HomeMy WebLinkAboutL 12979 P 855 1111111 IIII iilll illll VIII lull VIII IIIA(IIII IIII IIII
1111111111111111 IIII 1111
SUFFOLK COUNTY CLERK
RECORDS OFFICE
RECORDING PAGE
Type of Instrument: DEED Recorded: 09/25/2018
Number of Pages : 4 At: 12 : 00 :24 PM
Receipt Number : 18-0178664
TRANSFER TAX NUMBER: 18-06324 LIBER: D00012979
PAGE : 855
District: Section: Block: Lot:
1000 004 . 00 05 . 00 005 . 016
EXAMINED AND CHARGED AS FOLLOWS
Deed Amount: $0 . 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 $5 . 00 NO RPT $200 .00 NO
Transfer tax $0 . 00 NO Comm.Pres $0 .00 NO
Fees Paid $400 . 00
TRANSFER TAX NUMBER: 18-06324
THIS PAGE IS A PART OF THE INSTRUMENT
THIS IS NOT A BILL
JUDITH A. PASCALE
County Clerk, Suffolk County
r
- ❑t 2❑
Y
RECORDED
Number of pages 2018 Sep 25 12.uCi r 24 PM
JUDITH G. PASCALE
CLERK OF
This document will be public SUFFOLK COUFIT,3
record.Please remove all L D00012979
Social Security Numbers P 855
prior to recording. IaT# 18-06324
Deed/Mortgage Instrument Deed/Mortgage Tax Stamp Recording/Filing Stamps
3 FEES
Page/Filing Fee AD Mortgage Amt.
1.Basic Tax
Handling 20. 00 2. Additional Tax
TP-584Sub Total
Notation Spec./Assit.
or
EA-52 17(County) Sub Total5.� Spec./Add.
R.P.T. 7(State) _'
TOT.MTG.TAX
Dual Town Dual County _
R.P.T.S.A. Held for Appointment
Comm.of Ed. S. 00 Transfer Tax
Affidavit • + Mansion Tax
1:5— IRSThe property covered by this mortgage is
Certified Copyor will be improved by a one or two
NYS Surcharge 15. 00family dwelling only.
Sub Total YES or NO
Other
Grand Total e4a'— If NO, see a pna tax clause on
page# o ' in trument. C`
1�
4 Dist )5.016 5 Community ervation Fund
18030213 i000 ooaoo osoo oosoie
Real ProK P T" S Consideration Amount$
Ver fiat) OIDTYs P-1A IIIp
IuIIIElIII��I��l�fl IIlll�ulll�II�IIIIIII CPF Tax Due $ —��
Improved i
6 Satisfactions/Discharges/Releases List Property Owners Mailing Address
RECORD&RETURN TO: Vacant Land
STEPHEN L.HAM, III,ESQ. TD
MATTHEWS&HAM TD
38 NUGENT STREET
SOUTHAMPTON,NY 11968 TO
Mail to: Judith A. Pascale, Suffolk County Clerk 7 Title Company Information
310 Center Drive, Riverhead, NY 11901 Co.Name ,W
www.suffolkcountyny.gov/clerk Title# Coin — ISa
8 Suffolk County Recording, & Endorsement Page
This page forms part of the attached DEED made
by: (SPECIFY TYPE OF INSTRUMENT)
SAMUEL S.POLK The premises herein is situated in
SUFFOLK COUNTY,NEW YORK.
TO In the TOWN of SOUTHOLD
SAMUEL S.POLK,AS TRUSTEE OF THE In the VILLAGE
SAMUEL S.POLK REVOCABLE TRUST or HAMLET of FISHERS ISLAND
dated April 3, 2018
BOXES 6 THRU 8 MUST BE TYPED OR PRINTED IN BLACK INK ONLY PRIOR TO RECORDING OR FILING.
over
CONSULT,YOUR LAWYER BEFORE SIGNING THIS INSTRUMENT-THIS INSTRUMENT SHOULD BE USED BY LAWYERS ONLY
t
THIS INDENTURE,made the 16"' day of August,two thousand eighteen,
BETWEEN
SAMUEL S.POLK, 11651 SE Florida Avenue, Hobe Sound,Florida 33455,
party of the first part,and
SAMUEL S.POLK,as Trustee of the SAMUEL S.POLK REVOCABLE TRUST dated April 3,2018,11651 SE
Florida Avenue,Hobe Sound, Florida 33455,
party of the second part,
WITNESSETH,that the party of the first part,without 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 at Fishers Island, Town of Southold, County of Suffolk and State of New York-known, shown and
designated as Lot 2 on a certain map entitled"Minor Subdivision Plan,Property of Samuel S.Polk",whict map.vda`s
filed in the Office of the Suffolk County Clerk on May 22,1992 as Map No.9223,said Lot 2 being more particularly
bounded and described as set forth on Schedule A hereto.
BEING AND INTENDED TO BE a portion of the same premises conveyed to the party of the first part by deed,
dated December 6,1990 and recorded in the Office of the Suffolk County Clerk on January 15,1991 in Liber 11205
page 127.
rl
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. ,. t
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"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 firstabove written.
IN PRESENCE OF: n p
Samuel S.Polk
Standard N.Y.B.T.U.Form 8002-Bargain and Sale Deed,with Covenant against Grantor's Acts—Uniform Acknowledgment
i T
SCHEDULE A
to
Deed
Party of the First Part: Samuel S. Polk
Party of the Second Part: Samuel S. Polk, as Trustee of the Samuel S. Polk
Revocable Trust dated April 3, 2018
Deed Dated: August 2018
BEGINNING at an iron pin on the southerly line of a road, said iron pin being 63.13 feet
North of a point which is 132.88 feet West of a monument marking the United States Coast
and Geodetic Triangulation Station "CHOCOMOUNT 2"; and
RUNNING THENCE South 38 degrees 19 minutes 31 seconds West, 459.35 feet to an
iron pipe;
THENCE South 54 degrees 38 minutes 30 seconds East, 360.66 feet to an iron pipe;
THENCE North 0 degrees 47 minutes 20 seconds West, 49.75 feet to an iron pipe;
THENCE North 21 degrees 57 minutes 50 seconds East, 120.25 feet to an iron pipe;
THENCE due North 444.14 feet to a point on the southeasterly line of said road, said point
being at a point of a curve to the right having a radius of 50.00 feet and the direction of
whose radius at that point is North 74 degrees 29 minutes 32 seconds West; and
THENCE southwestwardly, following the arc of said curve, 70.41 feet to the iron pin at the
point or place of BEGINNING.
TO BE USED ONLY WHEN THE ACKNOWLEDGMENT IS MADE IN NEW YORK STATE
State of New York,County of Suffolk ss.: State of New York,County of ss.:
On the 1� day of August in the year 2018 before me,the On the day of in the year
undersigned,personally appeared before me,the undersigned,personally appeared
Samuel S.Polk
pe 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 individualW whose namef2y is satisfactory evidence to be the individual(s)whose name(s)is
(aya�subscribedtothewithininstrumentandacknowledgedtome (are)subscribed to the within instrument and acknowledged to me
that he/sheAhey executed the same in hisA%FAheiccapacity(iipef, that he/she/they executed the same in his/herAheir capacity(ies),
and that by his/herAbeir signatureW on the instrument, the and that by his/her/their signature(s) on the instrument, the
individuaw,or the person upon behalf of which the individuajs' individual(s),or the person upon behalf of which the individuals
acted,exe u d the i m nt. acted,executed the instrument.
S 2 K.22
Notary Public ZZ2S�3 Notary Public
)y;�signature'and,office of individual taking acknowledgment) (signature and office of individual taking acknowledgment)
Q• z
.•yam IT ,
OR TO BE USED ONLY WHEN THE ACKNOWLEDGMENT IS MADE OUTSIDE NEW YORK STATE
if
State of ;County of SS.:
On the day of in the year before me,the undersigned,personally appeared
personally known to me or proved to me on the basis of satisfactory evidence to be the individuals whose names are subscribed to the
Within instrument and acknowledged to me that they executed the same in their capacities,and that by their signatures on the instrument,
the individuals,or the person upon behalf of which the individuals acted,executed the instrument,and that such individuals made such
appearance before the undersigned in the in the State of
(insert the City or other political subdivision)
(signature and office of individual taking acknowledgment)
My Commission Expires On:
BARGAIN AND SALE DEED DISTRICT 1000
WITH COVENANT AGAINST GRANTOR'S ACTS SECTION 004.00
BLOCK 05.00
Title No. LOT 005.016
COUNTY OR TOWN SUFFOLK-SOUTHOLD
STREET ADDRESS 1180 Top of the World Drive
SAMUEL S.POLK Fishers Island, New York 06390
TO
SAMUEL S.POLK,AS TRUSTEE OF THE
SAMUEL S.POLK REVOCABLE TRUST DM 4/3/2018 RETURN BY MAIL TO:
STANDARD FORM OF NEW YORK BOARD OF TITLE UNDERWRITERS
Distributed by
RESERVE THIS SPACE FOR USE OF RECORDING OFFICE
FOR COUNTY USE ONLY- tINSTRUCTIONS(RP-5217-PDF-INS):www.orps.slatemy.us
Ct.31MS Code Now York Efate Department of
.�^L�i J Taxation and Finance
C2.Date Deed Recorded LQ OS � I Office of Real Property Tax ServicestNFO�RMATION C3.800k C4.Page I RP-5217-PDF
PROPERTY I Real Property Tranahr Report(8110)
rty
1 Loatioon 1180 ---- TOP OF THE WORLD DRIVE
NINEx ------ -
TOWN OF SOUTHOLD
-- FiSHRRS ISLAND
�rT,-ter. ----------- - 05390
2.slaver
Name SAMUEL S. POLK REVD TRUST ------- '�Pc�F -
_
F iiil Y.V -------
3.Tax LIST R.Vr. -------
Billing Indicate where future Tax Blas are to be am
Address 9 Other than buyer addresstat bottom of form) .asi vYVrAw4'.N• - .
�w7S:LI.RF --�-
•
4.Indicate do number of Assessment ST--r SFCQCE
T
Roll W reeb transferred on the dead.---a or Parcels OR LJ Part of a Parcel (Only If Part of■Parcel)Check as,tial,apply:
L Deed p 4A.Planning Board with Subdivision Authority Exists 1-I
PfOPalty -•ri'1M1TreE1 - -•n'F1• OR 2-44 48.Subdi anon Ragmred far TransMr L.I
Stu •.rlEs Approve,
was J
4C.Parcel Approved for Subdivision with Map Provided r
Pozx `I
B.Seller ;.s*h.wswn s. ------ SAM EL S.
Name
-
9.Select the description which most accurately describes the Check the bum below,as th a -----
use o/the Property at the Bme of axis: y PWY
rL�w e-Ownership Type is CondominiumI�
A.O'x'i':If111Iy'I�PSIfl4`fll l✓f( 9.New Can LJ
------------ - sanction on a Vaunt Land rl
1111A.Property Located within an AgriculluiW District I^
108.BoYar f lmived a disclosure notice Indicating that the properly is m an 7
SALE INFORMATION Agricultural District ❑
19.Check ow or more oftlwae Wnditbm es eppliubiv to transfer.
1 L Sale Contract pats 07/27/2018 U A.Sale Between Rel"tives or Former Relatives
-- ___ B Sal"btlaroed Related Companies or Portnere in Business.
C.One of the Buyers Is also a Seller
12.Date of SalolTnnsfer o8/3.6/2018 ��
-_ I.I D.Buyer or 3e3sr is GovernmentAgenLy or Lending Ingitid,oll
I I E.Deed Type not Warranty or Bargain and Sale(Specify Below,
'13.Full Sale Price 0.00 F Sale Or Fractional or Less than Fee Interest ISpecily Befdw)
_ _-_ G.Significant Change in Property Behwsen Taxehle Status and Sale Dates
I Full Sal"Price is Iia total amount paid for the Property Including Personal properly N.Sale of Business is Included In Sale Price
That payment may be in the form Or cash,other Property Of goods.or the assumption of L Other Unusual Factors Affecting Sale Price 15peclfy Below)
mortgages or other obligations.)Pleeae round to the neereat stel"ddteramamt J None
'COrnmwnt(U on Condition:
14.Indicate clic valve Of personal
property Included In the sale _ 0 .00
ASSESSMENT INFORMATION-Data should reflect the latest Final TiUL4SFER .•-C REV`•:A;I;E TRZI T
Assessment Roll and Tax BIII --
19.Year of Aesessmam Roll from which Information taken(YY) 17 '17.Total Assesso l Valve
23,200
'19.Property Clsax 2'_C - -- -
- •19.School DlydrfetName PISBERS ISLATD
'20.Tax Map Identlfier(syRoll Idengaer(s)its more than four,attach sheet with additional Identl me)) --
1000 004.00-04.00-005.015
CERTIFICATION
CeNly that all of ft tams of InMrmatlon mbr*d on this farm are true and canaet(to the best of my knowledge end ballet)and I undOmUnd that the making of any wltiful
al"o statement of material fact herein subject me to the PlOvisi9ee 01.90 penal.Nwr.rel"tivie to the making and 91ing of falso instrumeltis.
SELLER S1G11AIUBE t BUYEBCONrADTINEOBMATjo n
S ,Ener lnFjr sax•air ire buyar.h'W If buwern LI Cuda y assomeen.wrperewn Ant e'Atl.ranpariy,ewe air
Only eaI Is 9N s:.4%is .11]arr.rl fiducsn.eel a vna and xn'x Ffam:M.la l cyan 65r-pony.
e u
A'LF+S.'.---•]--\C1L!(1 ---�.�6-`a" iwrb wnc ra�a•Iseer queaod:sr%amr.gia:•a+L4rnuetbeams:ed 7ypsar plea Wary.)
ry LSF ver
BUYERSIGNATURE I POLK SAMUEL S.
TY.YF �-
,,D
(631) 788-7708
J4 --------
zmR,&%L_ ----- -_ I •.ifs 'CR •lelr�l•C•CwY7EN:Faw.1/Itpp;-
1.L651 __ SE FLORrDA AVENUE
•S'PF,.-M.Yeryt •61-EF'N.16
1
HOBS SOUND FL33455
I
BUYERZATL08NEY TR Vine
IHAM STEPHEN L., CIC
.AST
I --------- FMSTWNL ------•
283-2400--- -
4YE.00CL
TElcl'YC•zYlYery;lFy ewf&Ie.