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SUFFOLK COUNTY CLERK
RECORDS OFFICE
RECORDING PAGE
Type of Instrument: DEED Recorded: 08/06/2015
Number of Pages: 4 At: 03:03:59 PM
Receipt Number : 15-0105879
TRANSFER TAX NUMBER: 15-00543 LIBER: D00012827
PAGE: 018
District: Section: Block: Lot:
1000 086.00 02 .00 013.000
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 $255.00
TRANSFER TAX NUMBER: 15-00543
THIS PAGE IS A PART OF THE INSTRUMENT
THIS IS NOT A BILL
JUDITH A. PASCALE
County Clerk, Suffolk County
1 2
•
RECORDED
Number of pages 2015 Ruq 06 03:03:59 PM
JUDITH A. PASCALE
CLERK OF
This document will be public SUFFOLK COUNTY
record.Please remove all L 000012827
Social Security Numbers P 018
prior to recording. DT# 15-00543
Deed/Mortgage Instrument Deed/Mortgage Tax Stamp Recording/Filing Stamps
3 FEES
/
1`�
Page/Filing Fee Mortgage Amt.
1.Basic Tax
Handling 20. 00 2. Additional Tax
TP-584 S Sub Total
Notation Spec./Assit.
t� or
EA 52 17(County) Sub Total Spec./Add.
EA-5217(State) /. TOT.MTG.TAX
.; �atQ/'`, Dual Town Dual County
R.P.T.S.A. e\ ,.: Held for Appointment
Comm.of Ed. 5. 00 1 t, Transfer Tax
,, d
„•:. i��M1 ,r, Mansion Tax
Affidavit ,'�
1't® ' The property covered by this mortgage is
Certified Copy or will be improved by a one or two
NYS Surcharge 15. 00 7„\C family dwelling only.
Sub Total r U ) YES or NO
Other
Grand Total If NO, see propriate tax clause on
page of this instrument
"-
i -
4 Dist.;« 150208511000 08600 0200 013000 70 5 Community Preservation Fund
Real Property T S ll�l��l��llll����lyll Consi �n Amount$ rerTax Service R CWH A 1\I\ 1II\ItI{III 1I `I 1 ,�-
Agency �PF Tax Due $
Verification 03-AUG-1
--- Improved
Satisfactions/Discharges/Releases List Property Owners Mailing Address
6
RECORD&RETURN TO: Vacant Land
0. l a�\eY Cie i1P TD /
1 LO e- \ V TD
\-\-kt(),,M t TD
Mail to:Judith A. Pascale, Suffolk County Clerk 7 Title Company Information
310 Center Drive, Riverhead, NY 11901 Co.Name V-`,i- ___A G\1RPih-,A,A
www.suffolkcountyny.gov/clerk Title# -----0-11O- 1 - R
8 Suffolk County Recording & Endorsement Page
This page forms part of the attached .— \k,> made
,1 (� (SPECIFY TYPE OF INSTRUMENT)
aid V p�Q.4-1 The premises herein is situated in
ILSUFFOLK COUNTY,NEW YORK.
l TO In the TOWN of �u ,d
t M, 1 1 lAei`Aa, In the VILLAGE
or HAMLET of
BOXES 6 THRU 8 MUST BE TYPED OR PRINTED IN BLACK INK ONLY PRIOR TO RECORDING OR FILING.
(over)
'Premises:3705 Wells Road,Peconic,NY 11958
SCHEDULE A
ALL that certain plot, piece or parcel of land, with
thPl2 c ldr and improvements thereon erected, situate,
lying and being in the Town of Southold, County of Suffolk and State of New
York, bounded and .described as follows: '
BEGINNING at a point on the southerly side of Wells Road distant
3595.08 feex .westerly from Main Road said point. being the -south-
.westerly. corner .df- land of Dansker, from said point of beginning;
Thence South 31 degrees 08 minutes East 144.2 feet to high water
mark of Richmond Creek;
' Thence Southwesterly, Westerly and Northwesterly along Richmond
Creek to a .oint which is located 260.51 feet o. a
bearing is South 71 degrees 41 minutes 20 seconds West from the end
•
of the last course;
Thence Due North 170 feet to the southerly side of Wells Road;
Thence Easterly along the southerly side of Wells Road along
the arc of a curve bearing to the left having a radius of 256.6 feet
a distance of 180 feet to the point or place of BEGINNING
•
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?delay of June,2015,
between
Paul V.Groben and Anne R.Groben,residing at 26 Lotowana Lane,Stony Brook,NY 11790,as husband and L
wife,
3\(�G�party of the first part,and
\ Anne M.Hooker,residing at 25 Emlu Drive,Selden,NY 11784,as Trustee of the Paul V.Groben Irrevocable
,Trust,dated May 15,2015,as to a 50%interest,AND Anne M.Hooker,as Trustee of the Anne R.Groben
�.'(\ Irrevocable Trust,dated June 2,2015,as to a 50%interest,
.;6 party of the second part,
0.
WITNESSETH, of the first part,in consideration of Ten Dollars and No Cents($10.00),
lawful money of the Unitedthat Statesthe ,paidpartyby the party of the second part,does hereby grant and release unto the
ob party of the second part,the heirs or successors and assigns of the party of the second part forever,
C?'" ALL that certain plot,piece or parcel of land,with the buildings and improvements thereon erected,
A situate,lying and being in the
V
0)\}). See Schedule A attached ,
BEING AND INTENDED TO BE the same premises conveyed to Anne R.Groben by deed
dated July 17,2007 and recorded in the Office of the Suffolk County Clerk on September 5,2007 in Liber 1252]
Page 22;and being and intended to be the same premises subsequently conveyed by deed dated June 2,2015 by Anne
R.Groben,as party of the first part,to Paul V.Groben and Anne R.Groben,as party of the second part, having been
executed even date herewith and recorded prior to the recording of the deed herein.
SAID premises known as and by 3705 Wells Road,Peconic,NY 11958,
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 PRESENCE OF:
Paul V.Groben /
/ —_ Ali
Anne R.Groben
trommxtritemaromi Met Est=Foonsatie) 02662Itlar w esiestar&C.,,a walkerofdos Grow
a.
•
Acknowledgment by a Person Within New York State(RPL§309-a)
STATE OF NEW YORK
COUNTY OF SUFFOLK )ss..
On the made the 2"d day of June,2015,before me,the undersigned,personally appeared Paul V.Groben
and Anne R.Groben,personally known to me or proved to me on the basis of satisfactory evidence to be the
individuals whose names are subscribed to the within instrument and acknowledged to me that they executed the
same in their capacities,and that by their signatures on the instrument,the individuals,or the person upon behalf
of which the individuals acted,executed the instrument.
JANNA P.VISCONTI
Notary Public,State of New York
No.02V16133667
! • Public� Qualltlyd in Suffolk County
Notary
Commission Expires September 19,20/2
Ba1'gain anb Sale Deeif
With Covenant Against Grantor's Acts SECTION 086.00
TITLE NO.�i(1�. a� BLOCK 02.00
�J� v LOT 013.000
COUNTY OR TOWN Suffolk County
STREET ADDRESS 3705 Wells Road
Peconic,NY 11958
Paul V.Groben&Anne R.Groben
TO
Anne M.(looker,as Trustee of 2 trusts
Return by Mail to:
Grabie&Grabie,LLP
162 Terry Road
Smithtown,NY 11787
(
•
NYSLA's Residential Real Estate Forms(9/00) 0 2002 Matthew Bender&Co.,a member of the LexisNexis Group.
-2-
•
INSTRUCTIONS(RP5217-PDF-INS):www.orps.stete.ny.us
FOR COUNTY USE ONLY , r .1.G. er1'
MabfkMate Depsetme tof
ct.SWlS Code • I`'C t 4 1 /1.4 a* ��
1 q � Taxation and Finance
C2.Date Deed Recorded I 071'i O( j '✓K1 �1 of Real Properlybc SeMoes
aim MY TW RP-5217-PDF
C3.1360k I (cal g l g-l./1 C4.Patio I I JO r I I I Real Properly Transfer Report MO)
PROPERTY INFORMATION I
1.Papery 3705 Wells Road
Location - -
•STMEET KAMM •ST.EiT NwE
Peconic • 11958
•C.TY OR TORN MAW, •AP COOS
2.Buyer Hooker, TLce of 2 trusts Anne M.
Name
•IASTu_ccoMrANT FREI NAVE
LOST NAAFCOMPPRY FAN NAm!
3'Tes InticatewMrefuture Tax Bilsare tobesem Groben Paul V. & Anne R.
Bulling d other than buyer address(at bottom of form) LOOT NtME.cow NY MST RAMC
Address
26 Lot owana Lane Stony Brook NY 11790
!MU l r.AGER AND NAME CITY 09 TOWN STATE 2P COOL
4.In lcate the number of Assessment 1fl Panora Parcel (Only a(OPut of■Parcel)Cheek se they apply:
Roll parcels bensferred on the deed 0 ot Percale OR ❑
4A.Planning Board with SubdNidon Authority Bests
5•Deed X OR 0.90 4B.Subdivision Approval was Required for Transfer ❑
Property •FROM HET •DEPTH "GRES
Size 4C.Parcel Approved for Subdivision with Map Provided ❑
Groben Paul V.
O.Seller •UST NNIEIeoalurY - - 'Ph1 NAM
Name -
Nem• Groben Anne R.
NST NAMEATOMPAP
MST HAW
'7.Select the description which most accurately describes the Check the boxes below as they apply:
use of the property at the time of sale: 8.Ownership Type a Condominium ❑
A.Oil,:Family Residential 9.New Construction on a Vacant Land ❑
10A.Property Located within an Agricultural District
10B.Buyer received a disclosure Twice indicating that the properly is in an ❑
Agricultural District
(SALE INFORMATION! 18.Check one or mon of those conditions as applIcabie to Sender:
A.Sale Between Relatives or Former Relatives
17 Sale Contract Dab _8.Sale between Related Companies or Partners in Business.
-- - C.One of the Buyers is also a Seller
•12.Data of Sal.RYansfer 06/02/2015 _D.Buyer or Seller is Govemment Agency or Lending Institution
_E Dead Type not Warnrdy or Bargain and Sale(Specify Below)
_F.Sale of Fractional or Less then Fee Interest(Spicily Baled)
'13.Full Sale Price 0.00 _G.S.ONrream Charge In Properly Between Taxable Status and Sale Dales
N.Sale of Business is InOWed In Sale Price
(Full Sale Price Is the teal amount paid for the property including personal properly. E I.Other Unusual Factors Affecting Sale Price(Specify Below)
TN.payment may be in the farm of cash,other property or goods,or the esaumMian of J(late
mortgages or other obligations)Please round to the nearest whole Cog eramount.
'Comment(s)on Condition:
14.Indicate the value of personal
property included in the sale 0.00 no consideration _ra:lsfor to _rust
IASSESSMENT INFORMATION-Data should relied the latest Final Assessment Roll and Tax Bill I
16.Year of Assessment Roll from which information taken(YY) 15 '17.Total Assessed Value 7,700
.10.Ampere/Class 210 _ '111.School District Name Southold
—
•2B Tax Map IdentiMr(syRoll Identifier(s)(if mom than four,attach sheet with additional IdentiMr(s))
1000-086.00-02.00-013.000
CERTIFICATION I
I Certify that all of the Items of Information entered on this foam are true and correct(to the best of my knowledge and ballet)and I understand that the making of any willful
false statement of material fact heroin subject me to as emvlalona tdlda.penalimtlrebtbe to She making End filing of false Instruments.
$ELLER SIGNAIURE BUYER CONTACT INFORMATION
(Ener ieanamm far vat buyer.Now:it buyer Is U.C..udey.essadaboll,=paragon.)ora stodl company,eniax or
r� 1} only err is nal Sr Mogul agent orrthatary.Men anoneara radon amm
dmmat an ndvaualeerm
pebls
() V.)A+.r= 4421 m umovWes
nary wn er amm
slnOane aasanahrm re
rmualer Sr print ia aleedy.)
sacra SIrwATIPE oATP
BUYER SIONATIIRF Hooker, as Trustee Anne M.
—-•LAW NAME FAST NAME
• /AA , .•.410.i"/L. •�4� lD/ CO VASA CODE •:CIEACre WMTES IF.KFKKI
BUTES smNA •- DATE
25 Emlu Drive
•mem-YUa1CR •ST:EET NAME
4 IJJI rt,',III I,r ; Selden NY 11Y84
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rri!k+ rl. i' ?, ; +I llII,{ IN NI (631)
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