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HomeMy WebLinkAboutL 12816 P 870SUFFOLK COUNTY CLERK RECORDS OFFICE RECORDING PAGE Type of Instrument: DEED WITH LIFE ESTATE Recorded: 05/13/2015 Number of Pages: 3 At: 02:22:17 PM Receipt Number : 15-0064229 TRANSFER TAX NUMBER: 14-25279 LIBER: D00012816 PAGE: 870 District: Section: Block: Lot: 1000 079.00 03.00 031.000 EXAMINED AND CHARGED AS FOLLOWS Deed Amount: $0.00 Received the Following Fees For Above Instrument JUDITH A. PASCALE County Clerk, Suffolk County 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: 14-25279 THIS PAGE IS A PART OF THE INSTRUMENT THIS IS NOT A BILL JUDITH A. PASCALE County Clerk, Suffolk County i Page /Filing Fee �tiJ_ Mortgage Amt. 1. Basic Tax Handling 20. 00 _ 2. Additional Tax TP -584 Sub Total Notation Spec,/Assit. / fl or EA -52 17 (County)— Sub Total L Spec, /Add. EA -5217 (State) J TOT, MTG. TAX R.P.T.S.A. coO Dual Town Dual County Held for Appointment Comm. of Ed. 5. 00 Transfer Tax Affidavit • + Mansion Tax " Y I The property covered by this mortgage is Certified Copy or will be improved by a one or two NYS Surcharge 15. 00OC�J� family dwelling only. Sub Total YES or NO Other _ Grand Total �© If NO, see appropriate tax clause on G page# of this instrument. 3-a -15 Number 3 15009579 1000 07900 0300 031000 RECORDED of pages TA9 en 2015 Mau 13 02:22:17 PM IIIIII VIII I JUDITH A. PASCALE ILII CLERK OF This document will be public IIII SUFFOLK COUNTY record. Please remove all L D00012816 Social Security Numbers P 6,70 DT# 14-25279 prior to recording. Verifica Deed / Mortgage Instrument Deed / Mortgage Tax Stamp Recording / Filing Stamps 3 1 FEES i Page /Filing Fee �tiJ_ Mortgage Amt. 1. Basic Tax Handling 20. 00 _ 2. Additional Tax TP -584 Sub Total Notation Spec,/Assit. / fl or EA -52 17 (County)— Sub Total L Spec, /Add. EA -5217 (State) J TOT, MTG. TAX R.P.T.S.A. coO Dual Town Dual County Held for Appointment Comm. of Ed. 5. 00 Transfer Tax Affidavit • + Mansion Tax " Y I The property covered by this mortgage is Certified Copy or will be improved by a one or two NYS Surcharge 15. 00OC�J� family dwelling only. Sub Total YES or NO Other _ Grand Total �© If NO, see appropriate tax clause on G page# of this instrument. 3-a -15 6 �)atisractlons/uischarges/Releases List Propen RECORD & RETURN TO: Rudolph H. Bruer, Esq. PO Box 1466 Southold, New York 11971 )31.000 1 5 1 Community Preservation Fund Consideration Amount $ td 1,CPF Tax Due $ Imoroved D� Vacant Land TD TD TD 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 County Recording & Endorsement Page This page forms part of the attached Bargain and Sale Deed — I,j-Ft made by: (SPECIFY TYPE OF INSTRUMENT) Barhra Moczulska a/k/a Barbara Moc7ulska The premises herein is situated in as surviving tenant by the entirety SUFFOLKCOUNTY, NEW YORK. TO In the TOWN of 1,nnthold Rarhara Mnczulcka In the VILLAGE or HAMLET of Southold BOXES 6THRU 8 MUST BE TYPED OR PRINTED IN BLACK INK ONLY PRIOR TO RECORDING OR FILING. over -LE 15009579 1000 07900 0300 031000 Real Pro TA9 en RLPA A I IIIIII VIII I I IIII ILII IIII I III OII IIII III Verifica 17 -APR -t 6 �)atisractlons/uischarges/Releases List Propen RECORD & RETURN TO: Rudolph H. Bruer, Esq. PO Box 1466 Southold, New York 11971 )31.000 1 5 1 Community Preservation Fund Consideration Amount $ td 1,CPF Tax Due $ Imoroved D� Vacant Land TD TD TD 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 County Recording & Endorsement Page This page forms part of the attached Bargain and Sale Deed — I,j-Ft made by: (SPECIFY TYPE OF INSTRUMENT) Barhra Moczulska a/k/a Barbara Moc7ulska The premises herein is situated in as surviving tenant by the entirety SUFFOLKCOUNTY, NEW YORK. TO In the TOWN of 1,nnthold Rarhara Mnczulcka In the VILLAGE or HAMLET of Southold BOXES 6THRU 8 MUST BE TYPED OR PRINTED IN BLACK INK ONLY PRIOR TO RECORDING OR FILING. over BARGAIN AND SALE DEED WITH COVENANT AGAINST GRANTOR'S ACTS (INDIVIDUAL OR CORPORATION) FORM 8007 CAUTION: THIS AGREEMENT SHOULD BE PREPARED BY AN ATTORNEY AND REVIEWED BY ATTORNEYS FOR SELLER AND PURCHASER BEFORE SIGNING. THIS INDENTURE, made the I qday of March, 2015 between BARBRA MOCZULSKA a/k/a BARBARA MOCZULSKA residing at 56-19 20151 Street, Bayside, New York 11364, as surviving tenant by the entirety with Andrzej Moczulski, her husband, who died a resident of Queens County, New York on January 5, 2015 party of the first part, BARBARA MOCZULSKA residing at 56-19 201" Street, Bayside, New York 11364, party of the second part, WITNESSETH, that the party of the first part, in consideration of TEN DOLLARS ($10.00), lawful money of the United States, 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 at Bayview, near Southold, in the Town of Southold, County of Suffolk and State of New York, known and designated as Lot No. 11, on a certain map entitled, "Subdivision Map of Bayview Woods Estates", filed in the Office of the Clerk of the County of Suffolk on September 9, 1970 as Map No. 5520. SUBJECT TO life estates hereby reserved to JAN POGORZELSKI and TERESA POGORZELSKA for their life use and occupancy. BEING AND INTENDED TO BE the same premises conveyed to Barbra Moczulska and Andrzej Moczulski, her husband, by deed dated June 20, 2005 and recorded in the Suffolk County Clerk's Office on November 25, 2005 in Liber 12421 at Page 853. 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. Barbra Moczulska a/k/a Barbara Moczulska STATE OF NEW YORK :ss. COUNTY OF Kv,CW �o� : On the R0 day of March, 2015, before me, the undersigned, a Notary Public in and for said State, personally appeared Barbra Moczulska a/k/a Barbara Moczulska, personally known to me or proved to me on the basis of satisfactory evidence to be the individual whose name is subscribed to the within instrument and acknowledged to me that she executed the same in her capacity, and that by her signature on the instrument, the individual, or the person upon behalf of which the individual acted, executed the instrument. / Chr Os Lestage . • . Notary PubkLState of Newyork No. Of LEef 54792 . Oualifled In Nassau.County� My Commisslon Expires October 411 p6a. INSTRUCTIONS(RP5217-PDF-INS): www.orps.state.ny.us )R COUNTY USE ONLYr, r.� / ] C1. suns Cede LIY ()J( t� New York State Department of Taxation and Finance C2. Date Dead Recorded I n5/ M C3. Book C4. Pago V 1 [ I�I Office of Real Property Tax Services RP- 521T -PDF Real Property Transfer Report (8110) PROPERTY INFORMATION t. Properly 575 Location — Ships Drive mREEI NUIiERNMwYL CnY tin TOWX SIAIV rP CWE 4. Indicate the number of Assossment 11:1Part of a Parcel (Only If Part of a Parcel) Cheek as they apply: Roll parcels transferred on the dead a d Parcels OR ❑ 4A. Planning Beam with Subdivision Authority Fxiets 8. Dead —OR 0-56 40. SubdivisionElroParty • FROM. FEET .OLRiH 'ACNES APPnmI was Required for TronmlCn :Ino 4C. Parcel Approved for Subdivision with Map Provided Moczulska Southold 11571 _ O. Seller •usrwrrvcowwn • CITY OR TONR! va,...r • rP cm 2. Buyer Moczulska Barbara Noma NST NNwYCR~ '7. Select the description which most accurately describes the Check the boxes below as they apply: • LA4INN.QGCOWRNv rnsr was O. ownership Type is Condominium A. One rami lv Rnsident(ai IAS' NAnFICaw+ANY FIRST NAME 2. Tax IGA. Pmperty Located within an Agricultural District ❑ ogling Add.. Indicate where future Tax Bills aro to be sem g Other than buyer address(al bottom of form) ❑ uy: VAMC.RYpww 1 NS: NAML mREEI NUIiERNMwYL CnY tin TOWX SIAIV rP CWE 4. Indicate the number of Assossment 11:1Part of a Parcel (Only If Part of a Parcel) Cheek as they apply: Roll parcels transferred on the dead a d Parcels OR ❑ 4A. Planning Beam with Subdivision Authority Fxiets 8. Dead —OR 0-56 40. SubdivisionElroParty • FROM. FEET .OLRiH 'ACNES APPnmI was Required for TronmlCn :Ino 4C. Parcel Approved for Subdivision with Map Provided Moczulska Barbra a/k/a Barbara, as _ O. Seller •usrwrrvcowwn Fnsl Nxom. Nome Surviving tenant by the entirety FIRST NAIL NST NNwYCR~ '7. Select the description which most accurately describes the Check the boxes below as they apply: use of the Property at the time of Salo: O. ownership Type is Condominium A. One rami lv Rnsident(ai 9. Now Construction on a Vacant Land IGA. Pmperty Located within an Agricultural District ❑ 100. Buyer received a disclosure notice irdicoling OW the property is in an ❑ Agricultural District SALE INFORMATION 1s. Chock one or more of those conditions on applicable to Vansfer: A. Sale Between Relatives or Former Relatives 11. Salo Contract Data A B. Sale between Related Companies or Partners In Business. C. One of the Buyers is also a Sailer p _ 3 - - i 5 0. Buyer or Sailer is Government Agency, or Lending Insii uffion • 12. Dau of Salartransler 1 E. Docd Type not Werromy or Bargain and Sole (Specify Below) F. Salo of Fractional or Less than Fee Intaroal (Specify Below) •13. Full Sale Price 0 .00 _ G. Significant Change in Property Between Taxable Status and Sale Dates H. Sale of Business is Included in Sole Pelee ( Full Sala Price is the total amount pod for the property including personal property. N I. Other Unusual Factors Affecting Sato Price (Specify Below) TNS payment may be in the form of comb, other property w goods, a the assumption of J. None mw ape or other ob.4gabons.) Please round to the neeramit while dogar amount Commont(s) on Condltlen: 14. Indicate tha value of personal 0 .00 UTP property Included In the sae 16. Year of Assessment Roil from which Information taken(VY) 14 117. Total Assessod Value 5,500 •1a. Property Class 210 _ •19. School District Name SOuzhold •20. Tax Map Identifler(syltoll Identifier(s) (If more than four, ■loch sheet with additional Identifdr[s)) 1000-079.00-03.00-031.000 CERTIFICATION I Certify that a8 of the Hams of Information enured on this form aro true and correct (to the beat of my knowledge and WWII and I undemund that the making crony willful faits statement of national fact herein subject met* the.prgvle[gns.of ".paaaU roLrelative to tha making and filing of false Instruments. SELLER.SIGN MUREBUYER CONTAr.T MOBMATION tEnar Imclm■Rm rel ew buyer. uoaa. n b_` a ILG.s»olr. s■■oursn. mryomhon. pun 0.1 —.n,.o■•aw w amty SW M ml mndMW■ISeem wMWvy.elm■nano tad oni= mOnnamn of m r%MEua'ilwponWM al9i� pmywhoconanswerquestion■reaming■aumnsaerRw■Tbeem■red.TypewpHmeMarty) 6F1nLR5CNAIWL' WE BUYER SIGNA/T�UR�EJJJ' l� - WvEil Sa:YA1WE bol L Moczulska • IAST NNNE 631 Barbara I ■IST -E • (2Z -L 7r ?1 W I■.PSER.E. S]e ` 201st Street . SIRECI NAM Bayside NY 11364 •CITY m1 Tom -STATF VPCCOE BUYER'S ATTORNEY Bruer (631) 765-1222 Aaucew. Rudolph 1 NSI NAW ILLLHM]N[ kU1aCR IG: Pr■fi■i