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Home My WebLink AboutL 12860 P 528 1111111110 1101 liffi 11111 HIll 1111111111 111111111111 111111 VIII 11111 IIII IIII SUFFOLK COUNTY CLERK RECORDS OFFICE RECORDING PAGE Type of Instrument: DEED Recorded: 04/14/2016 Number of Pages : 4 At: 11 :08:53 AM Receipt Number : 16-0057282 TRANSFER TAX NUMBER: 15-25755 LIBER: D00012860 PAGE : 528 District: Section: Block: Lot: 1000 027 .00 03.00 006.002 EXAMINED AND CHARGED AS FOLLOWS Deed Amount: $225,000 .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 $200. 00 NO Transfer tax $0.00 NO Comm.Pres $1,500. 00 NO Fees Paid $1,895.00 TRANSFER TAX NUMBER: 15-25755 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 ✓74 201E Apr 14 11:08:53 P11 JUDITH A. PA=CALE CLERK OF This document will be public SUFFOLK COUNTY record. Please remove all L 000012850 P 528 Social Security Numbers FT# 15-25755 prior to recording. Deed/Mortgage Instrument Deed/Mortgage Tax Stamp Recording/Filing Stamps 3 FEES Page/Filing Fee Mortgage Amt. 1.Basic Tax Handling 20. 00 2. Additional Tax TP-584 Sub Total Notation Spec./Assit. or EA-52 17(County) Sub Total Spec./Add. EA-5217(State) TOT.MTG.TAX •;l 1: Dual Town Dual County R.P.T.S.A. �a` t " Held for A ppointnt Comm.of Ed. 5. 00 _ Transfer Taxes /6 Affidavit .,} Mansion Tax Certified Copy _ The property covered by this mortgage is or will be improved by a one or two NYS Surcharge 15. 00 family dwelling only. Sub Total YES or NO Other Grand Total r If NO, see appropriate tax clause on page i! of this instrument. 16010358 1000 02700 0300 006002 " 4 Dist.• P T s I I I D2 5 Community Preservation Fund Real Proper 08-APR-1. ftIHIIIIIIII�I�IIII�II��III� Consideration Amount Tax Service Agency ' . CPF Tax Due S f� Verification --- --- — - - Improved Satisfactions/Discharges/Releases List Propperty Owners Mailing Address 6 RECORD&RETURN TO: / Vacant Land Mary D. Dorman, Esq. Y( 134 West 26th Street Sutie 902 TD New York, NY 10001 TD TO Mail to:Judith A. Pascale,Suffolk County Clerk Title Company Information 7 310 Center Drive, Riverhead, NY 11901 Co.NameJudicial www.suffolkcountyny.gov/clerk Tide 25262 8 Suffolk County Recording & Endorsement Page This page forms part of the attached Deed made by: (SPECIFY TYPE OF INSTRUMENT) Claudia Slacik The premises herein is situated in Susan A Forbes SUFFOLK COUNTY,NEW YORK. TO In the TOWN of Southold Susan A Forbes 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) • BARGAIN AND SALE DEED WITH COVENANT AGAINST GRANTOR'S ACTS (INDIVIDUAL OR CORPORATION) FORM 8002 (short version), FORM 8007(long version) CAUTION: THIS AGREEMENT SHOULD BE PREPARED BY AN ATTORNEY AND REVIEWED BY ATTORNEYS FOR SELLER AND PURCHASER BEFORE SIGNING. THIS INDENTURE, made the [/1 ' day of January, 2016, BETWEENClaudia Slacik and Susan A.Forbes,as joint tenants with rights of survivorship,of45 Gramercy Park North, Apartment 8B, New York, NY 10010 and 2 Horatio Street, Apartment 3J, New York, NY 10014, respectively, party of the first part, and Susan A. Forbes,of 2 Horatio Street,Apartment 3J,New York,NY 10014, party of the second part, WITNESSETH, that the party of the first part, in consideration of Ten Dollars and No Cents($10.00)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 at Orient,Town of Southold,County of Suffolk and State of New York, bounded and described as follows: BEGINNING at a point on the northerly side of King Street(a/k/a Narrow River Road)distant 237.70 feet easterly from the corner formed by the intersection of the northerly side of King Street with the easterly side of King Street; RUNNING THENCE along land of Holtzman,North 25 degrees 03 minutes 20 seconds West 70.80 feet to land of Vilna Estates, Inc.; RUNNING THENCE along said land North 67 degrees 18 minutes 10 seconds East 157.62 feet to land of A. Blodgett; RUNNING THENCE along land of A. Blodgett, South 18 degrees 13 minutes 20 seconds East 82.60 feet to the northerly side of King Street; RUNNING THENCE along the northerly side of King Street,South 71 degrees 46 minutes 40 seconds West 148.72 feet to the point or place of BEGINNING. WITH the intended use of the premises being residential. 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; District 1000 Section: 027.00 Block: 03.00 Lot: 006.002 NYSBA's Residential Real Estate Forms(9/00) ®2015 Matthew Bender&Co.,a member of the LexisNexis Group. , 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. BEING'AND INTENDED TO BE the same premises as conveyed to the party of the first part by deed from Susan A.Forbes dated July 3, 1996 and recorded in the Office of the County Clerk,Suffolk County onl•-•VA Liber 111 Si?-- ,//ma ��lTt Page...25S 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. i IN WITNESS WHEREOF,thea of the first part has duly executed this deed the day and year first above • written. („) f,,„,,,L.. ,,,e, .......' Claudia Slacik • 400 tilt ifilal Susan A. Forbes Acknowledgment by a Person Within/Outside New York State(RPL§309-a) STATE OF Stu. 4 Weld-ld- ) COUNTY OF New yock- )ss.. On the G day of 1 ay.Jo.v4 in the year 1°t 6 ,before me,the undersigned,personally appeared Claudia Slacik,personally known tome or pro'ed to me on the basis of satisfactory evidence to be the individual whose name , is subscribed to the within instrument and acknowledged tome 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. n /,o n (} CAROL L BUELL (J.�•+.sLX�� Notary Public,State of New Yak (signature and office of individual taking acknowledgment) No.24-4834810 Oualified In toUngs County Commission Expires February 24,2OJ Acknowledgment by a Person Within/Outside New York State(RPL§309-a) STATE OF Mif,V VOP+C ) COUNTY OF A4 i Ya4c-- )55.. On the g1 r dayof D L rh.rw6`,e— in the year Z!o t C,before me,the undersigned,personally appeared Susan A.Forbes,personally known to me or proved to i r' an the basis of satisfactory evidence to be the individual whose name I is subscribed to the within instrument and ackn a - edg,a t. ;;,that she executed the same in her capacity,and that by her signature 1 on the instrument,the individ a or the perso .on a4-h. `-i which the individual acted,executed the instrument. hr 1 f L J (signature and office of individual taking ackn ledgment) a� Naury Public,State of New �Iv.vj1).sberms t oWine Jab,31, t i `2- Deed • Title No. District 1000 Claudia Slacik and Susan A. Forbes, as Section 027.00 joint tenants with rights of survivorship Block 03.00 To Lot 006.002 Susan A. Forbes County or Town Suffolk County Street Address 1075 Narrow River Road Orient,NY 11957 Return By Mail To: Mary D.Dorman,Esq. Law Office of Mary D. Dorman 134 West 26th Street, Suite 902 New York,NY 10001 Reserve This Space For Use Of Recording Office • -3- INSTRUCTIONS(RP-5217.PDF.INS):www.orps.state ny us FdR COUNTY USE ONLY e L L1� g � New Yodi State Departmental Cl.SwiS Code I 13131 1 11 Taxation and Finance C2.Date Deed Recorded i O / /f/i.901; arced Real Properly Tax Services p """ °w Y"' D-2 RP-5217-PDF C3.Book I / l-1 0 I/P l O C4.Page I 1 1 1 r I Real Property Transfer Repoli(8110) PROPERTY INFORMATION I 1-Property 1075 NARROW RIVER ROAD Location •BTSEET UMBER •STREET NNE ORIENT 11957 •err CR TOMI VLLAOE •a+CCCL 2.Buyer FORBES SUSAN A. Name •LAST NAMECariDD neon NAVE LAn MOrEr.0UF Ir FIRST DAM 7.Tax Indicate where future Tax Bills are to be sem Billing if alba than buyer eddmlatal bottom of form) WT M aDCOMPMry Flier MME Address S'R_hT tMVJMIDEMPE C TY CR TOM., STATE DP CODE 4.Indlub the number of Assessment 1 eel Parcels DR ❑Part or 1 Parcel (Only If Part of a Parcel)Chmck as they apply: Roll parcels transform!on the deed 4A.Planning Board with Suadivision AuthOrtty Exists 0 6.Deed X OR 0.26 4B.SubdMskn A .operty •moeT rooT •Drell. •ACRES Approval was Raquied for Transfer El BIas 4C.Percel Approved for Subdivision welt Map Provided 0 FORBES SUSAN A. 6.Seller •(ASrMAIIECOUPum MST NAME Nemo SLACIK CLAUDIA LAST NAMECOVPNIY Fop AMMO h.Select the description which most accurately describes the Check the hexes below as they apply: use of the properly at the time of sale: B.Ownership Type is Condomalum 0 A.One Family Residential 9.New Construction on a Vacant Land ❑ 10A.Property Located w411111 an Agricultural Dlelnd ❑ 10B.Buyer received a dledosure nonce Indicating plat Ole properly is Nan 0 Agricultural District 1 SALE INFORMATION' 15.Check one or more of these conditions es applicable to transfer. A Sale Between Mindless or Former Relatives 11.San Contract Date 3\.+10 t B.Sale between Related Companies or Posers n Buenas. C.One of Me Buyers is also a Seller °17. Data of SBIertlansfer `s ii d 3\VSI►6 D.Buyer or Seller Is Goverment Agency or Lendhig Institution E.Deed Type not Warranty or Bargain and Sale(Specify Below) F.Sale of Fractional or Leser Man Fee Interest(Specify Below) 13.Full Sale Price 225,000.00 G.Slgndaant Change In Property Between Taxable Status and Sale Dates H.Sale of Business is Included in Sale Price (Fut Sale Prte Is the total amount paid for the property inducting personal properly. I.Other Unusual Factors Affecting Sale Pride(Specify Below) This payment may be in ate form of cash,other properly or goods.or the assumption of J.None mortgages or other obligations.)Please round to ate nearest whole doyeremount. Comments)on Condition: 14.lndlcate the value of personal property Included In the sale •00 !ASSESSMENT INFORMATION-Data should reflect the latest Final Assessment Roll and Tax Bill 19.Year of Assessment Roll from which Information leken(YY) 15 17.Total Asaoasad Value 7,500 me Propery Class 210 _ 19.School District Name OYSTL'RPONDS '20.Tax Nap ldsnttite,syRoIl tdenteler(e)(if more than four,attach sheet with additional IdentMega)) Ivan-27-3-6.002 (SUFFOLK) !CERTIFICATION I I Certify that all of the Items of Information emored on this form are true and convict(to the best of my knowledge end belled)and I understand that the making of any willful false statement of material fact herein subject me to t e.provlsnne-of the.penal law.mlative to the making and Ming of false Instrument. SELLER SIGNATURE BUYER CONTACT INFORMATION (Era,iwanaeee to eel tweet.NM.2 peer"LLC e1Cay.Seward n.cepeaar On Back raneely,latae Or C3111/405c.t. L11,::::,/� aisle nal an Is t esDsidl agent a Canary,then a nems and eon=trfernsenen aerr nreuat urespmaae i'{L_/ /� �a�� rrpaywie ran arose.C cions raPrdn9 ea tvmhr mu"be wind Type or print Steely.) sr E■ewoonsts ) Ober_/ BUYER SIGNATURE FORBES SUSAN A 'LAS.NAPE nasn•.lee it I , /'''• VOY9/40 •NiGcow - •¢LCCM.LxoxaERls.mieeel; SraA,1Ra DATE 1075 NARROW RIVER ROAD •STREDT NUMMI -STREET wok 11 u i 1 II I A SOUTHOLD NY 11957 ill "r illi I+e 1111 II11 1 Ili L�,'1 J7 I��4�(Ili II 1� •CITY TOAD ��ypp�� }} p�py •aTATE •a'CODE IIS dIt'l'� {l ll l 1llll� I�r r Ill 71#II1IrI II l'Ji;v'i��Ill BUYERg iQor ,ll•IIS I II'`l`lllll l� �lrf111'1;111A 1le ll'5 IiI111�1IIll `'1411 14 II'Ill', Irl !))IIIn I Ii l 1i�1 I�,Jalr 1I, 'CII`Ijl Ir Illlii r' ( DORMAN MARY 1!Ifr1I71, +�1lI1IIL9l' 11{1 I il. 1. 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