HomeMy WebLinkAboutL 12919 P 411SUFFOLK COUNTY CLERK
RECORDS OFFICE
RECORDING PAGE
Type of Instrument: DEED
Recorded:
07/06/2017
Number of Pages:
8
At:
11:48:29 AM
Receipt Number :
17-0113209
Handling
$20.00
TRANSFER TAX NUMBER: 16-36231
LIBER:
D00012919
NO
NYS SRCHG
PAGE:
411
District:
Section:
Block: Lot:
EA -STATE
1000
014.00
03.00 001.000
$5.00
EXAMINED AND
CHARGED AS FOLLOWS
$0.00
Deed Amount:
$2,200,000.00
$0.00
NO
Received the Following Fees For Above Instrument
JUDITH A. PASCALE
County Clerk, Suffolk County
Exempt
Exempt
Page/Filing
$40.00
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 $8,800.00
NO
Mansion Tax
$22,000.00
NO
Comm.Pres
$41,000.00
NO
Fees Paid
$72,215.00
TRANSFER TAX
NUMBER: 16-36231
THIS PAGE
IS A PART
OF THE INSTRUMENT
THIS IS NOT
A BILL
JUDITH A. PASCALE
County Clerk, Suffolk County
1
Number of pages
This document will be public
record. Please remove all
Social Security Numbers
prior to recording.
Deed /Mortgage Instrument
3
Page / Filing Fee
Handling 20. 00
TP -584 �►/
Notation
EA -52 17 (County)
EA -5217 (State)
i
R.P.T.S.A. 0
0
Comm. of Ed. 5. 00
Affidavit
Certified Copy
NYS Surcharge 15, 00
Other
Deed / Mortgage Tax Stamp
Sub Total
Sub Total / vc
Grand Total
4 Gist . i � t)r1D c
FEES
REC RD6. D
7'p -r7
Judith A. Pascale
CLERK OF
SUFFOLK COUNTY
C)°°a(Zg/9
��. 3�
6 Satisfactions/Discharges Releases List Property Owners Mailing Ad
R CORD & RETURN TO:
N,do/c's m. N u.do
P, 0 • nbeyc T03
v�6r 0r0oK-, N Y I n90
Recording / Filing Stamp
1. Basic Tax I
2. Additional Tax
SubTotal
Spec./Assit.
or
Spec. /Add.
TOT. MTG. TAX
Dual Town Dual CounIty
Held forAppointment
TransferTax
Mansion Tax ow'I'm
The property covered by this mIortgage is
or will be improved by a onle or two
family dwelling only.
YES orNO I
If NO, see appropriate tax clause on
page p of this Ostruihent.
Community Preservation
Consideration Amount $ Apr, 40P'0b
I CPF Tax Due S y!, M,'09 _
Improved
Vacant Land
TO 10
TD
TD
Mail to: Judith A. Pascale, Suffolk County Clerk 7 1 Title Company information
310 Center Drive, Riverhead, NY 11901 Co. Name SAFE HARBOR TITLE AGENCY, LTD!
www.suffolkcountyny.gov/clerk Title p
8 Suffolk County Recording & Endorsement Page
This page forms part of the attached
by: n� nn r^ (SPECIFY TYPE OF INSTRUMENT)
.J09Lpk �t F OSP Rtfgglld t105G 0..KV. The premises herein is situated in
SeSSrLLttk or 0, 3-0,M4, R. it05f J -00 -ti R•Ro5C SUFFOLK COUNTY, NEW YORK. ,
TO In the TOWN of 5oAv
_144 - In the VILLAGE
or HAMLET of0 r-� .4—
BOXES 6 THRU 8 MUST BE TYPED OR PRINTED IN BLACK INK ONLY PRIOR TO RECORDING OR FILING.
ade
-11U"U97
1000 01400 0300 001000
Rea I Proc
T
L
11111111milli III
Agency
05 -17
Verificatic
6 Satisfactions/Discharges Releases List Property Owners Mailing Ad
R CORD & RETURN TO:
N,do/c's m. N u.do
P, 0 • nbeyc T03
v�6r 0r0oK-, N Y I n90
Recording / Filing Stamp
1. Basic Tax I
2. Additional Tax
SubTotal
Spec./Assit.
or
Spec. /Add.
TOT. MTG. TAX
Dual Town Dual CounIty
Held forAppointment
TransferTax
Mansion Tax ow'I'm
The property covered by this mIortgage is
or will be improved by a onle or two
family dwelling only.
YES orNO I
If NO, see appropriate tax clause on
page p of this Ostruihent.
Community Preservation
Consideration Amount $ Apr, 40P'0b
I CPF Tax Due S y!, M,'09 _
Improved
Vacant Land
TO 10
TD
TD
Mail to: Judith A. Pascale, Suffolk County Clerk 7 1 Title Company information
310 Center Drive, Riverhead, NY 11901 Co. Name SAFE HARBOR TITLE AGENCY, LTD!
www.suffolkcountyny.gov/clerk Title p
8 Suffolk County Recording & Endorsement Page
This page forms part of the attached
by: n� nn r^ (SPECIFY TYPE OF INSTRUMENT)
.J09Lpk �t F OSP Rtfgglld t105G 0..KV. The premises herein is situated in
SeSSrLLttk or 0, 3-0,M4, R. it05f J -00 -ti R•Ro5C SUFFOLK COUNTY, NEW YORK. ,
TO In the TOWN of 5oAv
_144 - In the VILLAGE
or HAMLET of0 r-� .4—
BOXES 6 THRU 8 MUST BE TYPED OR PRINTED IN BLACK INK ONLY PRIOR TO RECORDING OR FILING.
ade
wCB 1,
S/99
(uniform nck.)
Ski MON
5—Ja,J N.Y. B.T.U. Fo 8001 -Ba, pa; and S+Ic D"J...,:hou, C....... apo. „ Guoiu,'s Aa,-Indrviduat ., C.,p.—m. (Sinplt Sheri)
CONSiAT YOUR LAWyljR DEFORE SIGIWASG THIS INSTjIUMEtdT—THIS INSTRUMBPNT SHOULD Oil USED BY L&WYIEUM OfAV.
F
THIS INDENTURE, made the day of a1 (� V-+�Q in the year 2017
BETWEEN
Joseph E. Rose residing at 276 Woodland Ave., Manorville, NY)11946, Margaret
Rose Duffy, residing at 21 Skookwams Court, West Islip, NY 11795,,/ Jessica Moro,
residing at 363 Tyler Ave., Miller Place, New York 117642 James . Rose, residing
at 60 Sunset Ave., Selden, New York, 11784 and John -/R. Rose, residing at
2 Scotts Cove Lane, Setauket, New York 11733.
party of the First part, and y m' V 2
John Pontisakosl�,�Qfdfll� �"� (ll`riR�O� L��� LIO`� F4�G�'���]ti/
party of the second part,
WrrNESSIV FH -7, that the party of the first part, 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 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 in the Hamlet of Orient, County of Suffolk, State of New York,
more particularly described on Schedule A annexed, designated as District 100;
Section 14; Brock 03; Lot 001 on the Suffolk County land and tax map and
known as 12654'Terry Lane, Orient, New York. _
WITNESSETH, that the party of the first part, in consideration of ten dollars paid by the party of the second
part, does hereby remise, release and quitclaim 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 in the hamlet of Orient, County of Suffolk, State of New York more
particularly bounded and described on Schedule'B annexed.
TOGETHER with all right, tills and interest, if any, of the party of the first part in and to any streets and
roads abutting the above describes: premises to the center lines thereof ; TOGrt in and to saidETHER with the a pu AND
TO
and all t estate
and
herein rof the anted unto�the pasty of of the first he second part, the hei sremsor successors and es; TO HAV aisigns of
HOLD premises
the party of the second part orever:
AND the party of the first part, in compliance with Section 13 of the Lien Law, covenants that the party of
the first part �v�l] receive the consideration for this conveyance and will hold the right to receive such consid-
eration as a trust fund to be applied first for the purpose of paying the cost of the improvement and will apply
improvement before using any part of the total of the same for
the soma first to the payment of the cost Of the
any other purpose.
The word "party" shall be construed as if it read "parties" whenever the sense of this indenture so requires.
the party of the first part has duly executed this deed the day and year first above
IN WITNESS WHEREOF,
written.
IN PRESENCE Ole:
Margaret tcosj Duiay
v✓�—
Jame . Rose
Joh;;-- -
1 \
essica
SCHEDULE A
DESCRIPTION OF PREMISES
Title No. SP34589-S
ALL that certain plot piece or parcel of land, situate, lying and being in the Hamlet of
Orient, County of Suffolk, State of New York, more particularly bounded and described as
follows:
BEGINNING at a point of the northerly line of a certain 25 foot right of way at the
southwesterly corner of premises herein described said point being the following two courses
from monument set on the northerly line of Main Road on the boundary line between land of
the party of the first part and Iand of Orient Realty Company;
1) North 14 degrees 05 minutes 00 seconds West 2171.21 feet
2) North 75 degrees 55 minutes 00 seconds East 150.00 feet to said point of beginning.
RUNNING THENCE along other land of said party of the first part North 14 degrees 05
minutes 05 seconds West 460 feet, more or less, to ordinary high water mark of Long Island
Sound;
THENCE easterly along said high water mark 150 feet, more or less, to other land of said party
of the first part;
THENCE along said other land, South I4 degrees 05 minutes 00 seconds East 455 feet, more
or less, to the northerly line of said 25 foot right of way;
THENCE along said 25 foot right of way, South 75 degrees 55 minutes 00 seconds West
150.00 feet to the point or place of beginning. Containing 68.500 square feet, more or less.
More particularly bounded and described as follows:
BEGINNING at a monument set on the northerly line of Man Road on the boundary line
between land of the party of the first part and land of Orient Realty Company and running the
following ten courses:
-continued-
1) North 14 degrees 05 minutes 00 seconds West 2171.21 feet;
2) North 75 degrees 55 minutes 00 seconds East 337.00 feet;
3) North 14 degrees 05 minutes 00 seconds West 37.50 feet;
4) North 75 degrees 55 minutes 00 seconds East 102.65 feet;
5) South 12 degrees 33 minutes 50 seconds East 100.04 feet;
6) South 75 degrees 55 minutes 00 seconds West 100.00 feet;
7) North 14 degrees 05 minutes 00 seconds West 37.50 feet;
8) South 75 degrees 55 minutes 00 seconds West 312.00 feet;
9) South 14 degrees 05 minutes 00 seconds East 2149.17 feet;
10) South 82 degrees 40 minutes 10 seconds West 25.18 feet to the point or place of
BEGINNING.
ALL that certain plot piece or parcel of land, situate, lying and being in the Hamlet of
Orient, County of Suffolk, State of New York, more particularly bounded and described as
follows:
BEGINNING at a point on the northerly line a certain 25 foot right of way at the
southwesterly corner of the premises herein described, said point being the following two
courses from a monument set on the northerly line of Main Road on the boundary line
between land of the party of the first part and land of Orient Realty Company;
1) North 14 degrees 05 minutes 00 West 2171.21 feet;
2) North 75 degrees 55 minutes 00 seconds East 150.00 feet to said point of beginning.
RUNNING THENCE along other land of said party of the first part, North 14 degrees 05
minutes 00 seconds West 461.64 feet to ordinary high water mark of Long Island Sound;
THENCE easterly along said high water mark on the following tie lines, more or less, to a
point on the westerly line of land now or formerly of Helminck;
THENCE along said other land, South 14 degrees 05 minutes 00 seconds East_ along last
mentioned -land 458.07 feet, to the northerly line of said 25 foot right of way;
-continued-
THENCE along said 25 foot right of way, South 75 degrees 55 minutes 00 seconds West
150.00 feet to the point of BEGINNING.
TOGETHER with a non-exclusive right of way from Main Road to premises, said right of
way being described as follows:
BEGINNING at a monument set on the northerly side of Main Road on the boundary line
between land of the party of the first part and land of Orient Realty Company;
RUNNING THENCE the following ten courses and distances:
1) North 14 degrees 05 minutes 00 seconds West 2171.21 feet;
2) North 75 degrees 55 minutes 00 seconds East 337.00 feet
3) North 14 degrees 05 minutes 00 seconds West 37.50 feet;
4) North 75 degrees 55 minutes 00 seconds East 102.65 feet;
5) South 12 degrees 33 minutes 00 seconds East 100.04 feet;
6) South 75 degrees 55 minutes 00 seconds West 100.00 feet;
7) North 14 degrees 05 minutes 00 seconds West 37.50 feet;
8) South 75 degrees 55 minutes 00 seconds West 312.00 feet;
9) South 14 degrees 05 minutes 00 seconds East 2149.17 feet;
10) South 82 degrees 49 minutes 10 seconds West 25.00 feet to the point of BEGINNING.
The policy to be issued under this report will insure the title to such building and improvements erected on the premises which
by law constitute real property: -- - __. _...._ _..... ...._.
FOR CONVEYANCING ONLY:
TOGETHER with all 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.
DESCRIPTION
Safe Harbor Title Agency, Ltd.
Schedule il B
Title Number SH178014
Underwriter 638-S-13329
Page i
ALL that certain plot, piece or parcel of land, situate, lying and being in the
Hamlet of Orient, County of Suffolk and State of New York, more particularly
bounded and described as follows:
BEGINNING at a point on the northerly side of a certain 25 foot Right of Way at
the southwesterly corner of the premises herein described, said point being the
following two courses from a monument set on the northerly side of Main Road
on the boundary fine between land of the party of the first part and land of Orient
Realty Company;
RUNNING THENCE:
1) North 14 degrees 05 minutes 00 seconds West, 2171.21 feet;
2) North 75 degrees 55 minutes 00 seconds East, 150.00 feet to said point of
beginning:
RUNNING THENCE along other land of said party of the first part, North 14
degrees 05 minutes 00 seconds West, 461.64 feet, to the ordinary high water
mark of the Long Island Sound;
THENCE easterly along said high water mark, on the following tie line, North 77
degrees 16 minutes 50 seconds East, more or less, to a point in the westerly
side of land now or formerly of Helminck;
THENCE along other said land, South 14 degrees 05 minutes 00 seconds East,
along last mentioned land, 458.07 feet, to the northerly side of said 25 foot Right
of Way;
THENCE along said 25 foot Right of Way, South 75 degrees 55 minutes 00
seconds West, 150.00 feet to the point or place of BEGINNING.
TOGETHER with a non-exclusive Right of Way from Main Road to premises,
said Right of Way being described as follows:
BEGINNING at a monument set on the northerly side of Main Road, on the
boundary line between land of the party of the first part and land of Orient Realty
Company;
For Conveyancing Only, if intended to be conveyed.
Together with all right, title and interest of, in and to any streets and roads abutting the above described premises,
to the center fine thereof.
Continued On Next Page
Safe Harbor Title Agency, Ltd.
Safe Harbor Title Agency, Ltd.
Schedule - continued
Title Number SH178014 Page 2
Underwriter 638-S-13329
RUNNING THENCE the following ten courses and distances:
1) North 14 degrees 05 minutes 00 seconds West, 2171.21 feet;
2) North 75 degrees 55 minutes 00 seconds East, 337.00 feet;
3) North 14 degrees 05 minutes 00 seconds West, 37,50 feet;
4) North 75 degrees 5 5minutes 00 seconds East, 102.65 feet;
5) South 12 degrees 33 minutes 00 seconds East, 100.04 feet;
6) South 75 degrees 55 minutes 00 seconds West, 100.00 feet;
7) North 14 degrees 05 minutes 00 seconds West, 37.50 feet;
8) South 75 degrees 55 minutes 00 seconds West, 312.00 feet;
9) South 14 degrees 05 minutes 00 seconds East, 2149.17 feet;
10) South 82 degrees 49 minutes 10 seconds West, 25.00 feet to the point or
place of BEGINNING.
For Conveyancing Only, if Intended to be conveyed.
Together with all right, title and interest of, in and to any streets and roads abutting the above described premises,
to the center line thereof.
IM Safe Harbor Title Agency, Ltd.
* STATE OF,NEW YORK)
) ss.:
COUNTY OF SUFFOLK)
2� T ✓
On the day of in the year 2017before me, the
undersigned, personally appeared Margaret Rose Duffy
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
JACQUELINE A. BARSARtVdividual taking acknowledgment
NOTARY PUBLIC, STATE OF NEWYORK
QUALIFIED IN SUFFOLK COUNTY, N0. 4878981
COMMISSION EXPIRES DEC. S, al��
* STATE OF NEW YORK)
) ss.:
COUNTY OF SUFFOLK)
�
On the/0
day of �u�t�`_ in- the year2017before me, the
undersigned, personally appeared Jessica Moro
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(ics), 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.
Nda
RECO
MARY C Stt[teofNenYork kdI
e and 0 ice of
ft48"171J,Suffolk Cotu�Eyt in dingacknowledgment
lean Eltplres An 811141 q
Bargain anh Fsalr 3Irrd
WITHOUT COVENAN'r AGAINST GRANTOR's Ac'rs
TITLE No.
Joseph E. Rose, Margaret Rose Duffy,
Jessica Moro, James R. Rose and John
R. Rose
TO
John Pontisakos
STANDARD FORM Or NEW TOM BOARD Of TITLE UNDERWRITERS
Distributed by
First American Title Insurance Conipany
of New York
* STATE OF NEW YORK
N 60(rk) ss.:
COUNTY OF SEEK)
On the �'' day of Su'R% in the year 2017before me, the
undersigned, personally appeared Joseph- Rose
personally known to me or proved to me on the basis of satisfactory
evidence to be the individual(s) whose names) is (are) subscribed to
the within instrument and acknowledged to me that he/shchlicy
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 behalfofwhich the individual(s) acted, executed the
instrument.
Signature and Office o
individual taking acknowledgment
II p
AIOfARY PUBLIC, S of NerYtuk
Na 489815% SIM�
le�El�UesAme
* *John
STAT OF NEW YORK). R. Rose
} ss.:
COUNTY OF SUFFOLK)
On thel'A"'"day of in the year2017 before me, the
undersigned, personally appeared James R -Rose*
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/heritheir 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
instr ment.
01
UN D GRECO
NOTARYPUBLIC StateofNtn y tk ignature and Office of
No.48981aStdfo9tcoft idual taking acknowledgment
SECTION 14
BLOCK 03
LOT 001
COUNTY OR TOWN SUFFOLK
ELIZABETH A. MARTINEZ
Notary Public, State of Now York
No. 01 MA4716913
Qualified in Suffolk County
C0rnrn4kV&Pi %Wf2016
First American Title Insurance Company of New York
RETURN BY MAIL TO:
Nicholas M. Nudo, Esq.
Stonybrook, NY 11790
Zip No.
VST RANEr_WP-W Him VAuL
9. Tax Indicate where future Tar &,Its are to be sent
Bsling If other Irian buyer addrese(st Worn of tone) LAW NAMMOVl'Aw FlafiT SME
Adtlras
BTREE: WNIIII.x AMIM m CM OR TOMB. SIAIL pFCO:IL
INSTRUCTIONS(RP-5217-PDF-INS): wyrytr.orps.state.ny.us
OR COUNTY USE ONLY
C1. SWIS Code
•�
4A. Planning Board with Subdivision Authority Exists
New York State Deparlmanl tut
Taxation and Finance
C2. Date Dood Recorded
�1
-1/ to / I 1 I
❑
Once of Real Properly Tax Services
4C. Partial Approved for Subdivision mth Map Provided
OR, -W
MAC3. C4. Pogo4LL
RoSe Q's1rZ1 �05e, - J)&&%
RP- 6217 -PDF
Book
e. Seller . J N.Y FCYRAMr
114.1 v !
Real Property Transfer Report (8110)
PROPERTY INFORMATION
John 11!'J-AN-•�03 � . � •i't 44',C.A.
'CI -OR TOM
Fne-NAME
I- Property 17.65
Location
.AL1 ."'A:DWMT
'7. Select the description which most accurately describes the
Terry Late
•slitcrwaeen
• STREET xANE
El
Southold
9. New Construction on a Vacant Land
OLior_
:1951
.C. CR'.
2. Buyer PonziSakos
VLr AGE
Cohn
•!FCCR
Name
• U14' MaIAx:NnMf•
FMS' NAVE
VST RANEr_WP-W Him VAuL
9. Tax Indicate where future Tar &,Its are to be sent
Bsling If other Irian buyer addrese(st Worn of tone) LAW NAMMOVl'Aw FlafiT SME
Adtlras
BTREE: WNIIII.x AMIM m CM OR TOMB. SIAIL pFCO:IL
4. Indicate the number of Assessment1 (Only N Part of a Parent) Check a they appy:
Pan d e Parcel
Roll parcels transferred on the dead 9 al Portals OR
4A. Planning Board with Subdivision Authority Exists
9. Dad X Olt 1 •
Property •RONI LLLI •RPInn •ACRES
40. Subdivision Approval was Required for Transfer
❑
Sles
4C. Partial Approved for Subdivision mth Map Provided
Z
RoSe Q's1rZ1 �05e, - J)&&%
Joseuh E.9
'STREET N -MW -P
e. Seller . J N.Y FCYRAMr
114.1 v !
Loyd Neck
.
Name RO9e 'r"orD
John 11!'J-AN-•�03 � . � •i't 44',C.A.
'CI -OR TOM
Fne-NAME
's-ArE •ZPCODE
.AL1 ."'A:DWMT
'7. Select the description which most accurately describes the
Check the boxes below as they apply:
use of the property at the time of Nle:
nd
S. Ownership Type is Condominium
El
One Family Residential
9. New Construction on a Vacant Land
❑
10A. Property L.ar tad within an Agnalhurel District
❑
190. Buyer received a disclosure notice Indicating that the property is in an
E]Agricultural
Distna
SALE INFORMATION
19.
Check one or more ofthsa conditions on applicable eltronsfor:
A. Selo Between Reisman or Fenner Relabvm
11. Salo Contract Bata 04/10/2017
B Sow, between Related Companies or Penn in Business.
C. One of the Buyers Is also a Seller
' 06/21/2017
D. Buyer or Seller is Government Agency or Lending Institution
12. Date of SaleR}onsfor
E. Deed Type not Warranty or Bargain and Sale (Specify Below)
F. Selo of Fractional or Less than Fee Internal (Specify Below)
'113. Full Sale Price 2, 2=., , 000 .00
G Significant Change In Property Between Towle Status and Sole Does
H. Sole of Sullins" is mduded in 819 Price
C Full Sale Pnce is the tool amount pard for the property including parsons] property.
I. Other Unusual Factors Affecting Sale Price (Spedfy Bdow)
This payment may be in the form of cash. other property or goods. or the assumption of
J None
mortgages or other obligations.) Please round to the namsf whole dollar amount.
Cammontls) on Condition:
14. Indicate the value of personal OtI
property Included In the sale
ASSESSMENT INFORMATION - Data should refied the latest Final Assessment Roll and Tax Bill
16. Year of Assessment Roll from which Information taken(YY) 1'/ '17. Total Assessed Volvo 4,800
•18.Property class 210 _ 1 •19.School District Name CysLez ?o-lds School
-20. Tax Map Idermtlor(syRoll Identifiogs) (if more then four. &path shoot with additional Identlaerls))
1000-014.00-03.00-00'-.000
CERTIFICATION
I CerylXdlat dl of the items of Information entered on this form are true and correct (to the hest of my knowledge and MIIM and I understand that the making of any willful
f ll96stesment of material fact heroin subject me to the omrielpns_of BIL nand law mlative to the making and filing of false Instruments.
;AIL
••1 T JW.YEt/RUSSIGNATURE
&
C-
1 -
(later rsemaboa for the Wier. Now. a buyer Is LLG.seealy. assoor". aspersion Jobs: meek cwnpor•y. Soma or
mLAy Nes is Iql Ln ndalevel agent or bCuasry thm ■ nems tuna edam Illwmabon e! on neew.asespeeabw
pity who wR snewergxskens reg rdng :nn -.-MIS air mum be evaled Type er print clearly )
Ponzisakos
John
-LAS I MVF.
F RST VRML
-EACJLE
'ILlLW1:7rF NLMkR
IE. e20etal
Z
Ad
'STREET N -MW -P
'fi1M.Ll \AMF
Loyd Neck
NY Ia7Y3
'CI -OR TOM
BUYER'S ATTORNEY
's-ArE •ZPCODE
Nudo Nicholas
.AST -ML ARBT"AVL
(631) 525-32'13
AREA COIL IF. FR ONE R'wILV IL. SWwwI