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L 12895 P 86
!1111111 IIII IIIII IIIII IIIII silll IIIII IIIII IIIII IIII IIII 111111 IIIII IIIII IIII Illi SUFFOLK COUNTY CLERK RECORDS OFFICE RECORDING PAGE Type of Instrument: DEED Recorded: 01/04/2017 Number of Pages : 5 At: 11 : 48 :58 AM Receipt Number : 17-0000994 TRANSFER TAX NUMBER: 16-16940 LIBER: D00012895 PAGE : 086 District: Section: Block: Lot: 1000 086. 00 02 .00 012 . 006 EXAMINED AND CHARGED AS FOLLOWS Deed Amount: $410, 000 . 00 Received the Following Fees For Above Instrument Exempt Exempt Page/Filing $25 . 00 NO Handling $20 . 00 NO COE $5 . 00 NO NYS SRCHG $15. 00 NO EA-CTY $5 . 00 NO EA-STATE $250 . 00 NO TP-584 $5 . 00 NO Notation $0 . 00 NO Cert.Copies $5 .20 NO RPT . $200 .00 NO Transfer tax $1, 640 .00 NO Comm.Pres $6,700 .00 NO Fees Paid $8, 870 .20 TRANSFER TAX NUMBER: 16-16940 THIS PAGE IS A PART OF THE INSTRUMENT THIS IS NOT A' BILL JUDITH A. PASCALE ' County Clerk, Suffolk' County + F-11❑ M -Number of pages RECORDED 2017 Jan 44 11:48:58 RM JUDITH R. PRSCRLE This document will be public CLERK OF record. Please remove all SUFFOLK COUNTY L D0E0012095 Social Security Numbers P 086 prior to recording. RT## 16-16940 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) �f Sub Total Spec./Add. EA-5217(State) (/ ) '_ TOT.MTG.TAX /,•n 11. Dual Town Dual County ?(J _ R.P.T.S.A. iHeld for Appointmen Comm.of Ed. 5. 00 Transfer Tax 0- ` Mansion Tax Affida ��� The property covered by this mortgage is Certified Copy or will be improved by a one or two urcharge l5. 00 family dwelling only. Sub Total 5—, "' YES or NO Other Grand Total �/ C),- If NO,see appropriate tax clause on page# of this instrumprit7 4 1 Dist.%00 16040522 1000 08600 0200 012006 04P 5 Community Preservation Fund Real Property 29-DEC-1 I IIIIIIIIIII VIII II I VIII A V III IN 1111111 Consideration Amount $ 9&0110.QQ Tax Service DHo A l i AgencyF Tax Due $ rD700.DO Verification Improved 6 Satisfactions/Discharges/Releases List Property Owners Mailing Address RECORD&RETURN TO: Vacant Land V-,-fiat' j-.I-r� `` ff TD 3.50 b f�1 !s-M �1�C�r1. TD TD Mail to: Judith A. Pascale, Suffolk County Clerk 7 Title Company Information 310 Center Drive, Riverhead, NY 11901 Co. a www.suffolkcountyny.gov/clerk Title# S O S Suffolk County Recording & Endorsement Page This page forms part of the attached le)-'�L c� I --e P l __ __ _ ____ made by: 1 r L (SPECIFY TYPE OF INSTRUMENT) 'ytkV1 Ck G. TzA P LS n,4- b�u �. The premises herein is situated in n-' 01— SUFFOLK COUNTY,NEW YORK. rNx�i l' rr"o i- d44 g)7--aoj1 TO In the TOWN of C S S (tey t— In the VILLAGE p l) f`P f\kN S or HAMLET of BOXES 6 THRU 8 MUST BE TYPED OR PRINTED IN BLACK INK ONLY PRIOR TO RECORDING OR FILING. 12:0104AW08kk over CONSULT YOUR LAWYER BEFORE SIGNING THIS INSTRUMENT-THIS INSTRUMENT SHOULD BE USED BY LAWYERS ONLY p ere,�er THIS INDENTURE,made the /a day of f o"Ai4w,2016 BETWEEN DAVID G. EDELSTEIN and LIBBY A.GOLDSTEIN, both residing at 4300 Bellaire Avenue, Studio City,CA 91604,as Co-Trustees of the E.G.STEIN FAMILY TRUST dated August 17,2011 party of the first part,and CHARLES W. GRIMES and BRENDA GRIMES, husband and wife, both residing at 3501 Bonita Bay Boulevard,Bonita Springs,FL 34134 party of the second part, WITNESSETH, that the party of the first part, in consideration of FOUR HUNDRED TEN THOUSAND and no/100ths($410,000.00)dollars 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, SEE SCHEDULE"A"ANNEXED HERETO AND MADE A PART HEREOF BEING AND INTENDED TO BE the same premises conveyed to the parties of the first part by deed made by David G. Edelstein and Libby A.Goldstein, his wife,dated August 17,2011 and recorded in the Suffolk County Clerk's Office on July 30,2012 in Liber 12700 Page 573. 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: i DAVID G.EDE E N,as Trustee r-- ( 44&� �U LIBBY VobbSTEIN,as Trustee Title No.: NST-16-0480 SCHEDULE ALL, that certain plot, piece or parcel af land, situate, lying and being at Neconic, in the 'row" of Southold. County of Suffolk and State of New York. beim more particularly hounded and described as follows: BEGINNING at a point on the southwesterly side of Wells Road distant 315.00 feet southeasterly from the corner formed by the intersection of the southeasterly side of Wells Road with the southwesterly side of Wells Road; said point also beim where the division line between the premises herein described and land now or formerly of Susan Hallock intersects the southwesterly side of Wells Road; RUNNING THENCE South 59 degrees 45 minutes 30 seconds hast along the southwesterly side of Wells Road, 150.00 feet to a monument and land now or formerly of Anne N. Mitchell and Robert E, Mitchell; THENCE South 30 degrees 14 minutes 30 seconds West along said land now or formerly of Mitchell, 164.00 feet to the mean high water mark of Richmond Creek: THENCE westerly alone; Richmond Creel: the folio, ing two tic line courst:s and distances: 1.) South 84 degrees 02 minutes 38 seconds West. 122.21 Feet, 2.) North 74 degrees 22 minutes 57 seconds West. 1231.38 Ieet to land now or formerly of Susan Hallock; THENCE North 48 degrees 27 minutes 40 seconds East along said land now or formerly of Susan Hallock, 258.37 feet to the southwesterly side of Wells Road. at the point or place of BEGINNING. The policy to be issued under this report %vill insure the title to such building's and improvements erected on the premises which by law constitute real property. TOGETHER with all the right, title and inierest o1'the pan[y uf'tfte first purl.of in �,r9 pR{y and to the land lying in the street in Front ofand ad.ioininL said premises. CALIFORNIA ALL- PURPOSE- CERTIFICATE OF ACKNOWLEDGMENT A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of California } County of L 03 A'n90-PeS } On DirC. i 2 O1 Lp before me, Mia Raquel Vazquez, Notary Public , Were two name and cae of me =) personally appeared D Gt,4l'cl G1. _�cd sjc� n and Li bb j k. G of cUS j n who proved to me on the basis of satisfactory evidence to be the persorl(q whose nam t ]s is/ re ubscribed to the within instrument and acknowledged to me that he xecuted the same in.kaWhtar4eir uthorized capacity es and that by htsfher eir ignature0on the instalment the person(9 or the entity upon behalf of which thepersoUS acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. MIA RAQUEL VAZQUEZ COMM. * 2011525 WITNESS my hand and official seal. NOTARY PUBLIC-CAUFORNIA0 F - SAN FRANCISCO COUNTY Q My Commission Expires " March 11,2017 Notary Public Sign a (Notary Public Seal) INSTRUCTIONS FOR COMPLETING THIS FORMADDITIONAL6pTION INFORMATION Thisformcomplieswith current California statutes regarding notary wording and, DESCRIPTION OF THE ATTACHED DOCUMENT ifneeded,should be completed wtd attached to the document.Acknowledgments from other states may be completed for documents being sent to that state so long t as the nrording docs not require the California notary to violate California notary d law. (Title or description of attached document) a State and County information must be the State and County where the document signcr(s)personally appeared before the notary public for acknowledgment. • Date of notarization must be the date that the signer(s)personally appeared which (Ttle or description of attached document conllntted) most also be the sane:dare the acknowledgment is completed. . The notary public must print his or her name as it appears within his or tier Number of Pages 2 Document Dale commission followed by a comma and then your title(notary public)., o Print the names) of document signcr(s) who personally appear at the time of notarization. CAPACITY CLAIMED BY THE SIGNER • Indicate the correct singular or plural forms by crossing ol7 incorrect forms(i.e. he lsiuJthoy,-is lata)or circling flu correct forms.l-ailuro to correctly indicate this C1 Individual (s) information may lead to rejection of document recording. D Corporate officer • The notary seal impression must be clear and photographically reproducible, Impression must not cover text or lines. If seal impression smudges,re-seal if a Title sufficient arca pmnits,otherwise complete a different acknowledgnnent form. ❑ Partner(s) • Signature of the notary public must match the signature on file with the office of the county clerk. ❑ Attomey-in-FactAdditional information is not required but could help to ensure this -;g T'rustee(D •• ackn rwlcdgncnt is not misused or attached to a diffcrcnt document- E, Indicate title or type of attached document,number of pages and date. © Indicate the capacity claimed by the sigacr. If the claimed capacity is a corporate officer,indicate dw title(i.e,C11.0,CFO,Secretary), 2015 Version YnAv.NotaryClasses.com 800-873-9685 9��ctlrcW%mch this document to the signed document with a staple. ' TO BE USED ONLY WHEN THE ACKNOWLEDGMENT IS MADE IN NEW YORK STATE ,State of New York,County of ss: State of New York,County of ss: On the day of in the year On the day of in the year before me,the undersigned,personally appeared Before me,the undersigned,personally appeared personally known to me or proved to me on the basis of personally known to me or proved to me on the basis of satisfactory evidence to be the individual(s)whose name(s)is satisfactory evidence to be the individual(s)whose name(s)is (are)subscribed to the within instrument and acknowledged to (are)subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their me that helshelthey executed the same in hislherltheir capacity(ies), and that by his/her/their signature(s) on the capacity(ies), and that by his/herltheir signature(s) on the instrument,the individual(s),or the person upon behalf of which instrument,the individual(s),or the person upon behalf of which the individual(s)acted,executed the instrument. the individual(s)acted,executed the instrument. (signature and office of individual taking acknowledgment) (signature and office of individual taking acknowledgment) TO BE USED ONLY WHEN THE ACKNOWLEDGMENT IS MADE OUTSIDE NEW YORK STATE State(or District of Colu a,Territory,or Foreign Country)of California ss: On the da f November in the year 2016 before me, the undersigned, personally appeared DAVID G. EDELSTEIN and LIBBY A.GOLD IN personally known to me or proved to eon the basis of satisfactory evidence to be the individual(s)whose name(s) is (are) subscribed to the within instrument and ac Wedged 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 instru nt,the individual(s), or the person upon behalf of which the individual(s)acted, executed the instrument,and that such individual a such appearance before the undersigned in the in Ca'ornia (insert the City or other political subdivision) (and sert the State or Country or other place the acknowledgment was taken) (signature and office of individual taking acknowledgment) y NOTAR LIBLIC /orc,,,kJ9cMc1T� oiffPchrov-,nf -dor .Gr BARGAIN AND SALEDEED DISTRICT 03 0 SECTION 033.00 WITH COVENANT AGAINST GRANTOR'S ACTS BLOCK 04.00 Title No. LOT 055.000 COUNTY OR TOWN DAVID G.EDELSTEIN&LIBBY A.GOLDSTEIN,as STREET ADDRESS Trustees Recorded at Request of TO CHARLES W.GRIMES&BRENDA GRIMES COMMONWEALTH LAND TITLE INSURANCE COMPANY RETURN BY MAIL T07 STANDARD FORM OF NEW YORK BOARD OF TITLE UNDERWRITERS Distributed by CHARLES W.GRIMES,ESQ. 3501 Bonita Bay Boulevard 4P Commonwealth Bonita Springs, FL 34134 1 L11v()AAIIRIU GONP.1\�' COMMONWEALTH LAND TITLE INSURANCE COMPANY W U LL O z K O U W K O W N 4' U LL W U Q 0. N Z f- W 7 W N INSTRUCTIONS(RP-5217-PDF-INS):www.orps.atatomy.us FOR COUNTY USE ONLYO I O I I New York State Department of Si.SWIS Code A73L� I Taxation and Finance G2.Data Deed Recorded ;01 !Q 7 j Office of Real Property Tax Serv,cos C3.Back J C4.Page d.Y J Reel PRroparty rT216r r RaDF lu,ol PROPERTY INFORMATION 1.Property I- •.r we]Is P*ad Location •5.1+Pr'ruWEA •stag-iN6E ST;•111.)1:)1;, Peron,'c •!•Pfeil:LMti vLLACE •SIP Cad: 2.Buyer C•1:-010$ C*,ar1es W. Name -LAST raMa_COVPM.r FIRST NRYr .—•__.__ „T,1 mos. Brenda :ARI%WFa•AMIA%1 MRSTrdME 3.Tae tndirste whore future Tax Bills ire to be Sent Billing if clear than buyer eddress(st L•otlom of form) usTNMlernuP.w• FAST NAVE Address a11a.LI N.-M!11 W:I-1 CMOR-Om. SIAIL LPtJL_ 4.Indicate the number of AssessmentPart of a Parcel (Only if Part of a Parml)Check as they apply: Roll percale transferred on the deed -.I..... s u1 Pectate OR 4A Planning Board with Subd vision Authority Exists a S Deed X OR ---- 48 Subdivisi in Approval was Required Its Transfer Property -r!wNi.L'I L •CEPT- 'W LS --- •-- Size 4C.Parcel Approved for Subdivision wEh Map Provided F{Icist_:r, as Truster_ David G. O.Seller •LJSTNMQR?TPPAN...;-Zi7 _...... ...... . .._.....__—__ rIRST aM6. Name Coldstein, as .,usena L.Lbby A. 4STRME.COMPIWr •• _ •--'— INS'IAVL '7.Soled the description which most accurately describes the Check the boats below as they apply: use of the property at the time of sale: 8.Ownership Type is Condominium C.Residential Vacant land 8.New Construction on a Vacant Land 1011 Properly Located willun an Agricultural District f OB.Buyer received a disclosure notice indicating that sed prooc'ly is in an Agr.ciAurat District SALE INFORMATION 15.Cheek one or more of those conditions as applicable to transfer: A.Sale nemsen Relalives or Forrror Relatives 11.Sale ContTid Data 11/01/2016 0.Sule oolwoon Related Companies Or Par,-ers In Business. •----- C.One of the Buyers 1s also a Se.'er D Buyer o•Seller Is Govdmmont Agency or Land.ng IrRl.tution 12.Date W SalerTransfer 12/12/2016 E.Dead 1 ype not warranty Or Bargain arid SaIN(Specify Below) F Sale of rroe.anal or Leis then Fee Inle:est(Specify Below) '13.Full Sala Price 410,C00 •00 G Srgnlhcant ChangR.n Property Between Tapable Status and Sole Dares H.Salo of Business Is Induced In Sea Price I Fu:'Sold Pnce Is the total arnowit pard for the property ndudlng personal prup+•rly. I.Other Unusual factors Affect rig Solu Price iSpucify Boles.') f his payment may be In the form of cash•other propery or goods.Or the assumPbO'i Of 7( J None mo•Igages or other obligations.)Alaose round to the nearest whNe doge,armn.m. CommeM(s)on Condition: 14.Indicate the value of personal GG property included In the sale _ ASSESSMENT INFORMATION-Date should reflect the latest Final Assessment Roll and Tax Bill 16.Year of Assessment Roll from which Information taksn(YY) 17 117.Total Assessed Value 3200 Property Class 31: _ '1A School District Name Sou thold '20.Tax Map Montifror(s)1Roll IdomiBor(s)Of more than four•attach shoal with additional ldeMiller(s)) 10004086.00-02.00-012.006 CERTIFICATION I Canty that all of the Items of Information entered on this form are tms and correct[to the best of my knowledge and belief)and I understand that the making of any willful false statement of material fid herein subject me to the provlsion"Lthp pjtol Ipyr•relative to the making end filing of false Instruments. SELLER SIGNATURE t;I.U.YE&GQNTACT INFQRMA7JQ.H i IF--r•amissi !IK the 0.te•.Now If dryer 6 Lt c.socwlY.aMeeatall,wipa vie l Iar1610 k m,rp ny.estate or V it IMI k-1 all WIM:Ld Mabe or fiduciary.Ikon a no-w did I 1&.I Inlnmellon or ar rdwWour"pa•uiblu p.ty aFa cr an",ir q.sshY•a,Maid rp ere erre men be-!—d.rid.Type or print cree ly I RFI.FR _- V' tz WE a, • +�EkV�pkln Tr-vAL Grimes C^arlc•s W. ATIJRE f - _ •_ASTtiWE - RFST%wg 203 2b 39890 _ •®/�� •AaucJx:L �i Ll i.:T+x+:n.iwlra!r,wRa'a '- 1 n..ir V L•AI_.. J ��4r1lsWr 35C1 BOniLa Bray Boi_lcvard ,�� nl `�-� S-RFFT N-VEER -STRFPTNAVE I i I I Bonita Spr.i rigs •_--_ YL 34134 •:IN OR P]aN 4-ATr• 7r:d11 BUYER'S ATTORNEY kI I + G!rine Char:es W. t I! 1 LASTNWE �....._._ Ras_-WF I t .'C3 2 5 3 9 S 9 t I r ARU VXL nftfl h:4--.%-i la.H 2jh<I •�II 1 11 I I L� � 6� III ......_..