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Thomas Subd. TOWN OF WAPPINGER �Y PLANNING BOARD ^ DISTRIBUTION SUBDIVISION - SIGNED RESOLUTION & FILED MAP FILED MAP## 12275 PROJECT NAME: Thomas Subdivision DATE PREPARED. November 6, 2009 DISTRIBUTED FOR YOUR RECORDS RESOLUTION WITH APPROVED PLANS.. 2 CERTIFIED COPIES & C copies of filed map x TOWN FILE—Certified Map X TOWN CLERK —Original Resolution & Certified Map X TOWN ENGINEER X TOWN PLANNER X BUILDING INSPECTOR x HIGHWAY SUPERINTENDENT X DUTCIIESS 9]] ADDRESSING OFFICE X ZONING ADMINISTRATOR RESOLUTION ONLY: - x RESOLUTION FILE X TOWN ATTORNEY X TOWN BOARD x TOWN SUPERVISOR X TOWN ASSESSOR. X FIRE PREVENTION BUREAU x APPLICANT N APPLICANT'S ENGINEER/ARCHITECT X DUTCHESS COUNTY SOIL & WATER X CENTRAL HUDSON—EASEMENT/UTILITY PAGE RECREATION DC DEPT. OF PUBLIC WORKS (COUNTY ROAD) DEPT. OF TRANSPORTATION (STATE ROAD) VILLAGE OR TOWN 1121 1121109 RESOLUTION TOWN OF WAPPINGER PLANNING BOARD RE: THOMAS SUBDIVISION— RESOLUTION OF PRELIMINARY AND FINAL SUBDIVISION PLAT AND WETLANDS PERMIT APPROVALS At a regular meeting of the Planning Board of the Town of Wappingers Dutchess County, NeW York, held at Town Hall, 20 Middlebush Road, Wappingers Falls., New York on the ���day of 94,7 l 2009 at 7:00 P.M. The meeting was called to order by Chairman Victor Fanuele and upon,roll being. called,the following were: PRESENT: Chairman - Victor Fanuele Boardmembers - William Kickham - Marsha Leed - Lori McElduff - Eugene Pinto - Robert L. Valdati - June Visconti The followin psolution was moved by A - f and seconded by WHEREAS, the Town of Wappinger Planning Board received an application of Frederick Thomas (the "Applicant" and "Owner") for subdivision plat and wetland permit approvals to subdivide one (1)±22.1-acre parcel of into two (2)residential lots of+15.5 acres (Lot 1) and±5.92 acres (Lot 2)in size(the "Project" or"Proposed Action"),- and WHEREAS, the subject property is known as tax lot 6056-02-706819 on the Town Tax Assessment Maps and is located at 197 Riverview Drive in the R-40 Zoning District (the"Subject Property„ or"Site"); and WHEREAS; the Applicant has submitted an application form for Preliminary Subdivision Plat Approval, dated May 14, 2008, an Owner Consent Form dated May 14, 2008, a Full Environmental Assessment Form (EAF) dated May 19, 2008, a Blanding Turtle's Habitat Assessment dated November 21, 2008 and prepared by Michael Nowicki of the Ecological Solutions, LLC; and the following two sheets of plans generally entitled "Preliminary Subdivision Plan — Thomas Subdivision," dated May 19, 2008,last revised ; December 1, 2008 and prepared by Hudson Land Design Professional Engineering PC- I Sheet 1 of 2, Subdivision Plan THOMAS SUBDIVISION RESOLUTION OF PRELIMINARY AND FINAL SUBDIVISION PLAT AND WETLAND PERMIT APPROVALS 2. Sheet 2 of 2, Construction Details; and WHEREAS, the Planning Board is familiar with the Subject Property and its surroundings, and has reviewed the Project in accordance with the standards for approval contained in the Zoning Law and the Land Subdivision Regulations; and WHEREAS, the Subject Property currently consists of one (1) tax parcel and..the Planning Board has determined that the Subdivision will result in the creation of one (1) additional building lot within the Town of Wappingers and WHEREAS, the Planning Board determined that the Project is an Unlisted action with respect to.SEQR and WEAR; and WHEREAS, a duly advertised public hearing on the Preliminary Plat was held on November 3, 200$.at the. Wappinger Town Hall, 20 Middlebush Road, Wappingers Falls,` New Fork at which time all those wishing to be heard were given the opportunity to be heard and the hearingwas closed on that date; and WHEREAS, a public hearing on the Final Plat will not be held because the Final Plat is in substantial conformance with the Preliminary Plat. NOW, THEREFORE,BE IT RESOLVED AS FOLLOWS: 1. The Planning Board hereby adopts and incorporates the recitations and statements set forth above as if fully set forth and resolved herein. 2. Pursuant to State. Environmental Quality Review regulations, the Planning Board hereby adopts a Negative Declaration on the grounds that the proposed action will not result in any significant adverse environmental impacts since any construction and land disturbance associated with the development of the lots will be controlled will be mitigated through proper drainage and erosion control. 3. The Planning Board hereby finds that a proper case exists for requiring that additional parklands be suitably located for playground and other recreational purposes within the Town of Wappinger, since, in accordance with the Land Subdivision.Regulations, one (1) new building lot will be created within.the Town of Wappinger as a result of the two (2) lot subdivision, and further, that lands appropriate for reservation for recreational purposes do not exist on Site, and therefore a fee in lieu. of the reservation of land for recreational purposes in- an amount based on the fee in existence at the time the Planning Board Chairman signs the final plat will be required as a condition of Final Plat approval: . 2 of 6 THOMAS SUBDTVISION RESOLUTION OF PRELIMINARY AND FINAL SUBDIVISION PLAT AND WETLAND PERMIT APPROVALS 4. The Planning Board hereby grants Preliminary and Final Subdivision Plat: and, Wetlands Permit Wetlands Permit Approvals for the subdivision of one (1) ± 22.1- acre parcel into two (2).residential lots as herein defined, subject to the following .: conditions and modifications which.must be satisfied prior to the signing of the.Final Plat by the Chairman of the Planning Board: The Applicant and Owner shall endorse a copy of this resolution and submit it to the Planning Board for its files: The Applicant shall prepare a final subdivision plat in accordance with �. Section A-5 of the Town of Wappinger.Land Subdivision Regulations. c. The Applicant shall submit a statement signed by the Town's Tax Collector that all taxes due on the Property have been paid in full. The following comments contained in the Town Engineer's letter to the ` 8 Planning Board, dated December 18, 2008, and all comments. in any �' subsequent letter(s) issued, shall be fulfilled to the satisfaction of the Town Engineer: (1) ' The following matters shall be reviewed and approved by the Town High�v.iy ,Superintendent: (a) The proposed driveway. shall be shown to be clear of the "cable ped,"and the electric and telephone facilities. } The plan.shall identify that the utility facilities be moved to provide safe separation to the proposed driveway and to the road extension. (c) The plan shall identify that it shall be the responsibility of the driveway permit holder to pay any utility charges. The relocated facilities shall be placed in a location satisfactory to.the Town Superintendent of Highways. (2' The. provisions for water supply and sewage disposal shall be . reviewed and approved by the Dutchess County Health Department. The.following items shall be reviewed and approved by the Town Attorney: 3 of 6 THOMAS SUBDIVISION RESOLUTION OF PRELIMINARY AND FINAL SUBDIVISION PIAT AND WETLAND PERMIT APPROVALS (a ROW dedication 1b) A metes and bounds deed description for the dedication area shall be prepared. (4) All required signatures and seals shall be shown on the Final Subdivision Plat. e The Applicant shall submit the plat to. the Dutchess County Department of Health for its review,approval and signature and shall submit proof of such approval to the satisfaction of the Town Engineer. The plans shall be signed and sealed by a licensed surveyor and engineer, �J all metes and bounds shall be finalized, and all required signature blocks shall be endorsed to the satisfaction of the Town Engineer. g. The Subdivision Plat shall be revised to include a legend to the satisfaction of: the Town Planner. - The Subdivision Plat shall be revised to be renamed "Preliminary and Final Subdivision Plan — Thomas Subdivision" to the satisfaction of the Town Planner. I. The Applicant shall submit an application form for Final Subdivision Plat Approval to the satisfaction of the Town Planner. 5. Conditional approval of the Final Plat shall expire one hundred eighty (180) days from the date of this resolution unless all requirements have been certified as completed or unless a written request for an extension of Final Subdivision Plat Approval (not to exceed two (2) ninety (90) day periods) is granted. 6. In accordance with the Town`s Schedule of Fees,the Owners shall be responsible for the payment of all application review fees incurred by the Planning Board in review . of this Project which are in excess-of the application review fees paid by the Owners to-date. Such fees shall be paid within thirty (30) days of the notification. to the. Owners that such fees are due. If such fees are not paid within this thirty (30) day period and an extension therefor has not been granted by the Planning Board, this resolution shall be rendered null and void.Refunds of any remaining funds within the' escrow account for the applications will not be made until six (6) months after the filing of the-subdivision plat: 4 of 6 THOMAS SUBDIVISION RESOLUTION OF PRELIMINARY AND FINAL SUBDIVISION PLAT AND WETLAND PERMIT APPROVALS 7. The Planning Board Chairman shall endorse a copy of this resolution certifying its correctness. The Owner and Applicant shall also sign a copy of this resolution after it has been initially endorsed by the Chairman acknowledging receipt of a copy of the resolution. When all of the conditions set forth in the conditions above have been satisfied, a copy of the final subdivision plat, revised as necessary, shall be submitted for endorsement by the Planning Board Chairman, certifying that the plans comply with the terms of this resolution, at which time, the Chairman shall also endorse this resolution in the space provided below, certifying that the Owner and/or Applicant have complied with the above conditions of approval and that the Final Plat is authorized for filing with the County Clerk,Division of Land Records. The question of adoption of the foregoing resolution was duly put to a vote on roll call, which resulted as follows.. Victor Fanuele,Chairman Voting: William Kickham Voting: Marsha Leed Voting: LoriMcElduff Voting:avW�Zt- Eugene Pinto Voting: Robert L. Valdati Voting: June Visconti Voting The resolution is hereby duly declared adopted. Dated:January 21,2009 Wappingers Falls,New York �,,ex Victor Fanucle,.Chairman Date Town of Wappinger Planning Board '71110q Frederick Thomas,the "Applicant" and"Owner" Date The following endorsement hereby confimis that the Owner and/or Applicant'have fizlfilled all of the conditions of this Resolution of Preliminary and Final Subdivision Plat Approval and authorizes the filing of the Final Subdivision Plat with the County Clerk; Division of Land Records- 5 of 6 THOMAS SUBDIVISION RESOLUTION OF PRELIMINARY AND FINAL SUBDIVISION PLAT AND WETLAND PERMIT APPROVALS "Z Victor Victor Fanuele, Chairman Date Town of Wappinger Planning Board 3:\D0CS215001Wappinger\Thomas Sabdivision.794.prn(p+fl:euk.doo 6of6 VERGILIS, STENGER, ROBERTS, DAVIS & DIAMOND, LLP ATTORNEYS AND COUNSELORS AT LAW GERALD A.VERGILIS* 1136 ROUTE 9 OF COUNSEL: KENNETH M.STENGER WAPPINGERS FALLS,NEW YORK 12590 KAREN MacNISH ALBERT P.ROBERTS LEGAL ASSISTANTS: THOMAS R.DAVIS STEPHEN E.DIAMOND**** (845)298-2000 AMY E.DECARLO JOAN F.GARRETT** FAX(845)298-2842 MARIA L.JONES SANDRA A.OAKLEY KEVIN T.McDERMOTT -kvww.vsrp.c0m SARAH SALISBURY ANGEL 1.FALCON e-mail: info@vsrp.com CLOSING COORDINATOR: ANTHONY M.DEFAZIO*** SUSAN E.CAFFLNE JAMES P.HORAN*** LISA M.COBB POUGHKEEPSIE OFFICE M.ELLEN O'SULLIVAN 276 MAIN MALL P *ADMITTED TO PRACTICE OUGHKEEPSIE,NY 12601 IN NY&FLA. $45 452-I045 ) "ADMITTED TO PRACTICE NEWBURGH OFFICE ADMITTED TTO PRACTICE IN NY& 372 FULLERTON AVENUE *** O IN NY&NI NEWBURGH,NY 12550 ****ADMITTED TO PRACTICE (845)567-3783 IN NY,FL&MA October 29, 2009 c�+ # Hon. John C. Masterson, Town Clerk RECENED Town of Wappinger OCT 3 0 20 20 Middlebush Road Wappingers Falls,New York 12590 TOWN Re: Thomas Subdivision File No. 12949.0531 Dear Chris: I enclose herewith the Title Certification and Judgment Affidavit along with the deed and accompanying TP-584 and RP-5217 in connection with the transfer of the Riverview Drive road extension. This Title Certification should be kept together with the deed and map in anticipation of the Town Board accepting same. Very truly yours, VERGILIS, STENGER, ROBERTS, DAVIS &DIAMOND, LLP a ALBERT R ROBERTS APR/so cc: Planning Board Town Board 0:1WappingerTlanningBoardlThomas1102909 transmittal letter to Masterson-deed and recording docs.doc DICTATED BUT NOT PROOF READ BY APR. WALLACE & WALLACE S//� ."w -e 299 MAIN STREET POUGHKEEPSIE, NEW YORK 12601 845-473-0900 FAX 845-473-5548 HERBERT N. WALLACE CRAIG M. WALLACE• -ADMITTED N.Y. AND CT October 5, 2009 RECEIVED Town Board OCT;3 Q 20 Town of Wappinger 22 Middlebush Road TOWN CLW, Wappingers Falls, NY 12590 Re: Offer of Cession and Dedication of Road Bed Premises. Thomas Subdivision (Portion of 197 Riverview Drive, Fishkill:AT) Dear Sir or Madam: We have had title to the above premises examined by River City Abstract and in rendering this opinion have reviewed the same and find as follows: (a) Title is clear with no outstanding liens or judgments against the premises or owners. A Judgment Affidavit is attached for an outstanding judgment against a debtor with a similar name. (b) Taxes are paid and up to date. We have relied on the title company and our review of their examination to give this title certification- Very truly yours, WALLACE & "LLACE, LLP Herbert N. Wallace HNW/dw 'OCT/28/20HAED 12:26 AM WALLACE AND WALLACE FAX No. 8454735548 P. 002 RECEIVED i,�, WOM Ak' MAVIT OGT'3 020 STATE OF New York ) WNCLEW C COUNTY OF Dutchcss �) being duty sworn;deposes and says: I am transf title to an casement from the premises known as 197'Riverview'Drive ernr� . Town of Wappurger,Dutchess County,New York. I have not been known by any other name for the past ten(10)years,other than There are no notices of nor any Federal tax claims oar liens assessed or filed against me, and no judgments unsatisfied of record entered in any Cort ofthis State or the United States; said premises are,as far as I know,free from all other deeds,leases,mortgages,taxes, a essment water charges,sewer rents Notice of Pendency,and other liens and. branm, ss � g , cy> except which is/are stated in the above-Captioned title report. No proceeding in bankruptcy have ever been instituted by or agaiwst me in any State Court or United States Court,nor have I at any time made an assignment for the benefit of creditors,nor is an assignment now in effect of the rents of said p7tcmises or any part thereof The judgments or liens,if any,retmned in the above-captioned report of title are not against your deponent but are against a person of the same or sinn"la. name and I have never resided.,worked or'done business at any of said addresses. There are no other liens or encumbrances except as stated in the above-captioned report. I am not a"foreign person" as defined in Sect. i445(f)of the Internal Revenue Code. I SHALL NOT SELL.a=,TRANSFER-MORTGAGE,AaSJ91L CONTRAC Pt EDG T lR�]�T T�YP[�TNRCA'f'E QR IN ANY WAY ENCt M BER THE SUBJECT i :_---- - ---ter.-- ==SES MUM TO THE BELODING OF llm-muz= UIV=THIS IATA RECEIVED OCT°.3 0 X09 BARGAIN AND SALE DEED WITH COVENANT AGAINST GRANT97f"9M THIS INDENTURE, made the September 25, 2009 BETWEEN FREDERICK A. THOMAS and MADELYN Z. THOMAS, of 197 Riverview Drive, Fishkill, New York 12524, party of the first part, and TOWN of WAPPINGER of 22 Middlebush Road, Wappingers Falls, New York 12590, party of the second part, WITNESSETH, that the party of the first part, in consideration of Ten Dollars and No Cents ($10.00), lawful money of the United States, 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 that tract, piece or parcel of land, lying and being in the Town of Wappinger, County of Dutchess and State of New York, more particularly bounded and described as follows: see attached Schedule A 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. a DESCRIPTION OF AN AREA TO BE OFFERED FOR DEDICATION TO THE TOWN OF WAPPINGER ALL that certain plot, piece or parcel of land, together with the buildings and improvements thereon erected, situate, lying and being in the Town of Wappinger, Dutchess County, and the State of New York said parcel of land shown on a certain subdivision map entitled "Final Subdivision Plan Thomas Subdivision, etc...", prepared by Steven J. Shaver, Land Surveyor and fled in the Dutchess County Clerk's office on _, 2009 as Filed Map No. and is more particularly bounded and described as follows: BEGINNING at point on the easterly street boundary of Riverview Drive on the west, said point also being the northerly division line of Lot No. 2 as shown on the abovementioned filed map entitled "Final Subdivision Plan Thomas Subdivision, etc...", on the south and the southerly division line of Lot No. I as shown on the abovementioned filed map entitled "final Subdivision Plan Thomas Subdivision, etc...", on the north,thence along said division line North 70°02'30" East 67.57 feet to a point, said point being the southwesterly corner of said Lot No. 2, thence through said Lot No. 2 North 70002'30" East 158.98 feet to a point, said point being on the northerly division line of lands now or formerly belonging to the Town of Wappinger on the south, thence along said division line South 43°49'40" West 113.19 feet to a point, said point being the northerly division line of lands now or formerly belong to Yatsko on the south, thence along said division line South 70°02'30" West 100.00 feet to a point, said point being the easterly street boundary of the abovementioned Riverview Drive on the west,thence along said street boundary North 46°31'22" West 55.90 feet to the point or place of beginning, said parcel of land contains 8,164 square feet of land more or less. Prepared by: Steven J. Shaver,Land Surveyor Suite 11 112 East Hook Cross Road Hopewell Jct.N.Y. 12533 April 11,2009 THOMAS ROAD DEDICATION04-11-09.doc _y M #S 1A�`��7�Il�T�S 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. Federick A. Thomas Madelyn Z Tftoma�)' IN PRESENCE OF: Acknowledgment by a Person Within New York State (RPL ' 309-a) STATE OF NEW YORK ss.: COUNTY OF DUTCHESS On the 25th day of September, 2009, before me, the undersigned, personally appeared FREDERICK A. THOMAS and MADELYN Z. THOMAS, 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 they executed the same in their capacitydes), and that by their signature(s) on the instrument, the individual(s), or the person upon behalf of which the individual(s) acted, executed the instrument. 9 11 . Uj k) (signature and office of individual taking acknowledgment) HERPERT N. WALLACE Notary Public, stnie Cf New York C C)Unt y o 3 2 Deed for Easement FREDERICK THOMAS Section 6056 MADELYN Z. THOMAS Block 02 TO Lot 706818 Town Of Wappinger County or Town Dutchess Street Address 197 Riverview Drive Wappinger Falls, NY 12590 Return By Mail To: AI Roberts, Esq 62 Middiebush Road Wappingers Falls, NY 12590 Reserve This Space For Use Of Recording Office 5 TM&l (3107) New York State Department of Taxation and Finance Combined Real Estate Recording office time stamp Transfer Tax Return, Credit Line Mortgage Certificate, and Certification of Exemption from the Payment of Estimated Personal Income Tax FMinIWI.WCjjI 11 See Form TP-5841, Instructions for Form TP-584,before completing this form.Please print or type. _ Schedule A—Information relating to conveyance Grantor/Transferor Name(if individual;last first,middle initial) Social security number M Individual FREDERICK A.THOMAS and MADELYN Z.THOMAS Ria– 5'9a 7/2.' ❑ Corporation Mailing address Social security number ❑ Partnership 197 Riverview Drive ❑ Estate/crust City State ZIP code ederal employer!dent.number ❑ other Fishkill New York 12524 Grantee/Transferee Name(if individual.last first,middle initial) Social security number ❑ Individual Town of Wappinger ❑x Corporation Mailing address Social security number ❑ Partnership 22 Middlebush Road ❑ Estatelfrust city State ZIP code Federal employer ident.number ❑ Other Wappingers Falls New York 12590 14 - 24 8 8 Location and description of property conveyed Tax map designation Address City/village Town County Section Block I Lot 197 Riverview Drive Wappinger Dutchess 6066 02 706819 Type of property conveyed (check applicable box) 1 ❑ One-to three-family house s ❑Commerciawndustrial Date of conveyance Percentage of real property 2 ❑ Residential cooperative 6 ❑Apartment building September 25, 2009 conveyed which is residential 0 3 ❑ Residentiai condominium 7 El Office building real property 4 ❑x Vacant land S ❑Other math day year /o (see instructions) Condition of conveyance (check all that apply) a. ❑x Conveyance of fee interest f.❑ Conveyance which consists of a I.❑ Option assignment or surrender mere change of identify or form of ownership or organization(attach b. El Acquisition of a controlling interest(state Form TP-584.1,Schedule F) m.El Leasehold assignment or surrender percentage acquired %) g.❑ Conveyance for which credit for tax n.❑ Leasehold grant c. ❑ Transfer of a controlling interest(state previously paid will be claimed(attach percentage transferred / oo) y Form TP-584.1,Schedule G) o.❑ Conveyance of an easement h.❑ Conveyance of cooperative apartment(s) d. ❑ Conveyance to cooperative housing p.❑ Conveyance for which exemption corporation i.❑ Syndication from transfer tax claimed (complete Schedule A Part HV e. ❑ Conveyance pursuant to or in lieu of j.❑ Conveyance of air rights or q.❑ Conveyance of property partly within foreclosure or enforcement of security development rights and partly outside the state interest(attach Form TP-584.1,Schedule E) k.❑ Contract assignment r.❑ Other(describe) For recording officer's use Amount received Date received Transaction number Schedule B., Part I $ Schedule B., Part H $ Page^?of 4 TP-584(3107) Schedule B—Real estate transfer tax return ax Law, Article 31 Part I–Computation of tax due 1 Enter amount of consideration for the conveyance (if you are claiming a total exemption from tax,check the exemption claimed box.enter consideration and proceed to Part Ill).............................. ❑ Exemption claimed 1. 0.00 2 Continuing lien deduction (see instructions if property is taken subject to mortgage or lien) ......................................... 2. 3 Taxable consideration (subtract line 2 from line 1) ................................................................................................... 3. 0.00 4 Tax:$2 for each$500,or fractional part thereof, of consideration on line 3......................................................... 4. 0.00 5 Amount of credit claimed (see instructions and attach Form TP-584.1,Schedule G) ................................................... 5. 6 Total tax due* (subtract line 5 from line 4) ................................................................................................................ 6. 1 0.00 Part II–Computation of additional tax due on the conveyance of residential real property for$1 million or more 1 Enter amount of consideration for conveyance(from Part I,line 1) ......................................... 1. 2 Taxable consideration(multiply line 1 by the percentage of the premises which is residential real property,as shown in Schedule A)... 2. 3 Total additional transfer tax due*(multiply line 2by 1%(01)).................................................................................. 3. Part III–Explanation of exemption claimed on Part I,line 1 (check any boxes that apply) The conveyance of real property is exempt from the real estate transfer tax for the following reason: a. Conveyance is to the United Nations,the United States of America,the state of New York, or any of their instrumentalities, agencies, or political subdivisions(or any public corporation, including a public corporation created pursuant to agreement or ❑ compact with another state or Canada).............................................................................................................................................. a b. Conveyance is to secure a debt or other obligation............................................................................................................................ b ❑ c. Conveyance is without additional consideration to confirm,correct,modify,or supplement a prior conveyance............................... c ❑ d. Conveyance of real property is without consideration and not in connection with a sale,including conveyances conveying realtyas bona fide gifts....................................................................................................................................................................... d ❑ e. Conveyance is given in connection with a tax sale............................................................................................................................. e ❑ f. Conveyance is a mere change of identity or form of ownership or organization where there is no change in beneficial ownership.(This exemption cannot be claimed for a conveyance to a cooperative housing corporation of real property comprising the cooperative dwelling or dwellings.)Attach Form TP-584.1,Schedule F.................................................................... f ❑ g. Conveyance consists of deed of partition........................................................................................................................................... g ❑ h. Conveyance is given pursuant to the federal Bankruptcy Act............................................................................................................. h ❑ i. Conveyance consists of the execution of a contract to sell real property,without the use or occupancy of such property, or Elthe granting of an option to purchase real property,without the use or occupancy of such property................................................. i j. Conveyance of an option or contract to purchase real property with the use or occupancy of such property where the consideration is less than$200,000 and such property was used solely by the grantor as the grantor's personal residence and consists of a one-,two-,or three-family house,an individual residential condominium unit, or the sale of stock in a cooperative housing corporation in connection with the grant or transfer of a proprietary leasehold covering an ❑ individual residential cooperative apartment....................................................................................................................................... j k. Conveyance is not a conveyance within the meaning of Tax Law,Article 31, section 1401(a) (attach documents supportingsuch claim)........................................................................................................................................................................... k ❑ I. Other(attach explanation) ��S�r'`..Q'�'� ................. I ❑ *Please make check(s)payable to the county clerk where the recording is to take place.If the recording is to take place in New York City, make check(s) payable to the NYC Department of Finance.If a recording is not required,send this return and your checks)made payable to the NYS Department of Taxation and Finance,directly to the NYS Tax Department, RETT Return Processing, PO Box 5045, Albany NY 12205-5045. Page 3 of 4 TP-584(3/07) Schedule C—Credit Line Mortgage Certificate(Tax Law, Article 11) Complete the following only it the interest being transferred is a fee simple interest. I(we)certify that: (check the appropriate box) 1. Fx-1 The real,property being sold or transferred is not subject to an outstanding credit line mortgage. 2. El The real property being sold or transferred is subject to an outstanding credit line mortgage.However, an exemption from the tax is claimed for the following reason: ElThe transfer of real property is a transfer of a fee simple interest to a person or persons who held a fee simple interest in the real property(whether as a joint tenant,a tenant in common or otherwise) immediately before the transfer. F-1 The transfer of real property is(A)to a person or persons related by blood, marriage or adoption to the original obligor or to one or more of the original obligors or(B)to a person or entity where 50%or more of the beneficial interest in such real property after the transfer is held by the transferor or such related person or persons (as in the case of a transfer to a trustee for the benefit of a minor or the transfer to a trust for the benefit of the transferor). F-1 The transfer of real property is a transfer to a trustee in bankruptcy, a receiver, assignee, or other officer of a court. The maximum principal amount secured by the credit line mortgage is$3,000,000 or more,and the real property being sold or transferred is not principally improved nor will it be improved by a one-to six-family owner-occupied residence or dwelling. Please note:for purposes of determining whether the maximum principal amount secured is$3,000,000 or more as described above,the amounts secured by two or more credit line mortgages may be aggregated under certain circumstances.See TSB-M-96(6)-R for more information regarding these aggregation requirements. Other(attach detailed explanation). 3. ❑ The real property being transferred is presently subject to an outstandings credit line mortgage.However, no tax is due for the following reason: A certificate of discharge of the credit line mortgage is being offered,at the time of recording the deed. A check has been drawn payable for transmission to the credit line mortgagee or his agent for the balance due,and a satisfaction of such mortgage will be recorded as soon as it is available. 4. 7 The real property being transferred is subject to an outstanding credit line mortgage recorded in (insert liber and page or reel or other identification of the mortgage).The maximum principal amount of debt or obligation secured by the mortgage is .No exemption from tax is claimed and the tax of is being paid herewith. (Make check payable to county clerk where deed will be recorded or, if the recording is to take place in New York City, make check payable to the NYC Department of Finance.) Signature(both the grantor(s)and grantee(s) must sign) The undersigned certify that the above information contained in schedules A, B, and C, including any return, certification, schedule,or attachment, is to the best of his/her knowledge,true and complete, and authorize the person(s)submitting such form on their behalf to receive a copy for purposes of recordingth eed or other instrument effecting thoeveyance. zr r 3 L_J P- Z I- <D i­ G e aTure ,-)jgn Grantor signature Title Gra6w Title Federick A.Thomas t- S -0 J Grant r signatur-e,,, Title Grantee signature Title Madelyn Z Thomas Reminder: Did you complete all of the required information in Schedules A, B, and G?Are you required to complete Schedule D? If you checked e, f, or g in Schedule A, did you complete Form TP-584.1? Have you attached your check(s)made payable to the county clerk where recording will take place or, if the recording is in New York City,to the NYC Department of Finance? If no recording is required,send your check(s), made payable to the Department of Taxation and Finance,directly to the NYS Tax Department, RETT Return Processing, PO Box 5045, Albany NY 12205-5045. Page 4 of 4 TP-584(3/07) Schedule D-Certification of exemption from the payment of estimated personal income tax(Tax Law,Article 22, section 663) Complete the following only if a fee simple interest or a cooperative unit is being transferred by an individual or estate or trust. Part I-New York State residents If you are a New York State resident transferor(s)/seller(s) listed in Schedule A of Form TP-584(or an attachment to Form TP-584),you must sign the certification below.If one or more transferors/sellers of the real property or cooperative unit is a resident of New York State,each resident transferor/seller must sign in the space provided.If more space is needed,please photocopy this Schedule D and submit as many schedules as necessary to accommodate all resident transferors/sellers. Certification of resident transferor(syseller(s) This is to certify that at the time of the sale or transfer of the real property or cooperative unit,the transferor(s)/seller(s)as signed below was a resident of New York State, and therefore is not required to pay estimated personal income tax under Tax Law,section 663(a)upon the sale or transfer of this real property or cooperative unit. s gp" r Print full name Date Federick A. Thomas 12rl.I 'A Signature Print full name Date -,I 1 Madelyn Z Thomas 12j_/05' ............ Sianature Prin fuel name date Signature Print full name l Date Note:A resident of New York State may still be required to pay estimated tax under Tax Law,section 685(c), but not as a condition of recording a deed. Part 11-Nonresidents of New York State If you are a nonresident of Now York State listed as a transferor/seller in Schedule A of Form TP-584(or an attachment to Form TP-584) but are not required to pay estimated personal income tax because one of the exemptions below applies under Tax Law,section 66,3(c),check the box of the appropriate exemption below. If any one of the exemptions below applies to the transferor(s)/seller(s),that transferor(s)/selter(s) is not required to pay estimated personal income tax to New York State under Tax Law, section 663.Each nonresident transferor/seller who qualifies under one of the exemptions below must sign in the space provided. If more space is needed, please photocopy this Schedule D and submit as many schedules as necessary to accommodate all nonresident transferors/sellers. If none of these exemption statements apply,you must complete Form IT-2663, Nonresident Real Property Estimated Income Tax Payment Form, or Form IT-2664, Nonresident Cooperative Unit Estimated Income Tax Payment Form.For more information,see Payment of estimated personal income tax;on page 1 of:Form TP-584-I. Exemption for nonresident transferor(s)/seller(s) This is to certify that at the time of the sale or transfer of the real property or cooperative unit,the transferor(s)/seller(s) (grantor)of this real property or cooperative unit was a nonresident of New York State, but is not required to pay estimated personal income tax under Tax Law, section 663 due to one of the following exemptions: The real property or cooperative unit being sold or transferred qualifies in total as the transferor's/sel lees principal residence (within the meaning of Internal Revenue Code,section 121)from - to- (see instructions). Date Date El The transferor/seller is a mortgagor conveying the mortgaged property to a mortgagee in foreclosure,or in lieu of foreclosure with no additional consideration. El The transferor or transferee is an agency or authority of the United States of America, an agency or authority of the state of New York,the Federal National Mortgage Association,the Federal Home Loan Mortgage Corporation,the Government National Mortgage Association,or a private mortgage insurance company. Signature Print full name Date Signature Print full name Date Signature Print full name Date Signature Print full name Date I -PLEASE TYPE OR PRESS FIRMLY"WHEN WRITING ON FORM INSTRUCTIONS:http:/,'www.orps.state.ny.us or PHONE(518)473-7222 '.. FOR COUNTY USE ONLY REAL PROPERTY TRANSFER REPORT Cl.SwIS Code I STATE OF NEW YORK C2.Date Deed Recorded I / / I STATE BOARD OF REAL PROPERTY SERVICESII Month Day year RP - 5217 C3.Book C4.Page I - -- AP-i217 Rev 3N7 I 4 PROPERTY INFORMATION I 1.Property li Location STREET NUMBER STREET NAME '. CIN ORTOWN VILLAGE ZIP CODE 2,Buyer T(1LTN !1'R LTARRING`ER _ Name LAST NAME;c MPArvr—"""� � ---- ---�-�� FIRST NAME I I J LAST NAME,COMPANY FIRST NAME 3.TaxIndicate where future Tax Bills are to be sent Billing if other than buyer address(at bottom of form) Address LASTNAME/COMPANY FIRST NAME STREET NUN.BFR AND STREFT NAME CITY OR TCAYN I 917— ZIP CODE 4.Indicate the number of Assessment (Only'rf Part of a Parcell Check as they apply: Roll parcels transferred on the deed I ( #of Parcels OR ❑ Part of a Parcel 4A planning Board with Subdivision Authority Exists ❑ S.Deed 4B.Subdivision Approval was Required for Transfor F-1 Property X OR ACRES 4C Parcel Approved for Subdivision with Map Provided F-1 FRONT FEET DEPTH 6.Sella THOMAS FRFF1FR Tf'Tt A Name usr NAME;COMPANY FIRST NAME THOMAS I MADELYN Z. LAST NAME,COMPANY nasi NAME 7.Check the box below which most accurately describes the use of the property at the time of sale: Check the boxes below as they apply: 8.Ownership Type is Condominium ❑ A One Family Residential E Agricultural I Community Service 9.New Construction un Vacant Land ❑ B 2 or 3 Family Residential F Commercial J Industrial 10A Property Located within an Agricultural District m ❑ C Residential Vacant Land G Apartent K Public Service 10B.Buys,received a disclosure notice indicating E] Non-Residential Vacant Land H Entertainment/Amusement L Forest that tna property''.s in an Agricultural District SALE INFORMATION 15.Check one or more of these conditions as applicable to transfer: 11.Sale Contract Date 1 6 / 9 J09 1 A Sale Between Relatives or Former Relatives Momh Day Year - B Sale Between Related Companies or Partners in Business C One of the Buyers is also a Seller 12.Date of Sale/Transfer 9 /95 / 09 D Buyer or Seller is Government Agency or Lending Institution Monro Dey Yoar E Deed Type not Warranty or Bargain and Sale(Specify Below) F Sale of Emotional or Less than Fee Interest(Specify Below) G Significant Change n Property Between Taxable Status and Sale Dates 13.Full Sale Price (.._ 0 0 1 ' ' H Sale of Business is Included in Sale Price (Full Sale Price is the total amount paid for the property including personal property, I Other Unusual Factors Affecting Sale Price(Specify Below) This payment may be in the form of cash,.,her property or goods,or the assumption of J None mortgages or other obligations.) Please round to the nearest whole dollar amount. 14.Indicate the value of personal I 0 0 I property included in the sale 3 ! e ASSESSMENT INFORMATION-Data should reflect the latest Final Assessment Roll and Tax Bill 18.Year of Assessment Fell from �I 17.Total Assessed Value(ora f all parcels in tnsfer) which information taken f f f 18.Property Class —U 19.School District Name 20.Tax Map Identdilms)/Roll Identifier(s)(If more than four,attach sheet with additional ident'dier(s)) I I I I I I I CERTIFICATION I certify that all of the items of information entered on this form are true and correct.(to the best of my knowledge and belief)and I understand that the mating of any willful false statement of material fact herein will subject me to the provisions of the penal Iaw relative to the making and filing of false instruments. PfIrTBUYER BUYER'S ATTORNEY Lt1 Ate. Roberts Al BUYE.SIGNATE_ DATE LAsr-Me FIRST NAME 00 M I Jd l e b u s 'h EcI . 8,45 09 8 O00 j STREET NUMBER STREET NAME RAFTER SALE) AREA CODE TELEPHONE NUMBER apo yrs I-o-I ISI r\�Y c CIN O TO N STATE ZIP CODE NEW YORK STATE COPY tNATE Frderick.A. Thomas and Madelyn A. Thomas