HomeMy WebLinkAboutL 12876 P 467 1111111 Illi VIII VIII IIIA II I I I I I I I I II II I I II II illi illi
I Il Illi lilll VIII II I I I II
SUFFOLK COUNTY CLERK
RECORDS OFFICE
RECORDING PAGE
Type of Instrument: DEED Recorded: 08/23/2016
Number of Pages : 4 At: 10 :50:54 AM
Receipt Number : 16-0131300
TRANSFER TAX NUMBER: 16-02329 LIBER: D00012876
PAGE: 467
District: Section: Block: Lot:
1000 064 .00 02 . 00 030.000
EXAMINED AND CHARGED AS FOLLOWS
Deed Amount: $4711000 . 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 $6,420.00 NO
Fees Paid $6,815. 00
TRANSFER TAX NUMBER: 16-02329
THIS PAGE IS A PART OF THE INSTRUMENT
THIS IS NOT A BILL
JUDITH A. PASCALE
County Clerk, Suffolk County
07
RECORDED
Number of pages 2016 Aug 23 10:50:54 AM
JUDITH A. PASC_ALE
CLERK OF
This document will be public SUFFOLK COUNTY
record.Please remove all L DOOD12876
Social Security Numbers P 467
prior to recording. DT# 16-023,29
Deed/Mortgage Instrument Deed/Mortgage Tax Stamp Recording/Filing Stamps
3 1
9- FEES
Mortgage Amt.
Page/Filing Fee
,�/
1.Basic Tax
Handling 20, 00
2. Additional Tax
TP-584 Sub Total
Notation / SpecJAssit.
or
EA-52 17(County) Sub Total Spec./Add.
EA-5217(State) TOT.MTG.TAX
R.P.T.S.A. 2�— Dual Town Dual County
Held for Appointment
Comm.of Ed. 5. 00 Transfer Tax
Affidavit
e , Mansion Tax
_
The property covered by this mortgage is
Certified Copy or will be improved by a one or two
NYS Surcharge 15. 00 family dwelling only.
Sub Total YES or NO
Other
Grand Total __j If NO,see appropriate tax clause on
page# of this instrument.
4 Dist. 10 1602_3148 1000 06400 0200 030000 0 5 Community Preservation Fund
Real Property P m
T , I I i I I f I Consideration Amount$ - �i a7
)
fc tion 04-AUG-16/ Illlll�Illllllllllllllllll�Illllfll�lllllllllli CPFITax Due $ f 06
Ver
'J Improved
6 Satisfactions/Discharges/Releases List Property Owners Mailing Address
RECORD&RETURN TO: Vacant Land
David Worthington Olsen,Esq. TD�0
Olsen&Olsen,L.L.P. TD
P.O.Box 706
Cutchogue,NY 11935 TD
Mail to:Judith A.Pascale,Suffolk County Clerk 7 Title Company Information
310 Center Drive, Riverhead, NY 11901 Co.Name Fidelity National Title Insurance
www.suffolkcountyny.gov/clerk Title# F16-7404-101989-SUFF
8 Suffolk County Recording & Endorsement Page
This page forms part of the attached Deed made
by: (SPECIFY TYPE OF INSTRUMENT)
Ursula C.Evans The premises herein is situated in
SUFFOLK COUNTY,NEW YORK.
TO In the TOWN of Southold
Anne M, Bertelsen In the VILLAGE
or HAMLET of Southold
BOXES 6 THRU 8 MUST BE TYPED OR PRINTED IN BLACK INK ONLY PRIOR TO RECORDING OR FILING.
over -
otj
NY WS-Bargain and Sale Deed with Covenant against Grantor's Acts Individual or Corporation(Single Shen)(NYBTU 8002)
CONSULT YOUR LAWYER BEFORE SIGNING THIS INSTRUMENT•THIS INSTRUMENT SHOULD BE USED BY LAWYERS ONLY
THIS INDENTURE,made the 9 day of July in the year 2016
BETWEEN
Ursula C.Evans
1710 Cloister Drive
Sun City Center,FL 33573
party of the first pan,and
/k' Anne Mai Bertelsen
`' 24 Midland Blvd.
Maplewood,NJ 07040
parry of the second pan,
WITNESSETH,that the party of the first pan,in consideration of Ten Dollars and other valuable consideration paid by the
party of the second part,does hereby grant and release unto the party of the second pan,the heirs or successors and assigns of
the party of the second part forever,
ALI.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 AND MADE A PART HEREOF.
BEING AND INTENDED TO BE the same premises as described in deed made by John
Ohlmann,Maureen Ohlmann,Stanley Swenson,Audrey Swenson,recorded 04-14-2003,Liber
12246 page 76 in the Suffolk County Clerk's Office.
TOGETHER with all right,title and interest,if any,of the patty of the first pan of,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 incumbered 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[his deed thee,,
day and year first above written.
IN PRESENCE OF: I,0V W� C',
VV /
Ursula C.Evans
USEACKNOWLEDGNFJVTF0RAf8E1.0WwnwNNEWYORKSTATEONLn USEACICNOWIEDG,NENTFORMBELOWW/THINNEWYORkSTATEONLY.•
State of New York,County of N0S'50J I ss.: State of New York,County of )ss.:
QQ
On the-I day of July in the year 2016 On the day of in the year
before me,the undersigned,personally appeared before me,the undersigned,personally appeared
Ursula C.Evans
personally known to me or proved to me on the basis of satisfactory 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 evidence to be the individual(s)whose name(s)is(are)subscribed to the
within instrument and acknowledged to me that be/she/they executed within instrument and acknowledged to me that he/she/they executed
the same in his/herAbeir capacity(ies), and that by his/her/their the same in his/her/their capacity(ies), and that by his/her/their
sigmure(s)on the instrument,the i "dual(s),or the person upon signature(s)on the instrument,the individual(s),or the person upon
behalf of which the individual(s)act �J'he" ent. behalf of which the individual(s)acted,executed the instrument.
ARTHUR H.JOHNSON,JR
Notary ptbllc•State of New Y 11
No.M)6161479 Notary ubl c
Qualftd In Nassau County 1
Lty Cassim Ex0es February 26,26,9 i4 01,a.'� N50N 5R
ACKNOWLEDGMEN•FORM FOR USE WLTHLNNEW YORKSTATEONLY.' ACKNOWLEDGMENT FORM FOR USE OUTSIDE NEW YORKSTATE ONLY:
(New York Subscribing Witness Acknowledgment Cerrifrcarel )Our of Starr or Foreign General Acknowledgment Certificate)
State of New York,County of I ss.: ..................................................}ss.:
(Comptes Venue with State,Country,Prm•ince orMunicipaligy
On the � day of ,_ in the year
before me,the undersigned,personally appeared On the day of in the year
before me,the undersigned,personally appeared
the subscribing witness to the foregoing instrument,with whom I am
personally acquainted,who,being by me duly swum,did depose and personally known to me or proved to me on the basis of satisfactory
say that he/shelthey reside(s)in 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
(if the place of residence is in a city,include the street and street number, the same in his/her/their capacity(ies).that by his/her/their signature(s)
if any,thereon:that he/shehhey know(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
to be the individual described in and who executed the foregoing made such appearance before the undersigned in the
mstrument that said subscribing witness was present and saw said
execute the same;and that said witness at the same time subscribed (Insert the city or other political subdivision rut!the state or country or
his/herAheir name(s)as a witness thereto. other place the acknowledgment was taken).
BARGAIN&SALE DEED
War COVENANTS AGAINST GRANTOR'S ALTS
TLTLENo. DISTRICT 1000
SECT[ON 064.00
Ursula C.Evans BLOCK 02.00
Lor 030.000
COUNTY OR TOWN Suffolk
TO
Anne Mai Bertelsen RECORDED AT REQUEST OF
Fidelity National Title Insurance Company
RETURN BY MAIL TO
FIDELPI•Y NATIONAL TITLE David Worthington Olsen,Esq.
INSURANCE COMPANY Olsen&Olsen,L.L.P.
Ixam-omrin 1928 P.O.BOX 706
r Fidelity f" Cutchogue,NY 11935
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Fidelity National Title Insurance Company
TITLE NO. F 16-7404-101989-SUFF
SCHEDULE A-1 (Description)
Amended 07/01/2016
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, shown and designated as Lot #49 and the Northerly part of Lot 450 on a map entitled, "Subdivision
Map of Founders Estates, situate at Southold, New York", made by Otto W. Van Tuyl, Engineer and Surveyor, Greenport,
New York, March 1927, and filed in the Suffolk County Clerk's Office at Riverhead, Suffolk County, New York on the
10th day of May, 1927 as Map 4834 and described as follows:
BEGINNING at a point on the Easterly side of Founders Path distant 131.62 feet Southerly from the corner formed by the
intersection of the Southerly side of Korn Road with the Easterly side of Founders Path;
RUNNING THENCE North 67 degrees 38 minutes 40 seconds East, 140.73 feet;
THENCE South 22 degrees 21 minutes 20 seconds East,62.50 feet;
THENCE South 67 degrees 38 minutes 40 seconds West, 133.89 feet to the Easterly side of Founders Path;
THENCE along the Easterly side of Founders Path North 28 degrees 35 minutes 40 seconds West, 62.87 feet to the point
or place of BEGINNING.
THE POLICY TO BE ISSUED under this commitment will insure the title to such buildings and improvements on the premises which
by law constitute real property.
FOR CONVEYANCING ONLY: Together with all the right, title and interest of the party of the first part, of in and to the land lying
in the street in front of and adjoining said premises.
SCHEDULER-1 (Description)
Rev.(03/04)
INSTRLICTIONS(RP-5217-PDF-INS):www.orps.state.ryr.us
FOR COUNTY USE ONLY �I Now York State Department of
C4,Swr6•coa. � 71 2 :3 R. 8 Taxation and Finance
C2.Dafe•Dead Recorded I f f j�J I Lq Office of Real Properly Tax Services
X.
D" Tr RP-5217-PDF
W.Book 7 C4.Page Rai Property Transfer Report(11MO)
PROPERTY INFORMATION
1.Property 145 Founders ?ath
Location
'STREET roAMBETM 'S1eCE1 W WE
Southold Southold 11971
.Cm OR TOM VLLJWk •rep cow
2.Buyer Bertelsen Anne M
Name
•WT NAYbCOYPANY Fper NINE
LAST NA.LCOWV FRO:NAME
3.Tax Indicate whom(Indus Tari Bias w to be Sam
Boling If other than buyer oddieseat bo lan d" LAST x INECO IAMW Faros NAM
Address
STREET NUMBER AND NINE CITYORTO N DATE LP CODE
4.Indicate 0%number M Assessment 1 F1 Pari d a Parcel (Only If Part M a Parcel)Chock as they appy:
Roll parcels transferred on the doral a d Parma OR M,Planning Board with Subdivision Authority Exists
6'Deed X OR 0-00 40.Subdiwdon Approval was RegWred for Transfer
Pmpaw •FRONT FEET •DEPTH 'ACRES
SIM 4C.Paral Approved for Subdivision with Map Provided ❑
Evans Ursula C.
6.Seller •LMT MF-COW =aa NNE
Name
LAST NAMFICOLPANY FOIST NINE
'T.Select tie description which moat ecduramly describes the Cheek the taxes below ss they appy:
use of the property at the time of sad: 8.Ownership Type is Condominlum ❑
A.Ono L'andly Residential I New Construction on a Vacant Land ❑
10A.Property Located within an Agricultural Diane!
10B.Buyer recewad a disclosure notice irdiesting that the property Is In an ❑
Agdorlturel Diatrkl
SALE INFORMATION T 0.Cheek one or more M these conditions as applicable to transfer.
A.Sale Balween Reladves or Former Relatives
11.Sols Contact eau 06/22/2016 B.See between RemM Companies or Pannsn In Business.
C.One of the Buyers is also a Seller
7 '
LIP D Buyer or Seller is Govemment Agency or Lending Institution12.Dau M SaWMnsfar E.Dead Type not Warranty or Bargain end Sale(Specify Below)
F.Sale of Fradiorul or Less ton Fes Interest(Specefy Below)
•13.Full SBIB Price 471,000.00 G.So ifcam change In Property Between Taxable Status and Sale Drees
H Sale Of Business Is Included in Sob Price
1 Full Sale Price is the lord amours paid for the property including personal properly. 1.Other Unusua Factors Affecting Sale Price(Specify Below)
This payment may be in the form of ash,other property or gooft or the assumption of J.None
mortgages or other obligations.)Pkaw mundto the nearest WaSto dalaradaad.
Cemmad(s)on Candflbn:
14.lndicato the value M personal
property Included In the sale 0.00
ASSESSMENT INFORMATION-Data should reflect the latest Final Assessment Roll and Tax BIII
05
16.Year of Assessment Roll horn which Information taken(YY) 16 '17.Total Assessed Value 3,9 o o
•18.Properly Class 210 _ •18.School District Name Southold
•20.Tax Map IdmdflafsyRoll Idemif er(s)(if more than four.attach sheet with additional IdentM@r(sl)
1000-064.00-02.00-030.000
CERTIFICATION
I Gray the erg M the Moms of Info So an altered on this form are true and coma fro the best of my knowledge and botbf)and I undsrWnd that the making of any willful
false statement of material fact herein subject me m the provisions Mtho penal law mIstiva to the making and filing Mobs Instruments.
SELLER co SIGNATURE DYER CONTACT INFORMATION
___ V ✓WI (EmerMraermeun for paw payer.FEro.if Surer Is LLC.soeary.oamaion.owporstan.Fort sack rompwry.eda:e or
Papa ISAho a req sn F queLM mss ear ng So.then■nems ant umB.mannep prior
r h fly.) eweepOMehro
WnT'who TJD corer quenons mpeeanp ale e'elwM moat W amend.TYP err pNm pnMM1yJ
SEI ER MOM URE C.- DATE
BIIYERSIONATURE Bertelsen Anne
�(. UYER BIG r� •LMT NAMa FAST NAME
&4 Iat 'AREA CODE 'TELEMUNENLAWRLE.rarNNr
Ir.RAtaM1E DATE
29 Midland Blvd.
•OmEEI Mass. 'smEET NAIQ
1 Maplewood NJ 07040
-CITY OR rgwr -STATE •ZPCDOE
BUYER'S ATTORNEY
Olsen. David
LMT NAME FRSI NAS:
(631) ,734-7666
APEACDOe TEIrABMC NUMBER oii Bsse R
t