HomeMy WebLinkAboutL 12764 P 769
SUFFOLK COUNTY CLERK
RECORDS OFFICE
RECORDING PAGE
Type of Instrument: MISCELLANEOUS - DEED Recorded: 02/25/2014
Number of Pages: 3 At: 12:28:10 PM
Receipt Number : 14-0022300
LIBER: D00012764
PAGE: 769
District: Section: Block: Lot:
0301 009.00 05.00 021.004
EXAMINED AND CHARGED AS FOLLOWS
Received the Following Fees For Above Instrument
Exempt Exempt
Page/Filing $0.00 YES Handling $0.00 YES
COE $0.00 YES NYS SRCHG $0.00 YES
EA-CTY $0.00 YES EA-STATE $0.00 YES
TP-584 $0.00 YES Notation $0.00 YES
Cert.Copies $0.00 YES RPT $0.00 YES
Fees Paid $0.00
THIS PAGE IS A PART OF THE INSTRUMENT
THIS IS NOT A BILL
JUDITH A. PASCALE
County Clerk, Suffolk County
11 2
Number of pages RECORDED
2014 Feb 25 12:28:10 PM
JUDITH A. PASCALE
CLERI: OF
This document will be public SUFFOLK COUNTY
record. Please remove all L DOD012764
P 76?
Stamp Recording / Filing Stamps
Page / Filing Fee Mortgage Amt.
1. Basic Tax
Handling 20. 00 2. Additional Tax
TP-584 Sub Total _
Notation SpecJAssit.
or
EA-52 17 (County) Sub Total Spec. lAdd.
EA-5217 (State) TOT. MTG. TAX
' / Dual Town Dual County
RRT.SA-+ Held for Appointment
Comm. of Ed. 5. 00 Transfer Tax
Af Mansion Tax
Affidavit ~
Certified Copy The properly covered by this mortgage is
or will be improved by a one or two
NYS Surcharge 15. DO family dwelling only.
Sub Total YES or NO
Other
Grand Total Z/ If NO, see appropriate tax clause on
page # of this instrument.
4 Dist. S.C. REAL PROPERTY TAX SERVICE 5 Community Preservation Fund
ATTN:PAT OLEJNICZAK
Real Property 310 CENTER DRIVE Consideration Amount $
Tax Service RIVERHEAD,NEWYORK 11941
Agency CPF Tex Due $
Verification
Improved
6 Satisfactions/Discharges/Releases List Property Owners Mailing Address
RECORD & RETURN TO: Vacant Land
5 X 1 W Y vl TD
U G ~Ai>`-2 TO
Mail to: Judith A. Pascale, Suffolk County Clerk 7 Title Company Information
310 Center Drive, Riverhead, NY 11901 Co. Name
www.suffolkcountyny.gov/clerk Title#
8 Suffolk Count Recordin & Endorsement Pa 2e
This page forms part of the attached made by:
(SPE OF INSTRUMENT)
The premises herein. is situated in
SUFFOLK COUNTY, NEW YORK.
TO In the TOWN of eI
In the VILLAGE j "j,
or HAMLET of
BOXES 6 THRU 8 MUST BE TYPED OR PRINTED IN BLACK INK ONLY PRIOR TO RECORDING OR FILING.
.m.I~
(over)
v
D
d vm
a cooooo O
C 00-•000 E
0
N co O N
(Q O A -4 M
w O O 0 0
ok ? - - m
N
% O N W W -1
T
° ° °
o o o x m
v
CA C/)
o 00 o c
00 00 O
00moo ° O o
0co co rwto
0 0 o m 0 0 3
CD 0J~.J J Z
m rn
Oro 0o A
000 00 C1 b
CD (O tD
000 O O r
O O O O O 3 n
d M n
100
000 00
-10
°2
>
Co 000 00 m m -i
N 000 oo m0 O
N
O_
O O Z
A 000
N O W N N r
O O O 000
O-4 O W p M (n TO
T
-+NN~yN W n rn
W N((Aco 00) m fn
A N N -I A A D
O '-i
m O
N A A 0 0 0 D
~WOOODVrn G) Z
m
0 ommmmmmm
m00
mmm(n(n
Z oodommC
mm3
Z
V' z
O
m
A TmAyrr TO CORRECT NLTNm IC IDEN=j EER
I, the undersigned, Deputy Director of the Real Property Tax Service Agency, Acting for
the Director of the Real Property Tax Service Agency, present this affidavit for the
purpose of correcting the Real Property Tax Map Identifier(s) listed on the reverse.
Gary M. Simonson
Deputy Director j V1
UNIFORM FORM CERTIFICA'T'E OF ACKNOWT EDGEMFN r
STATE OF NEW YORK )
COUNTY OF SUFFOLK )
n aolq
On the ol~ day of F U h S in the year ` A , the undersigned,
personally appeared GA A- l 1A~ c2 I17517A,) 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
capac ity(ies), and that by his/her/their signature(s) on the instrument, the individual(s), or the person
upon behalf for which the individual(s) acted, executed the instrument.
Notary Public
BRUCE M. HOTCHRISS
Notary Public, State of NOWYOtk
No. o1H061IW93
Qualified in Suffolk 0011114
Commission Expires 04/19/20.-