HomeMy WebLinkAboutL 13328 P 616 i
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I l l l l l l l l l l l l l l l l l l l l l l l l l l l l l l l l l l l l l l l l l l l l l l l l l l l
IIIIII IIIII lllll Illl IIII
SUFFOLK COUNTY CLERK
RECORDS OFFICE
RECORDING PAGE
Type of Instrument: DEED Recorded: 03/09/2026
Number of Pages : 4 At: 01 : 19 :03 PM
Receipt Number : 26-0028237
TRANSFER TAX NUMBER: 25-20767 LIBER: D00013328
PAGE : 616
District: Section: Block: Lot:
1000 026. 00 02 . 00 039 . 017
EXAMINED AND CHARGED AS FOLLOWS
Deed Amount: $10, 000 .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 $40 . 00 NO Comm. Pres $0 . 00 NO
Comm. Pres Fund $0 . 00 NO Comm.Housing Fund $0 . 00 NO
Fees Paid $440 . 00
TRANSFER TAX NUMBER: 25-20767
THIS PAGE IS A PART OF THE INSTRUMENT
THIS IS NOT A BILL
VINCENT PULEO
County Clerk, Suffolk County
F�T
Numberof pages RECORDED
1026 Mar 09 01:19:03 PM
VINCENT PULEO
This document will be public CLERK OF
record. Please remove all SUFFOLK COUNT3328V
L D0��a1332s
Social Security Numbers P 616
prior to recording. aT# 25-20757
Deed/Mortgage Instrument Deed/Mortgage Tax Stamp Recording/Filing Stamps
3 1 FEES
Page/Filing Fee ZO'G-o Mortgage Amt.
1.Basic Tax
Handling 20. 00
2. Additional Tax
TP-584 S 60 Sub Total
Notation Spec./Assit.
or
EA-5217(County) S Sub Total SO,GC Spec./Add.
EA-5217(State) �Z-S,CC TOT.MTG.TAX
Dual Town Dual County
R.P.T.S,A. Held for Appointment
Comm.of Ed. 5. 00 Transfer Tax yd� UG
Affidavi R;: 1Mansion Tax
Certified Copy p The property covered by this mortgage is
or will be improved by a one or two
NYS Surcharge 15. 00 family dwelling only.
Sub Total 3.5�• � YES or NO
Other
Grand Total LIOd cc' If NO,see appropriate tax clause on
page# of this instrume t.
2e0 2 )T
4 Dist.1( 26008688 1o00 02600 0200 039017 )17 5 Community Preservation Fund
Real Property 0sTn�2 (IIIII IIIII IIIII IIIII IIIII III Consideration Amount$ I0,UU�•G�
Tax Service Orr
Agency CPF Tax Due $
Verification
Improved
6 Satisfactions/Discharges/Releases List Property Owners Mailing Address
RECORD&RETURN TO: Vacant Land
Van Cott Ebrahimi P.C. TO /000
1600 Calebs Path Ext., Ste. 116
Hauppauge, NY 11788 TO
Attn: Bryan C. Van Cott, Esq. TO
Mail to: Vincent Puleo, Suffolk County Clerk 7 Title Company Information
310 Center Drive, Riverhead, NY 11901 Co.Name
www.suffo I kcou my ny.gov/clerk
Title#
8 Suffolk County Recording & Endorsement Page
This page forms part of the attached Bargain&Sale Deed made
by: (SPECIFY TYPE OF INSTRUMENT)
James R. Douglass The premises herein is situated in
SUFFOLK COUNTY, NEW YORK.
TO In the TOWN of Southold
Adam Nelson Douglass IntheVILLAGE
or HAMLET of
BOXES 6 THRU 8 MUST BE TYPED OR PRINTED IN BLACK INK ONLY PRIOR TO RECORDING OR FILING.
over
NY 005-Bargain and Sale Deed with Covenant against Grantor's Acts Individual or Corporation(Single Sheet)(NYBTU 8002)
CONSULT YOUR LAWYER BEFORE SIGNING THIS INSTRUMENTP-THIS INSTRUMENT SHOULD BE USED BY LAWYERS ONLY
THIS INDENTURE,made the, 18th day of February in the year 2026
BETWEEN
James R. Douglass, 188 Shade Tree Lane, Riverhead, NY 11901
party or the fit'SL part,and
Adam Nelson Douglass, 422 Willow Terrace Lane, Orient, NY 11957
parry of the second pan,
WITNESSETH,that the party of the first part,in consideration of Ten Dollars and other valuable consideration paid by the
party of the second pan,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
SEE SCHEDULE A — ATTACHED HERETO
AND MADE A PART HEREOF
BEING AND INTENDED TO BE the same premises conveyed to the grantor
herein by deed dated 9/20/2001, and recorded 10/3/2001 in the
Suffolk County Clerk's Office in Liber 12145 Page 156
THE INTENT OF THIS DEED IS TO CONVEY ALL OF THE RIGHT, TITLE AND
INTEREST OF THE PARTY OF THE FIRST PART.
TOGETHER with all right,title and interest,if any.of the party of the first pan of,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 pan forever.
AND the parry of the first pan covenants that the party of the first part has not done or suffered anything whereby the said
premises have been incumbered in any way whatever,except as aforesaid.
AND the party of the first pan,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 Hord"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: (�
es R. Douglass
USFACh7VOWl.FOGMF\TFORMRriDwivIT/IG1'NEWYORKSTATFONLY USF,icA oO viE1X:diFvTFORNRFroiv wrryiNNFivYORKSTATFONLY:
State of New York,County of Suffolk )ss.: Slate of New York,County of )ss:
On the day of February in the year 2 02 6 On the day of in the year
before me,the undersigned,personally appeared before me,the undersigned,personally appeared
James R. Douglass
personally known to me or proved to me on the basis of satisfactory 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 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 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 the same in his/her/their capacity(ies), and that by his/her/their
signature(s)on the instrument,Unc in ' ' ual(s).o the person upon signature(s)on the instrument,the individual(s),or the person upon
behalf of which the individual(s)acted,exe used th instrument. r�behalf of which the individual(s)acted,executed the instrument.
Not y Publilf3RYANC.VAN COTT D ^C.qks' �O
Notary Public,State of NAW York
Qualified in Suffolk County
N0.02VA5077332
Commission Expires May 5,20
ACf7VOwr.FDc%fFVT FORM FOR USE 1VrTIiLV NFW YORK STiTF.ON'Lt': ACKNOwIF.OGMENTFORM FOR USFOUTSIOFNF.w YORKSTATF ONLY-
(Neu,York Subseribing Witness Arko.,vledgment Crrrificolr/ lout of Scare or Foreign General Aeknowleelgmem Certificate/
State of New York.County of J ss.: ..................................................)SS.:
(Complete Vemte with State,Coumr.Province or Muuieipolin)
On the day of in the year
before me,the undersigned,personally appeared On the day of in the year
before me,the undersigned,personally appeared
the subscribing witness to the foregoing instrument,with whom I ant
personally acquainted,who,being by me duly sworn,did depose and personally known to me or proved to me on the basis of satisfactory
say that he/she/they reside(s)in evidence tobe die individual(s)whose name(s)is(arc)subscribed to the
within instrument and acknowledged to me that he/she/they executed
(ifthe placeofresidence is in acay,occlude ilia soverandstreel monber, the same in histherAheir capaciry(ies),that by his/her/their signature(s)
ifany,thereon:that helshe/they know(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
to be the individual described in and who executed the foregoing made such appearance before the undersigned in the
instrument;that said subscribing witness was present and saw said
execute the same;and that said witness at the same time subscribed (insert the cirrorolherpoliricalsubdivfsion and the stale orcowuryor•
his/her/their name(s)as a witness thereto. other place the acknowledgment was taken).
Notary Public
BARGAIN&SALE DF,EU
WRIT COVI_VANM AGAINST GRAA•r0R'S ACTS
T!'TLti NO. DISTRICT 1000
sccnoN 026.00
James R. Douglass, t BLOCK 02.00
LOT 039.017
COUNTYORTON'N Suffolk County
TO
Adam Nelson Douglass RrCORDEDATREQUESTGF
RETURN BY MAR.TO
Van Cott Ebrahimi P.C.
1600 Calebs Path Ext
Ste 116
Hauppauge, NY 11788
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SCHEDULE A
ALL that certain plot, piece,or parcel of land,with the buildings and Improvements thereon erected,
situate, lying and being at Orient,Town of Southold, County of Suffolk, and State of New York;and more
particularly described and designated as follows:
BEGINNING at appoint on the southerly line of Nelson Drive the following two courses and
distances from the corner formed by the intersection of the easterly line of Willow Terrace Lane and the
southerly line of Nelson Drive, as shown on a certain map entitled, "Map of Willow Terrace, Section One
at Orient,Town of Southold, Suffolk County, New York filed in the Suffolk County Clerk's Office on 11-
28-1969 as Map No. 5407:
(1) North 67 degrees 30 minutes East 115.00 feet; and
(2) South 88 degrees 21 minutes 50 seconds East, 54.92 feet;
RUNNING THENCE South 88 degrees 21 minutes 30 seconds East, 150.00 feet;
THENCE at right angles to the last-mentioned course South 1 degree 38 minutes 10 seconds,West 150.00
feet;
THENCE North 88 degrees 21 minutes 30 seconds West, 150,00 feet and
THENCE North i degree 38 minutes 10 seconds, East 150.00 feet to the point or place of BEGINNING.
TOGETHER WITH all that certain plot of land with buildings and improvements thereon being at Orient,
Town of Southold, County of Suffolk, and State of New York, more particularly described and designated
as Lot 12 on a certain map entitled "Map of Willow Terrace, Section One at Orient,Town of Southold,
Suffolk County, New York" filed in the Suffolk County Clerk's Office on 11-28-1969 as Map No. 5407.
INSTRUCTIONS(RP-5217-PDF-INS):www.orps.sta(emy.us
FOR COUNTY USE ONLY New York State Department of
C1.SWIS code (�, r Taxation and Finance
C2.Date Deed Recorded I / 7 / N I Office of Real Properly Tax Services
RP-5217-PDF
C3.Book 3 C4.Pego Real Property Transfer Report(olio)
PROPERTY INFORMATION
1.Property 4.658—0 S1P3 Willow Terrace Lane
Location
•amEET TBeeeER •sTREer NNE
Orient 11957
•dr7at1TONN MrAGE -apcooE
2.Buyer Douglass Adam Nelson
Name
•LASrrtANEsxtNPArtr FwsrNANE
LASTaANEAOYPMn Friar NAME
3.Tax Indices wham future Tax Bias Am to be Sent
Billing if other den buyer address(m botmm of form) LAST HMTACUPAW FIRST N•.E
Address
STRINTNUMOFAAraNME cnvan To— e4TE ZP0=
l Indicate the number of Assessment 1 pad of a Parcel (Only It Part of a Parcel)Chock as they apply:
Roll penes Vanefarred on the deed e of Pamafe OR 4A_Planning Board with Subdivision ALAhorlly Exists
5.Oood X OR 1.03 4B.Subdivision Approve was RMulma for Transfer
P-Party •MMITFUT •oEPTN -ACRES
Sias
K.Parcel Approved for Subdivision with Map Provided
Douglass James R.
G.Seller ydT NA VLe"PANF FIRM HAM
Name
LAW NYE001"AW FIRS NAYS
•7.Salsd No description which most accuratelydeseAbBS the
Chock the boxes below as they apply:
use of the property It the time of WIG: 8.Ownership Type Is Condominium
A.One Family Residential a.New Construction on a Vacant Land
10A.Property Located within an Agdwimrai oir sits
109.Buyer ralxtivea a disdolu To rubes Indiurmg that gm property Is In an ❑
Agricultural District
SALE INFORMATION 15.Check one or mom of these conditions as applicable to transfer.
A.Sale Between Rolotha s or Former RatelMe
B.Sale balvreen Related Companies or Partners it Business
11.Salo Contract Date G�. j O 1(o C.One of the Buyers Is also a Seller
•12.Date of Salarrmdefer 0 2/18/2 02 6 D.Buyer or Seller Is Governance Agency or Lending Institution
E.Dead Type net Viamenty or Bargain and Salo(Specify Be"
F.SW of Fractional or Lass thin Fee Interest(Specify Below)
•13.Full Sale Prim 10,000.00 G.Significant Change In Property Between Taxable States and Sole Dates
M,Sans of Buslnesa fe Inducted In Sale Price
(Full Safe Price is the total amount Pala for the property Including personal property. 1.Other Unusual Fades Affecting Sake Prim(Specify Beim*
This payment may be In the form of cash.other property or goods.or the assumption of J.None
mortgages or other obllge0dns.)Plasxe round to me esamst Whole doWamount.
•Comment(s)on Condition:
14.Indicate lea value of personal
property Included In the sale 0.00
ASSESSMENT INFORMATION-Date should reflect the latest Final Assessment Roll and Tax Bin
16.Yonrof Asummont Rolf*=which Information lakan(YY) 25 •17.Tare Assessed Value 290E909
Property Class 260 _ •12.School District Name Oysterponds
•2D.Tax Map IdentMet(s)IRoll Idontiflor(s)(N mom Nan four,Beach shoot with additional Idontaler(s))
1000-026.00-02.00-039.027
CERTIFICA ION
I Certify that all of the hems of Information entered on this form are true and correct(to the boat of my knowledge and betkA)and 1 understand that the making of any Tvll ful
fake statement of material fact herein subject me to No.prDyls(Ons of the MjUdN_mIadvo to the making and tang of false Instruments.
SELLER SIGNATURE BUYER CONTACT INFORMATION
�f (E.rCa aJamalbn fm re buyer.Nola It hryar is LMsodely oemdahrM1 cape.. .loin dadr—piny.adwo or
tenser
,f.(V/f� andtir and Ian s rot an adMaW Nam armlOdery.men a namB and mmaa imrmolbn a an buirrimrdAmpwd0o
Joe %Z, , Car quadion,MaBong the r .$W teenMe be ad.typo ar pdm ceudy.)
SE aONATUrm -19 Ip
BUYER SIGNATURE Douglass Adam Nelson
•uar N11E Frer N,WE
•ASEA0001 •TaeP MwNeRCE.swell
surmte TmPm DATE
P.O. Box 248
•maffT NUMBER •STREET NArm
1 Orient NY 11957
YAry oR ToxN 'STATE YICOOE
` BUYER'S ATTORNEY
r
Van Cott Bryan C.
LAm NNE FIRST W WE
(631) 939-2301
AREAcnGg MAPHDMMMBM&.sFinam)
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