUMENT-THIS INSTRUMENT SHOULD BE USED BY LAWYERS ONLY
THIS INDENTURE made the day of December, 2013
BETWEEN ELLEN M. SCHULTHEIS fka ELLEN M. LAWRENCE
Address: 430 Illinois Avenue 920 Meday Avenue, Mattituck, New York 11952
party of the first part,
AND ELLEN M. SCHULTHEIS fka ELLEN M. LAWRENCE and ROBERT 0. FARRELL, husband and wife
Address: 430 Illinois Avenue 920 Meday Avenue, Mattituck, New York 11952
party of the second part.
WITNESSETH, that the party of the first part, in consideration of ten ($10.00) dollars 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, situte, lying and being in the Town of Southold, at Mattituck,
County of Suffolk and State of New York, being known and designated as part of lots 40 and 41 on a certain
map entitled "Map of Tollewood" filed in the office of the Clerk of the County of Suffolk on January 25, 1927 as
Map No. 175, said parts of lots being bounded and described as follows:
BEGINNING at the corner formed by the intersection of the southerly side of Meday Avenue and the easterly
side of Illinois Avenue;
THENCE from said point of beginning, along the southerly side of Meday Avenue, North 75 degrees 22
minutes East, 107.24 feet to a monument;
THENCE South 6 degrees 23 minutes West, 120.71 feet (actual) (121.00 feet deed);
THENCE South 74 degrees 14 minutes 00 seconds West, 108.08 feet (actual).(107i07:f6et deed) to the
easterly side of Illinois Avenue, 31 i VOEf , .04
Vi.-tuoO Moiiu8 ri; belfitsiaQ
THENCE along the easterly side of Illinois Avenue, N9rthl£•,degfpes,~3~minuta a ta2J3~0 feet to the point
or place of BEGINNING.
Premises: 430 Illinois Avenue aka 920 Meday Avenue, Mattituck, New York 11952
SCTM#: District: 1000 Section: 113.00 Block: 11.00 Lot: 004.001
BEING AND INTENDED TO BE the same premises described in a certain Deed from William A. Lawrence to
Ellen M. Lawrence recorded on March 1, 2001 in Liber 12105 Page 254.
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 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 THE PRESENCE OF:
LLEN M. SCHULTHEi
ka ELLEN M. LAWRENCE
i
State of New York, County of Suffolk ss: State of New York, County of Suffolk ss:
Ro
On the day of December in the year 2013 On the day of in the year 20
before me, the undersigned, personally appeared before me, the undersigned, personally appeared
ELLEN M. SCHULTHEIS fka
ELLEN M. LAWRENCE
personally known to me or proved to me on the basis of
personally known to me or proved to me on the basis of satisfactory evidence to be the individual whose name is
satisfactory evidence to be the individual whose name is subscribed to the within instrument and acknowledged to me
subscribed to the within instrument and acknowledged to me that he executed the same in his capacity, and that by his
that she ted the same in her capacity, and that by her signature on the instrument, the individual, or the person upon
signatur o th instrument the individual, or the person upon behalf of which the individual acted, executed the instrument.
behalf o w 'ich t e in ' ual c x=the ment.
(signature and office of individual taking acknowledgment)
(signature and office of individual taking acknowledgment)
PAr-jt6i- C. ROSS
Notary Public, ii.-tw of New York
No. 4907176
Qualified in Suffolk County
Commission Expires Aug. 31, 20(?
Record and Return to:
Keegan & Keegan, Ross & Rosner, LLP
Attention: Daniel C. Ross, Esq.
315 Westphalia Avenue
PO Box 146
Mattituck, New York 11952
PLEASE TYPE OR PRESS FIRMLY WHEN WRITING ON FORM
INSTRUCTIONS (RP-52174NS): wwW.orps.state.ny.us
FOR COUNTY USE ONLY 73R, G C1. SWIS Code I i 6 , / I New York State Department of
Taxation and Finance
C2. Date Deed Recorded I /c;? / O9 71 ~I Office of Real Property Tax Services
• -yBook I/. A 7 S, i ca. P - 5217
r >w D~ Real Property Transfer Report (8110)
PROPERTY INFORMATION
1. Property "lw VVIJ- L.M (It V-Q XtUU -C ,
Caution LA 7
1145
IAGE aPCdDE
2. Witter I SC-`/?yt` p~S I Il It ad a N/1 I
Name T NPME I cop lIr1Y FlRS,
3• Tax Indicate whore future Tax Bills are to be sera {
Billing Bother than buyer address (at bottom of form) I.- Fln l-P I~ _J
Addreaa
I Po B.)( 7--O -lki -lu Lk- I hu I I (qS~ I
~Tf$EIEET ~cn~ OR i6ww nTE C
4. Indicate the number of Assessment 1 (Only N Pen of a Peroeq Check es they apply:
Roll parcels transferred on the dead I 19 of Parcels OR ? Pan of a Parcel
4A. Planning Board with Subdivision Authority Exists ?
& Deed 4e. Subdivision Approval was Required for Transfer El
Property I X I I the I 4C. Parcel Approved for Subdivision with Map Provided ?
sI"
&Seller I SJ',gk+ki%S(-C-~L&LQ04A ) 1 6.14vt M,
I
Name Ti3t rl~AhtEr ~~~Fwt
1 I
VSTfaDJri Flggl
7. Check the box below which most accurstay describes the use at the property at the time at sale: Check the boxes below as they apply: ?
& Ownership Type is Condominium
A no Family Residential L Agricultural I Community Service 9. Now Construction on Vacant Lend ?
B 2 or 3 Family Residential I. Commercial 1 • Industrial IDA. Property Located within an Agricultural District
?
C Residential Vacant Land G Aparanmmt K Public Service 108. Buyer received a diadosure notice Indicating ?
D Non-Residential Vacant Land I ( Entertainment I Amusement L Forest that the property is In an Agricultural District
SALE INFORMATION w A- ~ I& Check one or mom of these conditions as applicable to transfer:
11. Solis Contract Date f V I / / I A Salo Behreen Relatives or Fomrer Relatives
mord, Day seP < B Sale Between Related Companies or Partners in Business
C rte of the Buyers is also a Seller
12. Dam of Sole I Transfers 3 J D Buyer or Seller is Government Agency or Lending Institution
ant ow - car E Dead Type not Warranty or Bargain and Sale (Specify Below )
/ F Sale of Fractional or Less than Fee Interest ( Specify Below )
q~ Significant Change in Property Between Taxable Status and Sale Dates
13. Full Sale Price I ~J -s O , L I 11 So% W Business Is Included In Sale Pura
( Full Sale Price Is the total amount paid for the property Including personal property. I or Unusual Factors Affecting Selo Price (Specify Below )
This payment may be in the form of cash, other property, or goods, or the assumption of None
mortgages or other obligations.) Please round to tie nearad wholedolleremaunt. No J _ A
14. Indicate the value of personal -`-7CL property included In the sale - 0 0 us-f-_5
ASSESSMENT INFORMATION - Data should reflect the latest Final Assessment Roll and Tax Bill Q ^
16. Year of Ass"ement Roll from 17. Total Assessed Value (of all parcels In tr onsfe"A o
_ _ • O ,
which Information taken L.1
18. Properly Class 12, I D I- J 19. School District Name I mR~r,~j,(~~C ` C P'Xe. t~2, I
20. Tax Map Identifier(s) l Roll Identifier(s) (If more than four. attach sheet with additional Identifier(s) )
I T>LS~ri r•7' l 000 I I '-AA-Ji an 1 Q) r 00 I
I SZ-> ILXK Ll.00 I I Lod' Ooil-, oo I
CERTIFICATION
1 "rtay that all or the hem of Info n ammad an this rom, m true and correct (to one best of my knowledge and Italian and 1 understand that the making at any waful
false s at of material fast h will "Idea! me to the pmWalana of the panel law realise to 21. making end 11111.9 or Idle Imtnnrunta.
SELL SIGNATURE BUYER CONTACT INFORMATION
(Enter indermphon •-or the buyer. Note. lr buyer Is U.C. Mostly. assode:lon, oarpwahoa, ioial atotk
r Z 13 mmpwy. mh'm or an1_y That Is not an ndeldual agtea or Ildupwy. then a name and Contact
bdanmeat
_ of of at Indaduaymapa MD parry who ran amwar suasJaB reasdina the Uwwrar must be sensed.
SELLER SrAh7URE U/A IftT L Si- w Sr MTF Type or print alaary.)
BUYER SI TReRLE S ~y 1-1~LS 1 ~1 Ip vt ~ i
V 12/z3~~3~ LAST MUSE n rJ FIRST NkME
9UTER SrDN,LTURE E({Q,yt 11eLL L.14 s DATE I Z4D BUYER'S ATTORNEY weFaexmE TELEPHONE--ER
12Crf .1 -D *-,1 et 92-0 I W1 ¢Aku ;&q p_
STREETNUU IR STRFFTWWE
1031 I ZAS ` IZpo 1'YlakE-rEu(k- I Y1A1 I 11QSZ
AREA CODE TELEPHONE NUMBER
NEW YORK STATE CITY OR TOWN sTaTC LP CODE
COPY