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Home My WebLink AboutL 12856 P 30SUFFOLK COUNTY CLERK RECORDS OFFICE RECORDING PAGE Type of Instrument: DEED Recorded: 03/11/2016 Number of Pages: 4 At: 11:50:03 AM Receipt Number : 16-0037754 TRANSFER TAX NUMBER: 15-22360 LIBER: D00012856 PAGE: 030 District: Section: Block: Lot: 1000 079.00 04.00 004.001 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 $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 $200.00 NO Transfer tax $0.00 NO Comm.Pres $0.00 NO Fees Paid $395.00 TRANSFER TAX NUMBER: 15-22360 THIS PAGE IS A PART OF THE INSTRUMENT THIS IS NOT A BILL JUDITH A. PASCALE County Clerk, Suffolk County Numbero;pages This document will be public record. Please remove all Social Security Numbers prior to recording. RECORDED 201E 14ar 11 11:50;03 All JUDITH A. PASCALE CLERK OF SUFFOLK COUNTY L D00012856 P 030 DT# 15-22360 Deed/ Mortgage Instrument Deed / Mortgage Tax Stamp Recording / Filing Stamps 3 1 FEES Page/ Filing Fee Handling TP -584 Notation EA -52 17 (County) EA -5217 (State) R.P.TS.A. Comm. of Ed. Affidavit Certified Copy NYS Surcharge Other 4 1 Dist. Real Propert Tax Service Agency Verification r 5. 00 Sub Total 15, 00 Sub Total Grand Total 3 �+ 16007214 �„ R 1000 07900 0400 004001 .1 IIIIIIII�IIIIIIIIIIIIIIIIIIBIII�III�lll�lll� 6 Da(1sracnonsiL)iscnargesimeieases List Property RECORD & RETURN TO: Feldman Kramer & Monaco, PC 330 Vanderbilt Motor Parkway Suite 400 Hauppauge, NY 11788 Att: Gina Panzenbeck, Paralegal rs Mortgage Amt. 1, Basic Tax 2. Additional Tax Sub Total Spec./Assit. or Spec. /Add. TOT. MTG. TAX Dual Town -Dual County Held for Appointment Transfer Tax Mansion Tax The property covered by this mortgage is or will be improved by a one or two family dwelling only, YES or NO If NO, see appropriate tax clause on page # of this instrument. 5 Community Preservation Fund Consideration Amount $ CPF Tax Due $ Improved Vacant Land TD/ �vb TD 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 sr 8 Suffolk County Recording & Endorsement Page This page forms part of the attached Deed by: (SPECIFY TYPE OF INSTRUMENT) Lina Forosich The premises herein is situated in SUFFOLK COUNTY, NEW YORK. made TO In the TOWN of .. Southold and Rodney Sirmons. co-ttees In the VILLAGE or HAMLET of SQuibold BOXES 6 THRU 8 MUST BE TYPED OR PRINTED IN BLACK INK ONLY PRIOR TO RECORDING OR FILING. over CONSULT YOUR LAWYER BEFORE SIGNING THIS INSTRUMENT -THIS INSTRUMENT SHOULD BE USED BY LAWYERS ONLY No _ consideration THIS INDENTURE, made the 'day of &JkSt 2015 deed BETWEEN Lina Forosich, residing at 1405 Anchor Lane, Southold, NY party of the first part, and Nadalene Sirmons and Rodney Sirmons, Co -Trustees of the Forosich Family 2015 Irrevocable Trust, both DISTRICT residing at 1405 Anchor Lane, Southold, NY 1000 SECTION party of the second part, 079.00 WITNESSETH, that the party of the first part, in consideration of TEN dollars and other good and valuable consideration paid by the party of the second part, does hereby grant and release unto the party of the second BLOCK part, the heirs or successors and assigns of the party of the second part forever, 04.00 ALL that certain plot, piece or parcel of land, with the buildings and improvements thereon erected, situate, LOT lying and being at 004.001 SEE ATTACHED DESCRIPTION Subject to all covenants, restrictions, agreements and easements of record, if any. Said premises known as 1405 Anchor Lane, Southold, NY Being and intended to be the same premises as conveyed to the party of the first part by deed dated May 31, 2014 recorded August 1, 2014 in Liber 12783 page 302 in the Suffolk County Clerk's Office. 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. Ltn Forosich Standard N.Y.B.T.U. Form 8002 - Bargain and Sale Deed, with Covenant against Grantor's Acts — Uniform Acknowledgment Form 1000-7 TO BE USED ONLY WHEN THE ACKNOWLEDGMENT IS MADE IN NEW YORK STATE State of rNew York, County of Suffolk ss: State of New York, County of On the 19 day of A"iJJ9 -S-t-- in the year 2015 before me, the undersigned, personally appeared Lina Forosich 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 hislher/their capacity(ies), and that by his/her/their signature(s) on the instrument, the individual(s), or the person upon behalf of which the individual(s) acted, executed t e instrument. (signature and office of ind ldual taking acknowledgment) On the day of in the year before me, the undersigned, personally appeared ss: 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 capacity(ies), and that by his/her/their signature(s) on the instrument, the individual(s), or the person upon behalf of which the individual(s) acted, executed the instrument. (signature and office of individual taking acknowledgment) STEVEN KRAMER Notary u 1�2KR6t Of jeW York 01 Qualified In Suffolk County Commission Expires June 27, 20 f y TO BE USED ONLY WHEN THE ACKNOWLEDGMENT IS MADE OUTSIDE NEW YORK STATE State (or District of Columbia. Territory, or Foreign Country) of as: On the day of in the year before me, the undersigned, personally appeared 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 capacity(ies), and that by his/her/their signature(s) on the instrument, the individual(s), or the person upon behalf of which the individual(s) acted, executed the instrument, and that such individual made such appearance before the undersigned in the in (insert the City or other political subdivision) (and insert the State or Country or other place the acknowledgment was taken) LINA FOROSICH TO NADALENE SIRMONS AND RODNEY SIRMONS, CO -TRUSTEES BARGAIN AND SALE DEED WITH COVENANT AGAINST GRANTOR'S ACTS Title No. MA -14-8133 (signature and office of individual taking acknowledgment) DISTRICT 1000 SECTION 079.00 BLOCK 04.00 LOT 004.000 COUNTY OR TOWN Suffolk STREET ADDRESS 1405 Anchor Lane Southold, NY 11971 RETURN BY MAIL TO: Steven Kramer, Esq. Feldman, Kramer & Monaco, P.C. 330 Vanderbilt Motor Parkway Hauppauge, NY 11788 DESCRIPTION ALL that certain plot, piece or parcel of land, with the buildings and improvements thereon erected, situate, lying and being in the Town of Southold, County of Suffolk and State of New York, known and designated as Lot 15 on a certain map entitled, "Map of Harbor Lights Estates, Section 1," and filed in the Office of the Clerk of the County of Suffolk on June 8, 1465 as Map No.4362 ALL that certain plot, piece or parcel of land, 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 easterly side of Lot No. 2 as shown on Map of Harbor Lights Estates, Section 1, Map No. 4362, distant 25 feet northerly from the southeasterly corner of said Lot 2; running thence North 25 degrees 54 minutes 50 seconds East along the easterly side of said Lot 2, 25 feet; thence South 64 degrees 05 minutes 10 seconds East 31.28 feet; thence South 16 degrees 01 minutes 00 seconds West 25.37 feet; and North 64 degrees 05 minutes 10 seconds West 35.64 feet to the point or place of BEGINNING. INSTRUCTIONS(RP-5217-POF-INS): worps.stalemy.us )R COUNTY NTY USE ONLY c C1. SWIS Code - 7 3 8 8 I C2..DatelDoed Recorded 1 63 / f 1 1 a" m I �p /1"a T C9. Book 1 U, S 1 C4. Parte 138 I PROPERTY INFORMATION 1. Property 1405 Location Anchor Lane ' eTNEET NL r ST4EC. NAME 2. Buyer Name Southold Southold -cnreproses V LAW New York Stale Department of Taxation and Finance Office of Real Property Tax Services RP- 5217 -PDF Real Property Transfer Report IRMO) 11971 . bA CWE Forosich Family 2015 Irrevocable Trust ' LAST NANaCOepANY FAST NAME Nadalene Sirmons and WT NAIricoaeANY Rodney Sirmons, Co-TTEES FIRST NANE 7. Tax Indiratewhaafuture Tax saisare tobesent Forosich Lina use of the prop" at the time of sale: Billing d other then buyer address(et bottom d form) A. One Family Residential s. New Contraction on a Vacant Land Addrees 10A. Property Located within an Agricultural District LAST NANEWmwAW raSTNAVE 10B. Buyer rocelved a disdosuronobae Ind,rsting [het the property is in an 1505 Anchor Lane Southold ❑ SALE INFORMATION1 IL Check ens or mon of these conditions an applicable to tranafar. NY 11971 A. Sala Between Relative or Former Relatives smEET NusemAND.MWE C:W OR Taves. 5 -ATE ZF CODE 4. Indleate the number of Assessmente d Percelo 1 Part d a perwl (Only N Pert or a Pe moll Check as they appy: C. One d the Buyers is also a Seller Rail Pamela trasaferrad on the dead OR 4A. Planing Board with Subdivision Authority Exists S. Dead Property 'FRWFEET }( OR OEM. 0.50 'ACRES 4B. Subdivision Approval was Required for Transfer 13 Sin F. Sale d Fractional or Less than Fee Interest (Spedry Below) 113. Full Sale Pike 0 .00 4C. Pamel Approved for Subdivision with Map Provided ❑ Forosich Lina a. Seller .LAST NANeCOWAN FasrxAeE Nome UST NIWEICONFANY FIRST N HE 7. Select the descdpaon which most accurately describes the Check the boxes below as UW appy: use of the prop" at the time of sale: s. Ownership Type is Condominium 0 A. One Family Residential s. New Contraction on a Vacant Land 10A. Property Located within an Agricultural District 10B. Buyer rocelved a disdosuronobae Ind,rsting [het the property is in an Agricultural District ❑ SALE INFORMATION1 IL Check ens or mon of these conditions an applicable to tranafar. A. Sala Between Relative or Former Relatives 11. Sate Contract Date B. Sale between Related Companies or Partners in Business. ' r C. One d the Buyers is also a Seller • 12. Data of Spion vendor t�— i`i' ",�(5 D. Buyer or Seiler is Government Agency or Lancing Instilueon E. Dead Type not Wammy or Bargain and Sale (Spaaly Below) F. Sale d Fractional or Less than Fee Interest (Spedry Below) 113. Full Sale Pike 0 .00 G Significant Change In Prop" Between Taxotiq Status and Side Dates ( FUN Sale Pries is Na total amount paid for the properly induct rap praarl H. Sola d Business is Included In Sala Prim The payment may be m the form d cash, other property or goads, or Um ssaumplion d sumpie 1. Other Unusual Factors ARectin 0 Selo Prim (Specify Below) mortgagee Or 011181" obl4WMS.) Phase round ro aro neonate whoa dollar amount J WITS Commermt(sl on Condition: 14. Indicate the value of personal 0 property Included in the sale .00 Transfer to Trust ASSESSMENT INFORMATION - Data should feflocl the latest Final Assessment Roll and Tax Bill is. Year of Assessment Roll from which Information tekenlrf) 15 •17. Total Assessed Value 13 '1111. Property Class 210 — 99. School District Name •20. Tax Map Iderd onsyRoll IdenOnsr(S) (If more then four, attach shoot with additional IdnitlMgs)) 1000-079.00-04.00-004.001 Southold CERTIFICATION I Certify that all of the Items of Information entered on thin form are true and correct (to the bet of my knowledge and bellefl and I understand that the making of any willful fakes statameM of mmrlal fact herein subloel me to 1hs.9LQdjl ae.Of]hmnaLhxroladve to the making and filing of false Instrumema. SELLER SIGNATURE 1 BUYER CONTACT INFORMATION . IEnW Rxwmeson N eco Myer. Neu II Talyer a LLC,eoaa, aAemehwt mRws 1cA+eWdt aampaTry, ermate or wwp raw a ram m Yl iris al caring ar ang Iho Sun a rams era mead type or pro icor ndnRdrrewenponeae g 1"4�nrc Rw'tMpnma.cow eaRrme.SacopIM e.mrr muel be aavre4. TrRs e1" amnf- .) AE.. Ce e Aruvr mLTE BUYER SIGNATURE I Sirmons BInEA wGIMI'JILEY'R/I/rr Tti/eW «•• 11405: Nadalene and Rodney 1�V �06 ' _ •TEEW Vry .a•-rreER 1E. 7AfArA; Anchor Lane 'STNEETnAmE Southold NY 11971 •CnYORTOW, 'STATE 'LF LOSE BUXER'S ATTO N Y Petillo Christopher UST MLLE FwSTNANE (631) 231-1450 AREACbla •ELE FIphE hJV=n. eS j