HomeMy WebLinkAboutL 12943 P 397 I I I I I I I c I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I i
1111111 IIIII IIIII 11111111
SUFFOLK COUNTY CLERK
RECORDS OFFICE
RECORDING PAGE
Type of Instrument: DEED WITH LIFE ESTATE Recorded: 12/22/2017
Number of Pages : 5 At: 12 : 37 : 11 PM
Receipt Number : 17-0227690
TRANSFER TAX NUMBER: 17-16815 LIBER: D00012943
PAGE : 397
District: Section: Block: Lot:
1000 078 . 00 01 . 00 040 . 001
EXAMINED AND CHARGED AS FOLLOWS
Deed Amount: $0 .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 $125 .00 NO
TP-584 $5 . 00 NO Notation $0 . 00 NO
Cert.Copies $6 .25 NO RPT $600 . 00 NO
Transfer tax $0 . 00 NO Comm.Pres $0 . 00 NO
Fees Paid $806 .25
TRANSFER TAX NUMBER: 17-16815
THIS PAGE IS A PART OF THE INSTRUMENT
THIS IS NOT A BILL
JUDITH A. PASCALE
County Clerk, Suffolk County
P 27
RECORDED
Number of pages 2017 Dec 22 12:37:11 Pt9
JUDITH R. PPSCHLE
CLERK OF
This document will be public SUFFOLK COUNTY
record.Please remove all L D00012943
Social Security Numbers P 397
prior to recording. DT# 17-16815
Deed/Mortgage Instrument Deed/Mortgage Tax Stamp Recording/Filing Stamps
3 1 FEES
Page/Filing Fee Mortgage Amt.
1.Basic Tax
Handling 20. 00
_ 2. Additional Tax
TP-584 �— Sub Total
Notation Spec./Assit.
or
EA-52 17(County) Sub Total Spec../Add.
EA-52t ate) TOT.MTG.TAX
— Dual Town Dual County
R.P.T.S.A..� Held for Appointment
Comm.of Ed. 5. 00 Transfer Tax
Affidavit _
Mansion Tax
/ �S The property covered by this mortgage is
Certified Copy CO or will be improved by a one or two
NYS Surcharge 15. QO ., family dwelling only.
Sub Total YES or NO
Other c
Grand Total O 0(, If NO, see appropriate tax clause on
page# of this instrument.
( o-!5-4
4 1 Dist. IN 17043249 5 Community Preservation Fund
RTax eal IIIIIIIIIIII�III�III�IIVIIIIfIIII�IIIIIIIIII Consideration Amount$
Service 2 �AgecyC P1 / F Tax De
Verification 41 Improved X
6 Satisfactions/Discharges/Releases List Property Owners Mailing Address
RECORD&RETURN TO: Vacant Land
Marcia Z. Hefter,Esq. TD
Esseks,Hefter,Angel,Di Talia&Pasca,LLP
108 East Main Street TD
P.O.Box 279 TD
Riverhead,NY 1 1901
Mail to:Judith A.Pascale,Suffolk County Clerk 7 Title Company Information
310 Center Drive, Riverhead, NY 11901 Co.Name
www.suffolkcountyny.gov/clerk Title#
8 Suffolk County RecordingF & Endorsement Page
This page forms part of the attached Deed made
by: (SPECIFY TYPE OF INSTRUMENT)
.loan A. Polywoda Revocable Trust The premises herein is situated in
SUFFOLK COUNTY,NEW YORK.
TO In the TOWN of Southold
Joan A. Polywoda, as to a lifeestateand In the VILLAGE
Jill A. Klavas,aas tonaAremainderrinteresttorHAMLETof Southold
as tenants in common
BOXES 6 THRU 8 MUST BE TYPED OR PRINTED IN BLACK INK ONLY PRIOR TO RECORDING OR FILING.
over
p T S
Doc ID: 17043249 R DHO A
1-DEC-17
Tax Maps
District Secton Block Lot School District Sub Division Name
1000 07800 0100 011000
1000 07800 0100 040001 SOUTHOLD
1000 07800 0100 013002 SOUTHOLD
Standard N.Y,B.T,U.Form 5002-Bargain and Sale Deed,with Covenant against Grantor's Acts—Uniform Acknowledgment
CONSULT YOUR LAWYER BEFORE SIGNING THIS INSTRUMENT-THIS INSTRUMENT SHOULD BE USED BY LAWYERS ONLY
THIS INDENTURE,made the 5th day of December,2017,
BETWEEN
JOAN A.POLYWODA,residing at 2495 Bayview Avenue,P.O.Box 234,Southold,New York 11971,as
Trustee of the JOAN A.POLYWODA REVOCABLE TRUST DATED DECEMBER 13,2007
party of the first part,and
JOAN A.POLYWODA,residing at 2495 Bayview Avenue,P.O.Box 234,Southold,New York 11971,as to a
life estate,and JOHN A.POLYWODA,residing at 136 Weybridge Circle,Apt.A,Royal Palm Beach,Florida
33411;JOAN A.BROADHURST,residing at 10276 Roberts Road,P.O.Box 160,Sauquoit,New York 13456;
and JILL A.KLAVAS,residing at 255 Shepherd Drive,P.O.Box 1265,Southold,New York 11971,each as to
a 1/3rd remainder interest with ownership as tenants in common,
party of the second part,
WITNESSETH,that the party of the first part,inconsideration often($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 in the Town of Southold,County of Suffolk and State of New York,more particularly bounded and described on
Schedule A annexed hereto and made a part hereof.
BEING AND INTENDED to be the same premises conveyed to the party of the first part by deed dated December
13,2007 and recorded in the Office of the Clerk of the County of Suffolk on January 14,2008 in Liber 12537 at
Page 178.
Joan A.Polywoda shall have and hold a life estate interest in the above described property,together with the
tenements,hereditaments and appurtenances belonging to the property for her natural life. John A.Polywoda,
Joan A. Broadhurst and Jill A. Klavas shall have and hold the remainder interest in the above described
property together with the tenements,hereditaments and appurtenances belonging to the property,subjectto
the life tenancy of Joan A.Polywoda.
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 partwill
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"parry"shall be
construed as if it read"parties"when ever 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
JOAN A.POLYWODA REVOCABLE TRUST
By: O
Jo A.Polywoda,Trustee
I 1
State of New York,County of Suffolk ss: State of New York,County of ss:
On the 5th day of December,in the year 2017 On the day of in the year
before me,the undersigned,personally appeared before me,the undersigned,personally appeared
Joan A.Polywoda
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 whose name is satisfactory evidence to be the individual(s)whose name(s) is
subscribed to the within instrument and acknowledged to me that (are)subscribed to the within instrument and acknowledged to me
she executed the same in her capacity,and that by her signature that he/she/they executed the same in his/her/their capacity(ies),
on the instrument,the individual, or the person upon behalf of and that by his/herttheir signature(s) on the instrument, the
which the individual acted,executed the instrument. individual(s),or the person upon behalf of which the individual(s)
acted,executed the instrument.
(sig ature and offic indiv' u I taking acknowledgment) (signature and office of individual taking acknowledgment)
MARCIA Z.HEFTER
Notary Public,State of New York
No.02HE6830970
Qualified in Suffolk County
Commission Expires July 31,201E
TO BE USED ONLY WHEN THE ACKNOWLEDGMENT IS MADE OUTSIDE NEW YORK STATE
State(or District of Columbia,Territory,or Foreign Country)of SS:
On the day of in the year before me,the undersigned,personalty appeared
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 helshe/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,and that such individual made such appearance before the undersigned in the
in
(insert the City or other political subdivision) (and insert the Slate or Country or other place the acknowledgment was
taken)
(signature and office of individual taking acknowledgment)
SECTION:078.00
BLOCK:01.00
BARGAIN AND SALE DEED LOTS:011.000,040.001,
and 013.002
TOWN:Southold
WITH COVENANT AGAINST GRANTOR'S ACTS
Title No.
Joan A.Polywoda RevocableTrustTrust Recorded at Request of
Joan A.Polywoda,as to a life estate,and John A. COMMONWEALTH LAND TITLE INSURANCE COMPANY
Polywoda,Joan A.Broadhurst and Jill A. Klavas,as to
a remainder interest as tenants in common RETURN BY MAIL TO:
Distributed by Marcia Z.Hefter,Esq.
Esseks, Hefter&Angel, LLP
108 East Main Street
monwealth P.O.Box 279
11V* Riverhead, NY 11901
COMMONWEALTH LAND TITLE INSURANCE COMPANY
R ERVE THIS SPACE FOR USE OF RECORDING OFFICE
SCHEDULE A
DEED FROM JOAN A.POLYWODA REVOCABLE TRUST
TO
JOAN A.POLYWODA,as to a life estate,and
JOHN A.POLYWODA,JOAN A.BROADHURST and JILL A.KLAVAS,
as to a remainder interest with ownership as tenants in common
PARCEL 1: S.C.T.M.# 1000-078.00-01,00-011.000
ALL that tract or parcel of land lying,being and situate at Bayview,in the Village and
Town of Southold,County of Suffolk and State of New York,being more particularly
bounded and described as follows:
Beginning at a concrete monument set on the easterly line of Bayview Road at the
southwesterly corner of land of Alfred Dart and the northwesterly corner of land now
or formerly of Ida Polywoda,being about 1950 feet southerly along said easterly line
from Pine Neck Road;and running along said land of Dart,S.72° 59' 30"East 90.0
feet to an iron pipe;thence along other land now or formerly of Ida Polywoda,2
courses,as follows:
(1) South 23' 10' 50" West 110.36 feet to an iron pipe;thence
(2) North 72' 59' 30" West 86.0 feet to an iron pipe set on the easterly line of
Bayview Road;thence along said easterly line of Bayview Road,North 21° 06' 30"
East 110.0 feet to the point of beginning.
PARCEL II: S.C.T.M.4 1000-078.00-01.00-040.001
PART 1
ALL that certain plot,piece or parcel of land, situate, lying and being at Southold in
the Town of Southold,County of Suffolk and State of New York bounded and
described as follows:
BEGINNING at a point which is the southeasterly corner of land conveyed by
Theresa V.Polywoda to John A.Polywoda by deed dated October 23, 1976 herewith
and which is the southwesterly comer of land heretofore conveyed to Joan Polywoda
by deed recorded June 7, 1963 in Liber 5359 of Deeds page 256,which point is
distant 94 feet on a course South 74 degrees 44 minutes East along the southerly line
of the said lands conveyed to John A.Polywoda from a deflection point in the easterly
line of Bayview Road;running thence South 72 degrees 59 minutes 30 seconds East
along the southerly line of lands of Joan Polywoda 109.06 feet to the southeasterly
corner of lands of Joan Polywoda; running thence South 26 degrees 06 minutes 30
seconds West 8.7 feet to a point;running thence in a westerly direction more or less
along the existing fence line North 68 degrees 25 minutes 40 seconds West 108.03
feet to the point or place of BEGINNING.
Said deed is a correction deed and is given to correct the name of the grantee and the
description of premises heretofore conveyed by Teresa V.Polywoda to John A.
Polywoda in a certain deed dated February 23, 1973,recorded March 7, 1973 in Liber
7355 of Deeds at page 403,and John A.Polywoda the grantee therein,joins in this
deed for the purpose of correcting the said error in the prior deed in the name of the
grantee and in the description, and for no other purposes.
PART
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,bounded and described as
follows:
BEGINNING at an iron pipe on the boundary line between land of the party of the
first part and land now or formerly of Dart; said point of beginning being 90 feet
southeasterly along said boundary line from Bayview Road;said point of beginning
being also the northeasterly corner of land conveyed by the party of the first part to
John Poliwoda and Joan Poliwoda by deed dated October 31, 1953,and recorded in
the Suffolk County Clerk's office November 27, 1953;from said point of beginning
running along said land now or formerly of Dart;south 72° 59'30"east, 127.03 feet to
an iron pipe and land now or formerly of Wilsberg; thence along said land now or
formerly of Wilsberg,south 26° 06'30"west, 162.82 feet;thence along said land of
the party of the first part three courses,as follows: (1) north 72' 59'30"west, 109.06
feet;thence(2)north 19' 46' 50" east 51.09 feet;thence(3)north 72` 59' 30" west,
6.55 feet to the southeasterly comer of said land heretofore conveyed to Poliwoda as
aforesaid;thence along said land,north 23° 10' 50" east, 110.36 feet to the point or
place of beginning.
SUBJECT to any state of facts an accurate survey might show, and to covenants,
restrictions,easements,agreements,reservations,and zoning regulations of record, if
any.
PARCEL III: S.C.T.M.# 1000-078.00-01.00-013.002
ALL that certain plot,piece of parcel of land, situate, lying and being at Southold in
the Town of Southold,County of Suffolk and State of New York bounded and
described as follows:
BEGINNING at a point on the easterly line of Bayview Road at the southwesterly
corner of land conveyed by Ida Polywoda to John A. Polywoda Et.Ux.By deed dated
10/31/53 recorded 11/27/53;running thence along said land South 72 degrees 59
minutes 30 seconds East 86.0 feet;thence along land conveyed by Ida Polywoda to
Joan Polywoda by deed dated 6/5/63 recorded 6/7/63 in Liber 5359 cp 256,two
courses: (1) South 72 degrees 59 minutes 30 seconds East 6.55 feet;thence(2)South
19 degrees 46 minutes 50 seconds West 51.09 feet;thence along other land now or
formerly of Teresa Polywoda,North 74 degrees 44 minutes West 94.0 feet to a point
of deflection in said easterly line of Bayview Road;thence along said easterly line,
North 21 degrees 06 minutes 30 seconds East 54.03 feet to the point of BEGINNING.
Containing 4,887 square feet.
INSTRUCTIONS(RP-5217-PDF-INS):www.orps.state.ny.us
FOR COUNTY USE ONLY New York SLOW Wpartmsnt of
C1.SwIS code • I Taxation and Finance
C2.Daft Deed Recorded I �/ 1 ice of Real Properly Tax Services
" A RP-5217-PDF
C7.Book a y C4.Pape I � 1 Real Property Transfer Report(6110)
PROPERTY INFORMATION
I.Property 2495, 2443 and 2545 Main Bayview Road
'B'PL'LR MIYIEP .a:Rrr'MME
Southold Southold 11971
.C.V CR TOMM wGA:iL .2rcom
t.Buyer Polywoda, Joan A. Polywoda, John A.
Norm
L.bi NAIE,C.',lw•MY FIRRT 141(
Broadhurst, Joan A. Klavas, Jill A.
LAIR—MIXOMPAW FLIT NWE
7.Tu Indicate where Mum Tu Bills w to be sem Polywoda Joan A.
Billing it other than buyerat brach of Tam
Address addt ) .wT N.YE¢ow•AN• roar Was
P.O. Box 234 Southold NY 11571
SPCET WYBCR ANC NINE CI—'[e11 b:wfE 2I1CON
4.Indicate the number of Assessment 3 e d Parcels OR Pan a a Parcel luny R Pert of a Paruq Cheek a they appy: ❑
Roll percale transferred on the dead 4A.Planning Board with Subdivision Authority Exude
5'Deed \ OR 0.78 4B.Subdivision Approval was Required for Transfer
Property •IPONr WI •cfP •ACRLs
Sim
El
4C.Parcel Approved M Subdivision with Map Provided
Joan A. Polywoda Revocable Trust
G.Sellar .,AST NAI EICOMPA Fn47"VE
Name
feel vYEACOMPAn --•---'--- Fv1T UYF —•--
•7.Select lite description which most accurately doscdbas the Check the loxes below an their appy:
use of the property at the time of sole: S.Ownership Type is Condominium C
A.One Family Itesirlential�1�ACA►�" a.New Construction aLaVammLand G
10A.Pmporty Located within an Agricultural District
10.Buyer received a dsdmure notice indicating that die property Is In an ❑
Agricultural District
SALE INFORMATION 15.Check one or mom of these condldore as applicable to transfer.
A.Sale Between Reiadwm or Fordabva
Former Reaffirms
11.Sete Contract Dalt n/g B Brae between Related Companies or Partners in Business.
C.One at the Buyers is Neo a Seiler
12 Date of SoldTrenafer 1215/17 D.Buyer or Seller is Government Agency or I.endrg Institution
E Deed Type not Warranty or Bargain and Sole(Specify Below)
F.Sale of Fractional or Leser than Fair Intereat 1Speciy Below)
•13.Full Sale Price D .U() G.Significant Charge in Property Between Taxable Status and Sole Dates
H Sale ct Business rs Included in Sale Prim
1 ed p
Full Sale Price is the total amount paid for the property including poisonrapedy. 1.Other Unusual Factors Af tiding Sole Pop(Spedy Below)
'No payment may be In the term at cash.other property of goods.or the assumption at J.Nor,e
murigtiges cr other obligations)Please found to the n"nW whole de w&74um.
•Commerdls)on Condition: /
14.Indicate the value of personal v
Property Included In the ask .00 One trarafcrrdo roveives a life ea;a:e in'.erea.
ASSESSMENT INFORMATION-Date should retied the latest Final Assessment Roll and Tax Bill
15.Year of AssnsmsrR Roll from which Information takenlYY) 17 '17.ToUl Assessed Value
'16.Properly Class 210,312 5 311 _ 1e.School District Name Southold
•20.Tax Mop Mard(6ar(s)1Rod hiondRar(s)((f mom than four,attach shag with additional ldeldl6erlsl)
1000-078.00-01.00-011.000 1000-078.00-01.00-040.001 1000-078.00-01.00-013.002
CERTIFICATION
1 Certify that all otthe Items of Warrenton ordered on this form are true and coma(to the best of my knowledge and belief)and I understand that the making of any wlldul
false statement of materiel fart heroin subject me to tM.Pt'0y]etp0s_p[.the-pOnel lins.retaave to the making and filing of htu Inatmmsnb.
SELLERAIGlIATURE BUYER-CONTACT INFORMATION
IEnlwr Iraarmebpri for IIs rwyn.Note-If buyer u LLC mod".awapuaial,carparabon awR stock wnpwlT.ahem,w
a"1Lt ars IVI an i dRTdral agent w bpuoary.Von M m•ne am aract Irllorriaeon or on inevo nm sponsme
12/5/17 Mrywha an mwnraretbnw rnpanTrig me Vanslr ntWl oil erwrm Type argue Wanly)
Jo rATfolywoda, Tru Cee We Polywoda Joan A.
BUYERSIGNATURE
•lAy+W YL FAST W WE
(631) 765-2687
12/5 17 'AREACODE -TELERCfE NUMBER IF wrwel
9rGN.TuaE ti.IL
JO A. Polywoda 2495 Main Bayview Road
'STaEE-W1eEa 'ITREEr NAYS
Southold NY 11971
f 'CI IT v4 Iom ws-.IL 'LPcom
BUYER'S ATTORNEY
Hefter Marcia Z.
.AS;NAYL --- -RS'NAW.
(631) 369-170
` ANLAwx 41114ONI M,MICRIt.rrertawf
1 I