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Home My WebLink AboutL 12771 P 484 11111111 111111111 VIII VIII VIII 11111 Ilfll VIII IIII Illi 11111111111 IIIi1 IIII IIII SUFFOLK COUNTY CLERK RECORDS OFFICE RECORDING PAGE Type of Instrument: DEED WITH LIFE ESTATE Recorded: 04/22/2014 Number of Pages: 4 At: 03:57:39 PM Receipt Number : 14-0051918 TRANSFER TAX NUMBER: 13-24210 LIBER: D00012771 PAGE: 484 District: Section: Block: Lot: 1000 086.00 01.00 004.012 EXAMINED AND CHARGED AS FOLLOWS Deed Amount: $0.00 Received the Following Fees For Above Instrument Exempt Exempt Page/Filing $20.00 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 $5.00 NO RPT $60.00 NO Transfer tax $0.00 NO Comm.Pres $0.00 NO Fees Paid $260.00 TRANSFER TAX NUMBER: 13-24210 THIS PAGE IS A PART OF THE INSTRUMENT THIS IS NOT A BILL JUDITH A. PASCALE County Clerk, Suffolk County 1 2 r RECORDED Number of pages, 2014 Apr 22 03:57::9 P11 p g JUDITH A. PASCALE TORRENS CLERK OF SUFFOLK COUtITY Serial# L D00012771 P 484 Certificate# DT# 13-24210 Prior Ctf.# Deed.Mortgage Instrument Deed/Mortgage Tax Stamp Recording/Filing Stamps 3 1 FEES Page/Filing Fee Mortgage Amt. _ 1.Basic Tax Handling _ 00 2.Additional Tax TP-584 �� Sub Total _ Spec./Assit. Notation or EA-5217(County) Sub Total Spec./Add. r r TOT.MTG.TAX EA-5217(State) 1 Dual Town_ Dual County R.P.T.S.A. Held for Appointment __ _ Transfer Tax O Comm.of Ed. 5. 00 Mansion Tax _ ,M ,. The property covered by this motgage is Affidavit or will be improved by a one or two Certified family dwelling only. YES or NO Reg.Copy Sub Total V If NO,see appropriate tax clause on Others_ Grand TotalsQ page# of thiin trum 4 Distrialt 14010059 1000 0e600 0100 004012 "012 5 Community Preservation Fund Real 1 S Consideration Amount $i- Property 0 Tax Service PR-A II�I�l�i �fk�l If�11111 1E Illi CPF Tax Due $B Agency !� Improved Verification Vacant Land 6 Satisfaction/Discharges/Release List Property Owners Mailing Address TD RECORD&RETURN TO: Dr.Glenn J.Jakobsen TD 25 Willet Ave Hicksville,N.Y.11801 TD 7 Title Company Information Co.Name N/A Title#N/A 81 Suffolk County Recording & Endorsement Page This page forms part of the attached Deed with Life Estate made by: (SPECIFY TYPE OF INSTRUMENT) Frank.facobsen surviving Tenant by the The premisis herein is situated in Entirety of Bjerg Jacobsen SUFFOLK COUNTY,NEW YORK. TO In the Township of Southold Glenn lorstad Jakobsen and Suyin likobwn In the VILLAGE or HAMLET of Peconic BOXES 6 THROUGH 8 MUST BE TYPED OR PRINTED IN BLACK INK ONLY PRIOR TO RECORDING OR FILING. (over) 5 t NY 005-Bargain and Sale Deed with Covenant against Grantor's Acts Individual or Corporation(Single Sheet)(NYBTU 8002) CONSULT YOUR LAWYER BEFORE SIGNING THIS INSTRUMENT-THIS INSTRUMENT SHOULD RE USED BY LAWYERS ONLY THIS INDENTURE,made the 19 day of April in the year 2014 BETWEEN / Frank Jacobsen residing at 330 Shore Lane, Peconic,N.Y.11958,surviving tenant of the entirety of Bjorg Jacobsen who passed away a resident of Suffolk County on December 27, 2013 party of the first part,and Glenn Jorstad.Jakobsen and Suyin Jakobsen as husband and wife residing at 25 Willet Ave,Hicksville N.Y.11801 party of the second part, WITNESSETH,that the party of the fust pari,in consideration of Ten 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 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 See Schedule A attached Grantor expressly reserves unto himself and his assigns a Life Estate in the above-described property.The Grantor shall have full ownership,possession and use of the property,as well as the rents,revenues and profits generated by the property during the term of the Grantor's natural life. Upon the expiration of the Grantor's natural life,the ownership,possession,use,rents, revenues and profits of the above described property shall revert to the Grantee. Being and intended to be the premises conveyed to grantor Frank Jacobsen,surviving tenant of the entirety of Bjorg Jacobsen(who passed-way in and as a resident of Suffolk County,New York,December 27,2013)by deed made by Sehembri Homes Inc.dated 09/04/2003 recorded on 09/26/2003 in the office of the Clerk of Suffolk County in Liber 12274 at page 356 TOGETHER with all right,title and interest,if any,of the party of the first pari of,in and to any streets and roads abutting the above-dcscribed 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 patty 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 incumbered 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 fust 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 fust above written. IN PRESENCE OF: 0'" ` rank Jacobsen i USEACKNOWL60GMENTFORMBELOWwmaNNEWYORKSTATEONLK USEACKNOWLEDGMENTFORMBELOWWTMINNEWYORKSTATEONLY: State of New York,County of SUFFOLK )s&: State of New York,County of }ss: On the day of t�p—, L in the year &(c/ On the day of in the year before m�the undersigned,personally appeared before me,the undersigned,personally appeared Frank Jacobsen personally known to me or proved to me on the basis of satisfactory 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 evidence to be the individual(s)whose name(s)is(are)subscribed to the within instrument and acknowledged to me that h e ted within instrument and acknowledged to me that he/she/they executed the same in his/ter/their capacity(ies), at b their the same in his/her/their capacity(ies), and that by his/her/their signature(s)on the' ent,the' o pen signature(s)on the instrument,the individual(s),or the person upon behalf of which the in ivi s ac behalf of which the individual(s)acted,executed the instrument. RRAIUOLQ, Notary Public,State of New York No.02FE6125450 Qualified in Suffolk County Commission Expires April 18,200 ACKNOWLEDGMENT FORM FOR USE WrrHmNEw YORK STATE ONLY: AcKNowLwGMENT FORM FOR USE0UTs1DE NEW VoRKSTATE ONLY: (New York Subscribing Witness Acknowledgment Certificate) (Out f State or Foreign General Acknawtedgment Certificate) State of New York,County of }ss.: .................................................}ss.: (Complete Venue with State,Country,Province or Municipality) On the day of in the year before me,the undersigned,personally appeared On the day of in the year before me,the undersigned,personally appeared the subscribing witness to the foregoing instrument,with whom I am personally acquainted,who,being by me duly swom,did depose and personally known to me or proved to me on the basis of satisfactory say that he/she/they reside(s)in 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 (if the place of residence is in a city,include the street and street ntunber, the same in his/her/their capacity(ies),that by his/her/their signatures) if easy,tt--J);that hetnhe)they know(e) on the instrument.the individual(s).or the person upon behalf of which the individual(s)acted,executed the instrument,and that such individual to be the individual described in and who executed the foregoing made such appearance before the undersigned in the instrument;that said subscribing witness was present and saw said execute the same;and that said witness at the same time subscribed (Insert the city or other pohrical subdivision and the state or coup"or his/her/their name(s)as a witness thereto. other place the acknowledgment was taken). BARGAIN&SALE DEED wiry COVENANTS AGAINST ORANrOR'S AM TrrLE NO. D1smucr SECTION BLACK Lcrr COUNTY OR TOWN TO RECORDED AT REQUEST OF Fidelity National Title insurance Company of New York RETURN BY MAIL TO m _ FIDELITY NATIONAL TITLE INSURANCE COMPANY OF NEW YORK lxmgroxerev 192 Ma Mer New nb Y'ruM MAI AfJxb![nn W V LL LL 0 a a 8 0 v LL 0 a 0 LL W to yQ N N W� 7 Lu W N W S Schedule A ALL that certain plot piece or parcel of land,situate,tying and being at Peconic.Town of Southold,County of Suffolk and-State of New York known and designated as Lot 12 on the Map of Richmond Shore at Peconic,filed in the Office of the Clerk of the County of Suffolk on November 20. 1979 as Map No 6873,being more particularly bounded and described as follows: BEGINNING at a point on the easterly side of Shore Road distant 532.74 feet southerly from the southerly end of a curve having a radius at 25.00 feet and a length of 39.27 feet which curve connect the easterly side of Shore Lane with the southerly side of Richmond Lane; RUNNING THENCE North 78 degrees 09 minutes 00 seconds East, 163.10 feet to Reserved Area "C'; THENCE South 22 degrees 24 minutes 20 seconds East 171.46 feet to Lot 13; THENCE along said Lot North 84 degrees 39 minutes 00 seconds west, 220.00 feet to the easterly side of Shore Lane; THENCE Northerly along the easterly side of Shore Lane along an arc of a curve bearing to the left having a radius of 350.00 feet and a length of 105.07 feet to the point or place of BEGINNING. COUNTY USE ONLY Now York State Department of C1.SYgpCode i17 , 3, Taxation and Finance C2."Deed Raooemd I ` ! ?)L/ I Office of Real Property Tax Services m10101ow lowr RP-5217-PDF Ca. -.-1.7 —21 Book I , , 1 JC4.Page I y I? IV I I I Rad Pro"tj TaneAsr Repo t(GIII0) PROPERTY gfFORW►TION f.Pmpry 330 Shore Lane �� •s�rnaeer •afnanrNNa Southold Peconic L W •urraamaN wunm woom IBuir r Jakobsen Glenn Tor ST&b Near •wrmancorwrf marru! Jakobsen Suyi wrNMORXX~ Ferrser LTax IrafammmwlamlmlmmTrrelftmlobe writ eohm aoawtlrNbwofargmsMatbaaamof wrwarMaarwf mwrrwr errEnrralrtAMDlMrr arro"lom ams so= 4.bmembfe manbw of Aammmrtt 1 f of Proeb CR ❑Pal d a Prot (Only a�rtof o PareN)Cktok m ertp appy: Roe parado Im olm on am doad 4A.PWoeq DoaM win SubdMMarn Autrey EMas ❑ a.Came X OR 0.57 4LSWdddmAppwdwinPA*dredforTnmdw Flomill •wrrN. •omen woan as 4C.PaadMNmadfor3d*ANonwMMop Pow Jacobsen Frank 6.8mga •wrnumwwaar PMMAE Nair wrwwanraarrr mwtwr 7.aided er eanayean UhM end a MMW dmafsa dr Check air bomm below me OW appy: ❑ rran of ew pwopwq der am crude: a•DwnwwP Trlr Is f A.One Fw wdly Residential a.Nmw Carabudm an a Vbmd Land IQ&AMmIly LocaMd wasn an ApIOUMal Cbbkt ❑ tea.ergs m l - a dbdowrs wnmfam edlarrwp fwd as pmpry b M on Apdodrad Dlddid SALE INFORMATION ff.CbmdcomormmefeemocomMmmappfoobbtotwwfw Y A Sub adorn Rreema or Fanw Rol ifte 17.8ett Coeemd Ode 6.Sdb bdwaen Rdldud Carpels or Pewbmo in&eateoo C.Ons of fe Buyws b abo a SeINr n or LwMV Mdk*m hmawofadwTtarmr 09/14/2014 D. ordSole F.Salm of Frodlord orLoos ewan Fm harm-(Spsoly Bow4 '14.AM aide Pd a 0.00 R Sgrdoe Chmapm Im RW"aehrrn Trridm abkr ad Sda Ddm H.Sao of emoe lm Mulled b Sob Prime (FUR Salm Pwlmm b ft NW arrant pent forte proprgr lndafng po mid PmPNf• L 01nmr U mAud Fm*mAfbcag SM Rft(Spmey Wool TMs peprmd my be In fr farm d mk otw praprq or Mods orfo mmmefon d 1 Nona matQsam or ofw ablfeforr.)Pbm round b Mf mead weak deframcand. Comnr+ep)onCondeaa Itbdbdadovdmofpread 0 .00 pmpmrl f brndodoe In dr ode ASSESSMENT INFORMATION-Dam should meed the Ned Fh M Aaaemrmrlt Rall and Tac Big ILYoacfMawmwmdRag ftm dahm/annaI,, N* KM 14 MT.Total!AaemwadVideo 677,966 14LProMtjClow 210 _ _ 110.8drolDYUblfom Southold 473805 '20.Tia Bop (aMM hkmdlwM(I mm Nm foot.dame shed wb tldlbrwd MeoBM 1600/86.00/01.00/04.012 CERTIFICATION I Cady Ibd d of do lane of INAMMUot unbind on dna form wetrwawd rNmd(m air beat of wry burwI Ig and befdd and I awdramnd fid thin wnwallmwp of mgr oMi ,fain tidrwwe of nneemnitl fad InawaOw ard}d er bnotHoomMomFoklmiDdomiftandtOneffelokobwmntL Lg BUYER CONTACT • ✓ arrrmferrr ds"irettiq-#Nror oNpwdwalvmkwdctwmwww& PoNlow nMlwnblreeW atwewferwxeNnt nudbo I 'Tnarwpft,'l be4ereMapemat Pwbwroanwwrgamom wPmwdwkwNkrmwtwwewwl'LYw arMfdatmlpa if rudNrtaorrxw i�'�� ma t Jakobsen Glenn BUYER g1uf0ATURE •wrwar mwrxrrr _/ l� (516) 926-1051 �wrs ,lzfy// aar •raarwrwn+w®rp�awmrot surrnmaNttua ' 25 willet Ave. •erranruawer •rranrwwe Hicksville NY 11801 �emranronw Ceara •cream BUYERS ATTORNEY Forraiuolo Thomas wrrwm Nwwar (631) 765-9888 raaaeas fearrorerat®rOtcerwrn