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1111111 IIII IIIII VIII VIII VIII VIII VIII VIII IIII IIII !IIIII IIIII IIIII IIII IIII SUFFOLK COUNTY CLERK RECORDS OFFICE RECORDING PAGE Type of Instrument: DEED Recorded: 09/29/2014 Number of Pages: 4 At: 12 :04:16 PM Receipt Number : 14-0128379 TRANSFER TAX NUMBER: 14-05543 LIBER: D00012790 PAGE: 309 District: Section: Block: Lot: 1000 064.00 02.00 009.000 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 $0.00 NO RPT $60.00 NO Transfer tax $0.00 NO Comm.Pres $0.00 NO Fees Paid $255.00 TRANSFER TAX NUMBER: 14-05543 THIS PAGE IS A PART OF THE INSTRUMENT THIS IS NOT A BILL JUDITH A. PASCALE County Clerk, Suffolk County .. ..t 111121 Number of pages RECORDED 2014 Sep 29 12:04:1 . Pt4 This document will be public JUDITH A. PASCALE record. Please remove all CLERK OF \ Social Security Numbers L D00012790 prior toSUFFOLK COUNTY •recording. P 309 DT# 14-05543 Deed/Mortgage Instrument Deed/Mortgage T'ax Stamp Recording J Filing Stamps 3 FEES 0 Page/Fling Fee 1, Mortgage Amt, Handling 20, 00 1. Basic Tax — 2. Additional Tax TP•511 _,,,_ 1 . Sub Total Notation SpecJAssit. EA-522 17(CountY) Sub Totnl 50 orSpec,/Add. CA-5217(Stats) 'U( � TOT.MTC,TAX _~ R.P.T.S.A. �- Dual Town Dual County_ ,y Held for Appointment Comm,of Ed. $• Transfer Tax Affidavit _ �„ ��', Mansion Tint 1t� Certified Copy The property covered by this mortgage is ar will be lmpmved by a one or two Sub Total NYS Surcharge 15. 00 © family dwelling only, _ YES or NO Other Grand Total _ r 7 If NO,see appropriate tax clause on Page# of this ig `. 4 dtst 14026486 1000 06400 0200 009000 5 Community Preservation Fund Real Property CP,"TT Consideration Amount$ Tax Service Agency - Verification GPF T Due $ Satisfactions/Disc es/Rcleases List � � property Owners Mailing Address Improved RECORD&RETURN TO: Vacant Land Z-014IJ W 12, ES4. TD 10 _ 1-403 WeS7 NMaiO ST, :30,110 x90(0,.. TD t��ywi� Ny t nba TD Mail to:Judith A. Pascale, Suffolk County Clerk T. Title Cornyany Information 310 Center Drive, Riverhead, NY 11901 (_i��Tj 8300Dwww,suffolkcountyny.gov/clerk 'F3ds# t aCna-i Suffolk Countir Recor&n & Endorsement Page This page forms part of the attached made by:' (� (SPECIFY TYPE OF INSTRUMENT) The premises herein is situated in SUFFOLK COUNTY,NEW YORK. TO In the TOWN of �--- In the VILLAGE or HAMLET of BOXES 6 T14RU 8 MUST BE TYPED OR PRTNTED IN BLACK TNK ONLY PRIOR TO iECORDTNG OR FILTNG. f QUITCLAIM DEED (INDIVIDUAL OR CORPORATION) STANDARD NYBTU FORM 8007 CAUTION:THIS AGREEMENT SHOULD BE PREPARED BY AN ATTORNEY AND REVIEWED BY ATTORNEYS FOR SELLER AND PURCHASER BEFORE SIGNING. THIS INDENTURE,made Augustj8,2014,between Richard J Rothwell,Sr.and Suzanne Rothwell and Richard J Rothwell,Jr.and Breanne Rothwell,each respectively having a notice address of 371 Hickory Street,Massapequa NY 11758. party of the first part,and Richard J Rothwell,Sr.and Suzanne Rothwell,Husband and Wife,each respectively having a notice address of 371 Hickory Street,Massapequa NY 11758. party of the second part, WITNESSETH,that the party of the first part,in consideration of Ten($10.60)Dollars and other valuable consideration paid by the party of the second part,does hereby grant and release unto the party 'f the second part,the heirs or successors and assigns of the parry 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 HERETO Being and intended to be the same premises conveyed by Deed dated May 3,2011 and recorded 5/16/2011 in Liber 12659,Page 922. 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,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 PRESENCE OF. c CIN harrLJ Rot 1,Sr Suzanne R well / r Ric d J Rothw ,Jr LCL Brea a Rothwell NYSBA PRACTICE FORMS 3N8 RE067.16 y _I_ STATE OF NEW YORK ) i Ss.: COUNTY OF SUFFOLK } On Augustl8,2014,before me,the undersigned,a Notary Public in and for the State,personally appeared Richard J Rothwell,Sr.and Suzanne Rothwell and Richard J Rothwell,Jr,and Breanne Rothwell,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 she/he/they executed the same in her/his/their capacity(ies), and that by her/his/their signature(s)on the instrument,the individual(s)or the person upon behalf of which the individual(s)acted,executed the instrument. Signatur nd ffice of individ I aking acknowledgment JOHN WEBER NOTARY PUBLIC,State of New York No 52-4992315 nualifled in Suffolk County Commission Expires February 24,204 QUITCLAIM DEED Section 5 With Covenant against Grantor's Acts Block 05 Rothwell Lot 072 County or Town Suffolk TO Rothwell Return to: John Weber,Esq. 400 West Main Street,Suite 206 Babylon NY 1 1702 NYSBA PRACTICE FORMS 3/98 RE067.16 .2. LAND BOUND SERVICES, LLC. Title No: BF26273 AS AGENT FOR: CHICAGO TITLE INSURANCE COMPANY SCHEDULE A District: 1000 Section: 064.00 Block: 02.00 Lot: 009.000 ALL that certain plot, piece or parcel of land, with the buildings and improvements thereon erected, situate, lying and being in the Village and Town of Southold, County of Suffolk and State of New York, known and designated as Lot No. 13 and part of Lot No. 14 on a certain map entitled, "Map of Founders Estates, " and filed in the Office of the Clerk of the County of Suffolk on May 10, 1927 as Map No. 834, said lot and part of lot being more particularly bounded and described as follows: BEGINNING at a point on the easterly side of Hobart Avenue, distant 200.00 feet southerly from the corner formed by the intersection with the southerly side of L'Hommedieu Lane and the easterly side of Hobart Avenue; said point also being where the division line between Lot Nos. 12 and 13 on the abovementioned map intersects the said easterly side of Hobart Avenue; Running thence along said division line, North 64 degrees 05 minutes 00 seconds East, 150.00 feet; Thence South 25 degrees 55 minutes 00 seconds East, 75.00 feet; Thence South 64 degrees 05 minutes 00 seconds West, 150.00 feet to the easterly side of Hobart Avenue; Thence along said easterly side of Hobart Avenue, North 25 degrees 55 minutes 00 seconds West, 75.00 feet to the point or place of BEGINNING. Said premises being known as and by the street address: 1255 Hobart Road, Southold, NY 11971 (BF26273-14S.PFD/BF26273/23) INSTRUCTIONS(RP-5217•PDF-INS):www.orps.statemy.us FOR COUNTY USE ONLYI/ o Naw York State Department of C1.SWIS code I q. ,3,F,V I q I Taxation and Finance C2.Data Dead Recorded I q / i"I / ''1 ire of Real Property Tax Services car �,• RP-5217-PDF C3.Book I �,� �1(�Uo,w^I C4 Page I ✓, , ,, I Real Property Transfer Report(21`110) PROPERTY INFORMATION I.Property 1255 Hobart Road Location •atREEr NmeEn •mREr:r N■Nk Southold 11971 'CRY m 70NN Va!AOF •era CGOF 2.Buyer Rothwell Richard Sr Name •,ASr xw[hceePANr Farr NFME Rothwell Suzanne ua xArrmmwvwr —ST xPNF .- a'Tax Indwate where acture Tax Blas we to he Earn Billing if other than buyer addmss(at bottom of form) h TxAa.,coar•Am real—E Address 4TREETNUWERANnRAMS COY OR TOM STATE rPCOOE 4.Indicate the number of Assessment 1 port d a Fred (Only R Part of a Formal)Cheek ee thry appy: Rall p meb transferred of the deed a of Parmis OR ❑ 4A.Planning Board with Subdivision Authority Exists ❑ 9.Deed 75 x 150 OR 0.00 4&Subdivision Approval wan Required for Transfer ❑ Property 'FRONT FEET •alPTH 'AMES State 4C.Pared Approved for Subdivision with Map Provided ❑ Rothwell Richard Jr S.Sailer •aAFreiumvev— FIRSTNAr/E Nanw Rothwell 6reanre WT NAMecoMPANY PRET-HE •7.Select the dwdptlen which most accurately deeedhes the Check the bow below as they appy: use of the property of the dins of Salo: a.Ownership Type is Condominium 0 A.One ran lily Residhnnial 9.New Co anicson on a Vecent Land ❑ 14A.Property Loafed within an Agricultural District ❑ 1013.Buyer rerewed a dladosure notice ire icabng that the property ars in an Agricultural District ❑ SALE INFORMATION 19.Check one or pore of those eorMUons as applicable to transfer: A.Sala Between Renews or Former Reaches 17 Salo Cardnct Data B.Sate between Related Companies or Parsers in Business C One of to Buyers in also a Sailor •!L Data of Solorriansfar 08/18/2014 D.Buyer or Sailor is Government Agency or Lending Institution E.Dead Type not Vrahrohdy or Bargain and Sale(Specify Below) F.Sale of Fractional or Lem than Fee Interest(Spedy Below) •/2.Full Sale Price 0.00 O.Slgrslkam Change in Property Between Taxable Status and Sale Dates H.Sale of Business Is Included In Sale Price (Full Sale Palm Is thio total amoud paid for the property including personal property. 1.Oxer Unusual Fetors Meting Sale Prim(Spedy Below) This Farmers may be in the form of cash,other property at goods,or Sae assumption of J.Nom mortgagee or other obligations)Film Round to the Teamst whole dayarwrwunt Comnmrt(s)on Condition: 14,Indicate the value o1 personal property Included In the sale 0.00 No Consideration Transfer ASSESSMENT INFORMATION-Date should reflect the latest Final Assessment Roll and Tax Bill 19.Year of Assessmom Noll from which Into noun mkon(YY) 14 '17.Total Asoowd Value 3,900 '1L Property Chun 210 - 119.School Olstrkt Name Southold •20.Tax Map IdendMr(sNRoll MenOwis)In more don four,alfach soot with addkbml WwOfle(sg 1000-064.00-02.00-009.000 CERTIFICATION I Cordy tat an of bite Memo of Information 0 tom 0 on this form are true and comet Ito the best of my knowledge and baIIM and I undersmnd that the making of any vAltul hese statement of material fact herein subject me to the.pr9v101oI9.OL11R penstligimmtive to the making and N(Irag of false Instrumrds. NATURE BUYER rrONTACT INFO Rg(q'1'iON (Enise idomwmn Ir the buyer.Noe Ir buyer a LLC,—"..do..raposion.lord sock c■nwry.saws r 00, mull sal Is not an eventual spam rseeker.own amemo and oawera issrnhaan d an sHMedudNwomtft . P■rbrxWW ran■n■warqumawarap■dse cue trmrt■r mu■IeeeerHsee Typesrprtmcasay) eEL.ER 54NATUR BUYERDATE Rothwell Richard Sr IGNATURE 'Uel MNIF mT NRME y 7/'��a� �� �'�y'� (516) 743-223fi Of 'MlEnrhOE •TnEPgNE MJYOCRIEF NOW •-T E acwr DATE 371 Hickory SLreet '■IPEEIP-MR 'nRF.FT NAME ' Massapequa NY 11758 .0"as TOWN 'STATE '71P t AUYMS AIMINFY Weber John "or YAYa FWsr Nae (631) 321-6065 Nrrh C00E TELEPHONE NUMECR[EF:9MIar1 t