HomeMy WebLinkAboutL 12924 P 370 1111111111111111111111 illll 11111 11111 11111 11111 illl IIII
1111111(IIII IIIA IIII IIII
SUFFOLK COUNTY CLERK
RECORDS OFFICE
RECORDING PAGE
Type of Instrument: DEED Recorded: 08/10/2017
Number of Pages : 8 At: 09 : 55 :28 AM
Receipt Number : 17-0136930
TRANSFER TAX NUMBER: 17-01400 LIBER: D00012924
PAGE : 370
District: Section: Block: Lot:
1000 113 . 00 09 . 00 007 . 000
EXAMINED AND CHARGED AS FOLLOWS
Deed Amount: $0 . 00
Received the Following Fees For Above Instrument
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 $0 . 00 NO Comm.Pres $0 . 00 NO
Fees Paid $415 .00
TRANSFER TAX NUMBER: 17--01400
THIS PAGE IS A PART OF THE INSTRUMENT
THIS IS NOT A BILL
JUDITH A. PASCALE
County Clerk, Suffolk County
PIT
RECORDED
Number of pages 2017 Aug 10 09:55:22 AM
JUDITH R, PR5CALE
CLERK OF
This document will be public SUFFOLK COUNTY
record. Please remove all L DO0012924
Social Security Numbers F' :370
DT# 17-01400
prior to recording.
Deed/Mortgage Instrument Deed/Mortgage Tax Stamp Recording/Filing Stamps
3 1 FEES
Page/Filing Fee Mortgage Amt.
Handling 20. 00 1.Basic Tax
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
—�
R.P.T.S.A. ,y Dual Town Dual County
L.W �,},
Held forAppointment_
Comm.of Ed. 5. 00 k'
Transfer Tax
C
Affidavit _ Mansion Tax
Certified Copy The property Ycovered bV this mortgage u
or will be improved by a one or ar:o
NYS Surcharge 15. 00 family dwelling only.
Other Sub Total i YES orNO
Grand Total 1[No ee appropriate tax clause on
pa of this str lent
4 Dista 5 Community Preservati n Fund
17026263 1000 11300 0900 007000
TaxReal Proper, Consideration rltn0uni
Servicer, a I 111111111111111,I1IIIIIIII1lllll,�111li, CPF Tax Due $
Improved
6 Satisfactions/Discharges/Releases List Propperty Owners Mailing Address
RECORD&RETU RN T0:
Vacant La�q
/P Cr�� v^ FS{� U
TD
Cnt7 eo,#-+ TD
'2/ ; �I T?ClCta� Pdlfil= TD
Mail to:Judith A. Pascale,Suffolk County Clerk Title Company Information
310 Center Drive, Riverhead, NY 11901
y.gov/clerk
www.suffolkcounty n Co.Name
�I 2 /
Titlep Up 2
8 Suffolk County Recording & Endorsement Page
This page forms part of the attached (/t. eo
by: made
f (SPECIFY TYPE OF INSTRUMENT)
.,n bald �P JP�,�I� I�ry>bE[L The premises herein is situated in
`0 ev n : SUFFOLK COUNTY,NEW YORK.
/ /
7--* �� In the TOWN of SOU �7"
�`'� S,o �h C In the VILLAGE
or HAMLET of
BOXES 6 THRU 8 MUST BE TYPED OR PRINTED IN BLACK INK ONLY PRIOR TO RECORDING OR FILING.
loser
—Bargain and Sale Deed,with Covenant against Grantor's Acts—Individual or Corporation(Single Sheet)
CONSULT Y(jJR LAWYER BEFORE SIGNING THIS INSTRUMENT—THIS INSTRUMENT SHOULD BE USED BY LAWYERS ONLY.
THIS INDENTURE,made the AtA day of Al"—,in the year 2017
BETWEEN MARYANNE KIMBALL and FREDERICK KIMBALL,as her husband, 183 Beach 131st Street,Belle Harbor,
NY 11694 as to a 33.333%interest;LOIS GILDEA,5960 Boulder Bridge Lane,Shorewood,MN 55331 as to a 16.667%
interest;KEVIN M.GALLIGAN and ANNE E.GALLIGAN,his wife, 15 Rapp Run Road,Dresher,PA 19025 as to a
16.667%interest and WILLIAM GALLIGAN and EILEEN GALLIGAN,his wife,501 Briggs Street,Bellmore,NY 11710
as to a 33.333%interest,as Tenants in Common
party ofthe first part,and TALLYWOOD SP INC.with an address at 183 Beach 131"Street,Belle Harbor,NY 11694
party of the second part,
WITNESSETH,that the party of the first part,in consideration of
10(TEN)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,
ALL that certain plot,piece or parcel of land,with the buildings and improvements thereon erected,situate, lying and being
in the at Mattituck,in the Town of Southold,County of Suffolk and State of New York,and designated as and by Lots Nos.
42 and 43 on a certain map of property of William B.Codling,said map being filed in the Office of the Clerk of the County
of Suffolk as Map No.745 on or about the IO h day of May, 1921,said premises being bounded on the North by mean high
water mark of Mattituck Creek; on the East by land of Schutt; on the South by Meday Avenue and on the West by land
formerly of Ethel Wells.
Premises also being known as 1605 Meday Avenue,Southold, NY
Section: 113.00;Block 09.00;Lot 007.000
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:
MAR KIMBALL
FREDERICK KIMBALL
ADDENDUM TO DEED
1N PRESENCE OF:
161c�
Lois Gildea
J(,L,—V-
evin M.Galli n
QA A./- J0 � C
e E.Galljean
r
William Galliga
leen Galli
ACKNOyYLEkE11lENT TAKEN INNENY YORK STATE ACKNOWLEDGEMENT TAKEN IN NEW YORK STATE
State of New York.County of -1s: State of New York,County of ,ss:
On the day of in the year before roc,the On the day of in the year before mc,the
undersigned,personally appeared undersigned,personally appeared
,personally known tome or proved to me on the basis of ,personally known to me or proved to me on the basis of
satisfactory evidence to he the individual(s)whose name(s)is(are) satisfactory evidence to he the individual(s)whose nanle(s)is(are)
subscribed to the within instrument and acknowledged to me that subscribed to the within instrument and acknowledged to nlc that
he/shcAlicy executed the same in his/her/their capacity(ics),and that by helshchhey executed the same in his/her/their capacity(ics),and that by
hiss/her/their signature(s)on the instrument,the individual(s),or the his/her/their signatures)on the instrument,the individual(s),or the
person upon hchalf of which the individual(s)acted,executed the person upon hchalf'of which the individual(s)acted,executed the
instrument, instrument.
ACKNOWLEDGEMENT BYSUBSCRIBING WITNESS TAKEN ACKNOWLEDCENI ENTTAKEN OUTSIDE NEWYORK
IN NEW YORK STATE STATE
State of Ncwv fork.County of ss: *Staieof M INNESOI'A_County of
*(Or inscil District of Columhia,Ter nory, ossession or Foreign
Oil the day of in the year before tile,the County)
undersigned.a Notary Public in and for saidState,personally appeared
the suhscrihing witness to the foregoing instrument,with whom On the kN day d ill the,year J�I ,betorc me 4:&S
I[an personally acquainted,who,being by me duly sworn,did depose C"__"�'she undersi led personally appeared
and say that he/shefthey residu(s)in Lois (,1 ueG
Personally known to mo or proved to too on the basis of satisfactory
(ifthe plrce of—id,,—is it,a city,include the street and streel number if any.Iherent): evidence to he the individual(s)whose naine(s)is(are)suhscrihed to the
that he/she/they know(s) within instrument and acknowledged to inc that he/she/they executed the
sante in his/her/their capacity(ics), that by his/her/their signature(s)on
to he the individual described in and who executed the foregoing the instrument,the individual(%)or the person upon behalf of which the
instrument:thin said subscribing witness was present and saw said individual(s)acted,executed the instrument,and that such individual
make such appearance before the undersigned in the
execute the same:and that said witness at the same lime subscribed
his/her/their naine(s)as a witness thereto (add the city or political subdivision and the state or country or other
place th a nowle m h m
ANGELINA M MCCABE
Notary Public
State of Minnesota
Bargain and Sale Deed Myis Jt nuary31,20mmissin 21rea
With Covenants
SECTION:113,N)
BLOCK:09.00
Title No. LOT:007.000
COUNTY OR TOWN;SUFFOLK
KIMBALL,GILDEA&GALLIGAN
TO
TALLYWOOD SP INC.
RETURN BY MAIL TO:
DISTRIBUTED BY JAMES P.CRONIN,ESQ.,
KEWA MATERA d CtNQUEMANI.P.C.
2174 Jackson Avenue
YOUR TITLE EXPERTS Seaford,Ncw Yotti 11783
The Judicial Title Insurance Agency LLC (516)409-6200
800-281-TITLE(8485) FAX:800-FAX-9396
ACKNONYLEI'GEMENT TAKEN IN NEW YORK STATE ACKNOWLEDGEMENT TAKEN 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 before tile,the On the day of in the year before me,the
undersigned,personally appeared 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 he the individual(s)whose name(s)is(are) satisfactory evidence to he the individual(s)whose name(s)is(are)
subscribed to the within instrument and acknowledged to me that 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 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 his/her/their signaturc(s)on the instrument,the individual(s),or the
person upon hchalf of which the individual(s)acted,executed the person upon behalf of which the individual(s)acted,executed the
i n.st ru men t. instrument.
ACKNOWLEDGEM ENT BY SUBSCRIBING WITNESS TAKEN ACKNOWLEDGEMENT TAKEN OUTSIDE NEW YORK
IN NEW YORK STATE STATE pp
/`� I�B�T4
A
State of Neu York,County of ss: *Stale of PENNSYLVANIA.County of -
, Ss. )1t1ee-I
*(Or insert District of Columhia,Territory,Possession or Foreign
On die day of in the year before me,the County)
undersigned,it Notary Public in and for said State,personally appeared
,the subscribing witness to the foregoing instrument,with whom On the�I day of join the ycar�ojj ,hcfiirc me K-&Al+4-ot.
I all personally acquainted,who,being by me duly sworn,did depose GA.LktErh'id the//undersigned personalty appeared
and say that he/shekhcy reside(s)in Vev;t 0. W1--UA
Personally known to oro or proved to me on-(hc basis of satisfactory
porn•pl;rca urrcoldcta i,tri a dry.include IIic,Ircct mid stnet nuinber Arany,wc—f): evidence to he the individual(s)whose names)is(arc)subscribed to the
that he/she/they know(s) within instrument and acknowledged to me that he/she/they executed the
same in his/her/their capacity(ics), that by his/hcdtheir signature(s)on
to he the individual described in and who executed the foregoing the instrument,the individual(s)or the person upon behalf of which the
instrument:that said subscribing witness was present and saw said individual(s)acted,executed the instrument,and that such individual
make such appearance hefore the undersigned in the
execute the same:and that said witness at the same time subscribed
his/herhheir n:une(s)as a witness therein (add the city or political subdivision and the state or country or other
place the acknowledgement was taken).
COMMONWEALTH OF PE NSYLVANIA
NOTARIAL SEAL
Carol Pawlowski,Notary Public
Bargain and Sale Deed Upper Moreland Twp.,Montgomery County
g My Commission Expires May 31, 2019
With Covenants MEMaeR.P NNSYLVANIA AS O�IATI N 0 NO ARIES
SECTION:113.00
BLOCK:09,00
Title No. LOT:007.000
COUNTY OR TOWN:SUFFOLK
KIMBALL,GILDEA S GALLIGAN
TO
TALLYWOOD SP INC.
RETURN BY MAIL TO:
DISTRIBUTED BY JAMES P.CRONIN,ESQ.,
KE4 Jack on Avenue MATERA CCINQUEMANI,P.C.
2174 Jackson Avenue
r OUR TITLE EXPERTS Sealbnt,New York 11783
The Judicial Title Insurance Agency LLC (516)409.6200
800-281-TITLE(8485) FAX:800-FAX-9395
ACKNONVLE14GENIENT TAKEN IN NEW YORK STATE ACKNOWLEDGENI ENT TAKEN IN NEW YORK STATE
State of Ncw York.County of ,ss: State of New York,County of ,ss:
Ore the day of in the year before mc,the On the day of in the year before are.the
undersigned,personally appeared 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 he the individual(s)whose name(s)is(are) satisfactory evidence to he the individual(s)whose namc(s)is(arc)
subscribed to the within instrument and acknowledged to are that subscribed to the within instrument and acknowledged to me that
he/shchlicy executed the same in hislher/their capacity(ics),and that by he/she/they executed the same in his/her/their capacity(ies),and that by
his/her/their signaturc(s)on the instrument,the individual(s),or the hislherhhcir signalurcys)on the instrument,the individual(s),or the
person upon behalf of which.the individual(s)acted,executed the person upon behalf of which the individual(s)acted,cxeculc� the
instrument. instrument.
ACKNOWLEDGENIENT BY SUBSCRIBING WITNESS TAKEN ACKNONN ILEDGEMENT TAKEN OUTSIDE NEW YORK
IN NEW YORK STATE STATE
State of Ncw York.County of ss: 'State of PENNSYLV ANIA.County(it'
,
'{Or insert District of Columhiu,Territory,Posse>siot or Foreign
On the (lily of in the year hetore nte,the County)
undersigned,a Notary Public in and for said State,personally appeared.
the subscribing witness to the foregoing instrumetn,with whom On the a1 day ofn the year aQ 11.before me ANNE E.
Ian personally acquainted,who,being by me duly sworn,did depose GALLIGAN the uncle sR igned personally appeared A,, M and say that he/shellhcy reside(s)in
Personally known to ntc or proved to me on the basis of satistitctory
fit the place„t'rai&nce is in a city.include die sired and street number itnny,thcr-n; evidence to he the individual(s)whose nainc(s)is(are)subscribed to the
that he/she/they know(s) within instrument and acknowledged to me that he/she/they executed the
same in his/her/their capacity(ics), that by his/her/their signature(s)on
fo he the individual described in and who executed the foregoing the instrument,the individual(%)or the person upon hehalf of which the
nstrument;that said subscribing witness was present and saw said individual(%)acted,executed the instrument,and that such individual
make such appearance before the undersigned in the
execute the sante;and that said witness at the same time subscribed
his/hcr/fl.cir nanic(s)as a witness thereto (add the city or political subdivision and the state or country or other
place the acknowledgement was taken).
COMMONWEALTH OF PENNSYLVANIA
NOTARIAL SEAL
Carol Pawlowski, Notary Public
Bargain and Sale Deed Upper Moreland Twp.,Montgomery County
My Commission Expires May 31,2019_
With Covenants httfiaElt.PiNNSILVANIATAWSOMA73NOFN AWES
SECTION; 113.00
BLOCK:09.00
Title No. LOT-007.000
COUNTY OR TOWN:SUFFOLK
KIMBALL,GILDER&GALLIGAN
TO
TALLYWOOD SP INC.
RETURN BY MAIL TO:
DISTRIBUTED BY JAMES P.CRONIN,ESQ.,
KERLEY, MATERA S CINQUEMANh P.C.
2174 Jackson nu Avenue
YOUR TITLE EXPERTS Senfbnd,New York 11783
The Judicial Title Insurance Agency LLC (516)409-6300
800-281-TITLE(8485) FAX:800-FAX-9396
ACKNOWLEDGEMENT TAKEN IN NEW YORK STATE ACKNOWLEDGEMENT TAKEN IN NEW YORK STATE
State of New York,County of NASSAU,ss: State of New York,County of NASSAU,ss:
On the 26th day of JUNE in the year 2017,before me,the undersigned, On the 26th day of JUNE in the year 2017,before me,the undersigned,
personally appeared MARYANNE KIMBALL personally appeared FREDERICK KIMBALL.
,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(are) satisfactory evidence to be the individual(s)whose name(s)is(are)
subscribed to the within instrument and acknowledged to me that 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 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 his/her/their signature(s)on the instrument,the individual(s),or the
person upon behalf of which the individual(s)acted,executed the person upon behalf of which the individual(s)acted,executed the
instrument. instrument.
BRIAN R KERLEY BRIAN P.KERLEY
Notary Public,State of New York Notary Public,State of New Yor
No. 02KE4862533 No.02KE4862533
oualified in Nassau Countyi�c,�ualified in Nassau County
L Commission Expires May 20,�/$ " commission Expires May 20/AC/Si
ACKNOWLEDGEMENT BY SUBSCRIBING WITNESS TAKEN ACKNOWLEDGEMENT TAKEN OUTSIDE NEW YORK
IN NEW YORK STATE STATE
State of New York,County of ss: 'State of County of ss:
'(Or insert District of Columbia,Territory,Possession or Foreign
On the day of in the year before me,the County)
undersigned,a Notary Public in and for said State,personally appeared
,the subscribing witness to the foregoing instrument,with whom On the day of in the year before me the
I am personally acquainted,who,being by me duly sworn,did depose undersigned personally appeared
and say that he/she/they reside(s)in
Personally known to me or proved to me on the basis of satisfactory
(itlhe place ofiesideoce is in a city,include the street and street number ifany,thereot); evidence to be the individual(s)whose name(s)is(are)subscribed to the
that he/she/they know(s) within instrument and acknowledged to me that he/she/they executed the
same in his/her/their capacity(ies), that by his/her/their signature(s)on
to be the individual described in and who executed the foregoing the instrument,the individual(s)or the person upon behalf of which the
instrument;that said subscribing witness was present and saw said individual(s)acted,executed the instrument,and that such individual
make such appearance before the undersigned in the
execute the same;and that said witness at the same time subscribed
his/her/their names)as a witness thereto (add the city or political subdivision and the state or country or other
place the acknowledgement was taken).
Bargain and Sale Deed
With Covenants
SECTION:113.00
BLOCK:09.00
Title No. LOT:007.000
COUNTY OR TOWN:SUFFOLK
KIMBALL,GILDEA&GALLIGAN
TO
TALLYWOOD SP INC.
RETURN BY MAIL TO:
DISTRIBUTED BY JAMES P.CRONIN,ESQ,
KERLEY,WALSH,MATERA&CINQUEMANI,P.C.
2174 Jackson Avenue
YOUR TITLE EXPERTS Seaford,NewYork 11783
The Judicial Title Insurance Agency LLC (516)409-6200
800-281-TITLE(8485) FAX:800-FAX-9396
ACKNOWLEDGEMENT TAKEN IN NEW YORK STATE ACKNOWLEDGEMENT TAKEN IN NEW YORK STATE
State of New York,County of NASSAU,ss: State of New York,County of NASSAU,ss:
On the 26th day of JUNE in the year 2017.before me,the undersigned, On the 26th day of JUNE in the year 2017,before me,the undersigned,
personally appeared WILLIAM GALLIGAN personally appeared EILEEN GALLIGAN
,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(are) satisfactory evidence to be the individual(s)whose name(s)is(are)
subscribed to the within instrument and acknowledged to me that 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 he/shelthey 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 his/her/their signature(s)on the instrument,the individual(s),or the
person upon behalf of which the individual(s)acted,executed the person upon behalf of which the individual(s)acted,executed the
instrument. l/e/p /`'instrument. /��+ Jo
BRIAN P.KERLRLEY BRIAN P.KERLEY
Notary Public,State of New York Notary Public,State of New York
No.02KE4862533 No.02KE4862533
Qualified In Nassau County Qualified in Nassau County
Commission Expires May 20�. Commission Expires May 20/mak
ACKNOWLEDGEMENT BY SUBSCRIBING WITNESS TAKEN ACKNOWLEDGEMENT TAKEN OUTSIDE NEW YORK
IN NEW YORK STATE STATE
State of New York,County of ss: *State of County of ss:
*(Or insert District of Columbia,Territory.Possession or Foreign
On the day of in the year before me,the County)
undersigned,allotary Public in and for said State,personally appeared
,the subscribing witness to the foregoing instrument,with whom On the day of in the year before me the
1 am personally acquainted,who,being by me duly sworn,did depose undersigned personally appeared
and say that he/shelthey reside(s)in
Personally known to me or proved to me on the basis of satisfactory
(if the place of residence is in a city,include the street and street number if any,[hereon: evidence to be the individual(s)whose name(s)is(are)subscribed to the
that he/she/they know(s) within instrument and acknowledged to me that he/she/they executed the
same in his/her/their capacity(ies), that by his/her/their signature(s)on
to be the individual described in and who executed the foregoing the instrument,the individual(s)or the person upon behalf of which the
instrument;that said subscribing witness was present and saw said individual(s)acted,executed the instrument,and that such individual
make such appearance before the undersigned in the
execute the same;and that said witness at the same time subscribed
his/her/their name(s)as a witness thereto (add the city or political subdivision and the state or country or other
place the acknowledgement was taken).
Bargain and Sale Deed
With Covenants
SECTION:113.00
BLOCK:09.00
Title No. LOT:007.000
COUNTY OR TOWN:SUFFOLK
KIMBALL,GILDEA&GALLIGAN
TO
TALLYWOOD SP INC.
RETURN BY MAIL TO:
DISTRIBUTED BY JAMES P.CRONIN,ESQ.,
KEWALMATERA&CINQUEMAN[,P.C.
21744 Jackson Aveneri ue
YOUR TITLE EXPERTS Senford,NewYork 11783
The Judicial Title Insurance Agency LLC (516)409-6200
800-287-TITLE(8485) FAX:800-FAX-9396
INSTRUCTIONS(RP-5217-PDF•INS):www.orps state.ny.us
FOR COUNTY USE ONLY Now York State Department of
C1.8IAScederI '9/ 10
$ I Taxation and Finance
C2.Date Deed Recorded 1 y/ 10/� Office of Real Property Tax Services
nett I RP-5217-PDF
C9.Book I C1,2_AjC4•Page , �J Real Property Transfer Report(BnD)
PROPERTY INFORMATION
I.Property 1605 Meday Avenue
' Location
'STREET w1Y1[R " 'S-aLLI hAYE
Southold 11968
•CITY OR Tom VLLI[:e ••• .- 'ZIP Com
2.Buyer TALLYWOOD SP CNC. T
Na -WT NAMEICOMPAM, F1651
Nam MME
I45I NALEI lm— '•Otic NWE
3•Tax Indicate where future Tax Blis are to be said
B911ng II outer than buyer addraWal bottom of form)IAST NAMEAXM-Ah, rIR.T,,AM17
Address
STREET SUMMER M]'AM •C Tr OR IOPM• al A1C .ZIP CODE
4.Indicate the number of Assessment ) 1:1Part of a Parcel (onlyN Part of a Parent)Check as they appy:
Roll partials tmnsfamd on the deed t d Pared OR 4A,planning Board with Subdivision Authority Etdets
S.Dead X OR 0.56 40.Subdivision Approval was Regldred for Tranata
Prop" 'FRONTFLLI 'OFPTM -ACRES
Sura 4C.Parcel Approved for Subdivision with Map Provided
Kimball Maryanne
S.Sailer LAS!NARANCom— FAS-N1wL
Nam Kimball Frederick
FPS7 hA4C
LAST NAYCP101RANY
•7.Select the description which most accurately describes the Cheek Ws hTy below as minihey appy:
us of tho prop"at the time of vile: e.NowOwnershipCtType is Condominium ❑
El
A.One MaOnily)2esiLlrr'tlal 9.Now Construction on a Veeenl Lana
10A.Property Located within an Agnwhural District
10B.Buyer received a d'IsticaUre noau Indteating tient the property is in an ❑
AgrICU11ur91 District
SALE INFORMATION[- 15.Chock one or mom ofthose conditions as applicable to transfer:
A.Sale Between Relatives or Former Relatives
B.Sale between Relined Companies or Paters in Business
11.Sale Contract Date C.One of the Buyers E also a Sailer
7 17 D Buyer or Sailer in Government Agency or Lendng Institution
12.Dste of SelatTnsfer _ E Deed Type not Warranty or BCq n and Sale(Specify 1301101111
F.Sale of Fmctntnal or Leas than Foo Interest{Specify Bellow)
'17.Full Sale Price 0.00 G.Significant Change In Property Between Taxable Stafus and Sale Dales
– H'Solo o1 Business is Included In Sale Price
(FYII Sale Price Is me Lunt amount pad for the property including personal property. I Oiler Unusual Fac:on Affecting Sale Price(Spedy Below)
This payment may be in Um form Of cash.other property or goods.or the assumption of J None
mortgegs w othr obkgattons)Pissae rmmd to the aeamaf whdo doter aff4unt •Commentle)on Condition:
14.indicate the value of panoral
properly Included lathe Sale 0 •00 For 'estate P=anning 2urpasoe
ASSESSMENT INFORMATION-Data should reflect the latest Final Assessment Roll and Tax Bill
111.Yearaf Assessment Roll from which Information taken(YYI 17 •17.Total Aaaessod Value '11500
•19.Property Cfes 210 _ •19.School District Name Ma L t i tui:k
e2L Tax Map Montl9eUpRol IdontlRaga)IN mom than four.attach shoot with addillonml IdendBer(s))
113:09:007
CERTIFICATION
1 Certify that all of the fors of Info melon entered on this form aro true and correct Ito the best of my knowledge and bellef)and I understand that the making of any willful
Islas statement M material fact 114111111 subject me te the.Rro.WMs 9f.th9A0npIJl9Cmlaevs to the making and filing of false InsWmenb.
$Rn 1 FR 11111C2tlATURL ffiff9 Q0TAQLlNE4WMA1=
Mire'edamabor for the buyer NOW If Surfer a LLC.rtraeb'01=21al GppaebaL lRMOL AM*ramRarly.Sri t*Or
tinily Drat IS not m wawdal agent a bd.raary.IMh a I 6 aid OMM nrameam d an L'IdfVWWWfs%mmblm
7
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wrn alWwer euer'ACm regentlllg We trwl►•er mud tw erected Tye er pone Wormy)
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SELLER OATC
^ALLYWOOD SP INC.
BUYER SIGNATURE — Ias.—ML
:AST vAIA
Ur,16) 409-6100
S r��• 'MFA CG:)L ••LLFM101i.r.UM En CC.tIKGM:
eUrFR SI MTU - 0A:F
183 Beaute -31s: Street
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Belle Harbor NY _ 11694
-cry Ca•./1N'1 •STAIL 'aPCODE
• �.{�.�+pl.AT14.�1F.�
(Cronin James P.
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1 AS-•lAYe 1 YIDi NlWE
;
516;
409-6200_ _.
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