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Home My WebLink AboutL 13105 P 773 1111111111111111111111111 II 11111 IIIA VIII VIII I LI I I I II I I I I I I I l l l l l l l l SUFFOLK COUNTY CLERK RECORDS OFFICE RECORDING PAGE Type of Instrument: DEED Recorded: 05/25/202. 1 Number of Pages : 7 At: 11 :22 : 41 AM Receipt Number : 21-0099632 TRANSFER TAX NUMBER: 20-33318 LIBER: D00013105 PAGE : 773 District: Section: Block: Lot: 1000 006 . 00 03 . 00 009. 004 EXAMINED AND CHARGED AS FOLLOWS Deed Amount: $1, 850 ,000 . 00 Received the Following Fees For Above Instrument Exempt Exempt Page/Filing $35 . 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 $34 ,000.00 NO Fees Paid $34 , 410 .00 TRANSFER TAX NUMBER: 20-33318 THIS PAGE IS A PART OF THE INSTRUMENT THIS IS NOT A BILL JUDITH A. PASCALE County Clerk, Suffolk County -1 2 RECORDED Number of pages 2021 Mau 25 11.22.41 All JUDITH A. PASCPLE This document will be public CLERK OF SUFFOLK COUNTY record. Please remove all L DOOO13105 Social Security Numbers P 773 prior to recording. DT# 20-33318 Deed/Mortgage Instrument Deed/Mortgage Tax Stamp Recording/filing Stamps 3 1 FEES Page/Filing Fee Mortgage Amt. 1.Basic Tax Handling 20. 00 2. Additional Tax TP-584 Sub Total Notation Spec./Assit. or EA-52 17(County) Sub Total Spec./Add. EA-5217(State) TOT.MTG.TAX 2� Dual Town Dual County R.P.T.S.A. Held forAppointment Comm.of Ed. 5. 00 Transfer Tax pGQ �1`"Iyo Affidavit • + Mansion Tax The property covered by this mortgage.is Certified Copy or will be improved by a one or two NYS Surcharge 15. 00 family dwelling only. Sub Total YES orNO Other (�, Grand Total 1 1 a If NO, see appropriate tax clause on page# of this instrument. 4 Dist.1OC, 211027513 1000 00600 0300 009004 )4 5 Community Preservation Fund Real Property P T S Consideration Amount$ I$5C7.Cy Tax Service R Agency 13-MAY-2 IIWII��I�II�I�®W�I�IWf� i i`PFTaxDue) $ c34,00) Verification - - - --- - - - Improved— Satisfaction s/D i sch a rges mproved— Satisfactions/Discharges Releases List Properly Owners Mailing Address 6 RlCORD&RETURNTO: J- Vacant Land Matthews&Ham 38 Nugent St TD Southampton, NY 11968 TD D Attn Stephen L. Ham III, Esq TD Mail to:Judith A. Pascale, Suffolk County Clerk Title Company Information 310 Center Drive, Riverhead, NY 11901 Co.Name FNT/CT www.suffolkcountyny.gov/clerk Title# 7404-010244 8 Suffolk County Recording & Endorsement Page This page forms part of the attached Deed made by: (SPECiFYTYPE OF INSTRUMENT) Elinor O Howard 2017 QPRT&Roger M Howard 2017 The premises herein is situated in APRT and Elinor O Howard individually SUFFOLK COUNTY,NEW YORK. TO In the TOWN of Southold Jeffrey S Campbell and Ellen H Campbell In the VILLAGE 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 wiih Covenant against Grantor',Acts Individual or Corporation(Single Sheet)(NYBTU 8002) CONSULT YOUR LAWYER BEFORE SIGNING THIS INSTRUMENT-THP;INSTRUMENT SHOULD BE USED BY LAWYERS ONLY THIS INDENTURE,made the 3 day of F SX6%a(� in the year 2021 BETWEEN Elinor O.Howard and Roger M.Howard,as Trustees of the Elinor O.Howard 2017 Qualified Personal Residence Trust dated May 30,2017,and Elinor O.Howard and Roger M.Howard, as Trustees of the Roger M.Howard 2017 Qualified Personal Residence Trust dated May 30, 2017,and Elinor O.Howard,individually,residing at 215 Cider Brook Road,Avon,CT 06001, party of the first part,and Jeffrey S.Campbell and Ellen H.Campbell,husband and wife,residing at 253 Musketaquid Road,Concord,MA 01742, party of the second part, WITNESSETH, that the party of the first part, in consideration of One-Million Eight-Hundred-Fifty Thousand ($L850,000.00)dollars 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 in Schedule "A" attached hereto and made a part hereof. ,o BEING AND INTENDED TO BE the same premises conveyed to the party of the first part by: 3 Deed made by Elinor O.Howard dated January 10,2018 and recorded February 28,2018 in Liber 12952 Page 90 in the office of the Clerk of the County of Suffolk;and 9+q Deed made by Roger M.Howard dated January 10,2018 and recorded February 28,2018 in Liber 12952 Page 91 in the office of the Clerk of the County of Suffolk;and Deed made by Fishers Island Utility Company,Inc.dated August 18,2010 and recorded September 30,2010 in Liber 12638 Page 909 in the office of the Clerk of the County of Suffolk. TOGETHER with all right,title and interest,if any,of the party of the first part 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 fights 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 incumbered 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. Elim O.Howard Qualifies/Pusonal Residence 7hw By:Elinor 0.Howard,Trustee – -- i Elinor O.Howard r h r By:Rogir M.11—ard,Trustee Roger M.Howard Quallff nal Res den Tr t By:Elinor O.Howard.Trustee C... By:Ro er M.Howard,Trustee FIDELITY NATIONAL TITLE INSURANCE COMPANY TITLE NO. 7404-010244 SCHEDULE A-1 (Description of the Land) For Tax Map 1113(s): 1000-006.00-03.00-009.004 AMENDED 1/28/2021 AS TO TAX LOT 1000-006.00-03.00-009.004 PARCEL 1: ALL that certain plot, piece or parcel of land, situate, lying and being at Fishers Island, Town of Southold, County of Suffolk and State of New York, being bounded and described as follows: BEGINNING at a monument on the Northeasterly line of Munnatawket Road, said monument being located 4955.29 feet North of a point which is 515.07 feet West of another monument marking the United States Coast and Geodetic Triangulation Station "PROS"; and RUNNING THENCE along said road line, South 44 degrees 19 minutes 45 seconds East, 42.47 feet to the Northwesterly line of a right of way; THENCE North 49 degrees 57 minutes 00 seconds East, 104.76 feet; THENCE North 60 degrees 53 minutes 00 seconds East, 92.29 feet; THENCE North 78 degrees 14 minutes 00 seconds East, 146.90 feet; THENCE South 68 degrees 19 minutes 59 seconds East, 31.44 feet to a monument at the center of turnaround, having a radius of 40.00 feet located at the Northeasterly end of a right of way; THENCE North 81 degrees 26 minutes 00 seconds East, 189.59 feet to a monument; THENCE South 85 degrees 36 minutes 00 seconds East, 239.85 feet to a monument at the Westerly line of Central Avenue; THENCE along said Avenue line, North 04 degrees 11 minutes 20 seconds East, 150.00 feet to a monument; THENCE along the Southwesterly line of said Central Avenue, North 34 degrees 53 minutes 30 seconds West, 92.66 feet to a monument; THENCE along said Avenue line, North 73 degrees 57 minutes 20 seconds West, 137.30 feet to a monument; THENCE still along said Avenue line, North 73 degrees 57 minutes 20 seconds West, 257.06 feet to a monument; THENCE South 27 degrees 30 minutes 28 seconds West, 180.94 feet to a monument. THENCE North 74 degrees 48 minutes 33 seconds West, 25.00 feet to a monument; THENCE South 20 degrees 11 minutes 05 seconds West, 133.63 feet to a monument; THENCE North 74 degrees 50 minutes 45 seconds West, 146.50 feet to a monument; THENCE South 19 degrees 56 minutes 15 seconds West, 216.60 feet to the point of BEGINNING. TOGETHER with a right of way for the use as a roadway over a strip of land 25.00 feet in width extending Northeasterly Commitment for Title Insurance Printed: 02.03.21 Q 01:01 PM Schedule A-1 Description NY-FT-FRVH-01030.431004-SPS-1-20-7404-010244 FIDELITY NATIONAL TITLE INSURANCE COMPANY TITLE NO. 7404-010244 SCHEDULE A-1 (Continued) from said Munnatawket Road with a turnaround, having a radius of 40.00 feet at the Northeasterly end thereof, the center line of said right of way being bounded and described as follows: BEGINNING at a point on the Northeasterly line of said Munnatawket Road, said point being located 4915.95 feet North of a point which is 476.55 feet West of said "PROS" monument; and RUNNING THENCE North 49 degrees 57 minutes 00 seconds East, 102.63 feet; THENCE North 60 degrees 53 minutes 00 seconds East, 89.18 feet; THENCE North 78 degrees 14 minutes 00 seconds East, 120.62 feet; THENCE North 83 degrees 39 minutes 57 seconds East, 50.77 feet to a center of said turnaround. THE above described conveyed tract or parcel of land is conveyed subject to the rights of others to use that portion of the right of way located on the above described Parcel. THE above described tract or parcel of land is conveyed subject to the restriction that no structure or building shall be erected on that portion of the above described parcel, located Southeasterly of the following described lines: BEGINNING at a point on the Southwesterly line of Central Avenue, said point being 5303.65 feet North of a point which is 189.03 feet West of said "PROS" monument; and RUNNING THENCE South 26 degrees 49 minutes 20 seconds West, 178.00 feet; THENCE South 81 degrees 26 minutes 00 seconds West, 260.00 feet; THENCE North 68 degrees 18 minutes 00 seconds West, 30.00 feet; THENCE South 78 degrees 14 minutes 00 seconds West, about 87.00 feet. THE above described tract of parcel of land is conveyed subject to a right of way reserved in favor of West End Land Company, Inc., its successors and assigns,for utility lines through a strip of land 10.00 feet in width, being described as follows: (Utility lines shall include water mains, electric and telephone lines or cables) BEGINNING at said monument at the center of the turnaround at the Northeasterly end of the roadway; and RUNNING THENCE North 81 degrees 26 minutes 00 seconds East, 189.59 feet to a monument; THENCE South 85 degrees 36 minutes 00 seconds East, 51.33 feet; THENCE North 26 degrees 49 minutes 20 seconds East, 247.61 feet; THENCE North 73 degrees 57 minutes 20 seconds West, about 10.18 feet; THENCE South 26 degrees 49 minutes 20 seconds West, 239.02 feet; THENCE North 85 degrees 36 minutes 00 seconds West, about 45.78 feet; THENCE South 81 degrees 26 minutes 00 seconds West, about 207.82 feet; THENCE South 68 degrees 9 minutes 59 seconds East, about 19.81 feet to the point or place of BEGINNING. THE above described tract is conveyed subject to a right of way 10.00 feet in width for electric and telephone lines, the Commitment for Title Insurance Printed; 02.03.21 @ 01:01 PM Schedule A-1 Description NY-FT-FRVH-0 1 030.431004-SPS-1-20-7404-010244 FIDELITY NATIONAL TITLE INSURANCE COMPANY TITLE NO. 7404-010244 SCHEDULE A-1 (Continued) center lines of which is described as follows: BEGINNING at a point which is located South 19 degrees 35 minutes 42 seconds West, 32.00 feet from a monument at the most Northerly corner of the above described tract; and RUNNING THENCE North 89 degrees 35 minutes 42 seconds East, about 112.79 feet; THE above described Parcel being subject to the Covenants, Conditions and Restrictions in that certain Bargain and Sale Deed dated February 16, 1965 and recorded in Volume 5708 Page 219 of the Suffolk County Clerk's Office. SUBJECT TO an easement for the maintenance, repair and replacement of underground utility services in favor of premises adjoining the above described premises on the West, said benefited premises adjoining on the West consisting of a parcel to be conveyed to Edward S. Trippe and Roberta H. Trippe by the party of the first part by deed of even date herewith, as merged with premises already owned by the said Edward S. Trippe and Roberta H. Trippe, adjoining such parcel on the West, said Easement to be ten feet in width and the center line of which to be the line of the existing utility services. Commitment for Title Insurance Printed: 02.03.21 @ 01:01 PM ScheduteA-1 Description NY-FT-FRVH.01030.431004-SPS-1-20-7404-010244 USEACKVOI47EDGAfF„VTFOR,WBrlf,OW147TH7NNEW YORK STATF.ONLY. USEACKV01VIEDG,MEWFORMBELOW WITHIN/VFW YORKSTATF ONLY: State of New York,County of )ss.: State of New York,County of }sa: On the day of in the year On the day of in the year before me,the undersigned,personally appeared before me,the undersigned,personally appeared 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 individuals)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 carne in his/her/their capacity(ies), and that by his/her/their the same in hislher/their capacity(ies), and that by his/her/their signature(s)on the instrument, the individual(s),or the person upon signature(s)on the instrument,the individual(s).or the person upon behalf of which the individual(s)acted,executed the instrument. behalf of which the individual(s)acted,executed the instrument. Notary Public Notary Public ACKNOWLEDGMENT FORM FOR USE WrTHry NEN YORK STATE ONLY: ACKv044L8DGMENT FORM FOR USEOUISIDE NEW YORKSTATE ONLr:- (New York Subseribing Winless Acknowledgment CeiTificami (Out of'Stare m-Foreign Genera(Acknou'ledgurenr Cer'runt, State of Plew�orkTCounty of }ss.: State of.Connecticut,County_of.,,�,1V-��y.�,,)ss,:AWVN JL (Complete Venue Mih State,Country,Picini e or rllunicipnlih) On the�6day of� in the year��- before me,the undersigned,personally appeared On the'210 day of January in the year 2021 be Qre me,ik urdersigncd,personally appeared the subscribing witness to the foregoing instrument,with whom I ant 11rVfr 1't%"O 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 to be the individual(s)whose name(s)is(are)subscribed to the within instrument and acknowledged to me that heishe/they executed (f the place of residence is in a cine,include the street andstreet number, the same in his/her/their capacity(ies),that by his/her/their signatures) if any,thereof);that he/she/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 underskmedin the instrument that said subscribing witness was present and saw said State of Connecticut,County of 0(:ky-P-Y-CA execute the same: and that said witness at the same time subscribed (Insert the city or other political subdivision and the state or county or his/her/their name(s)as a witness thereto. other pl ce the ackrtorvledgntent was taken). T4 n 0410 JENNA CARPENTER Notary Public,State of Connectieut My Commission Expires Sept.30 2024 BARGAIN&SALE DF,F,D W rM COVENANTS AGAINST GRANT'OR'S ACTS Tt7LFNo.7404-010244 DISTRICT 1000 SECTION 006.00 Elinor O.Howard QPRT,Roger M. BLOCK 03.00 Howard QPRT,and Elinor O.Howard LOT 009.004 COUNTY OR TOWN SOUTHOLD TO Jeffrey S.Campbell and Ellen H.Campbell, RFCORDFIJ A T REQ1,rF5T OF husband and wife Fidelity National Title Insurance Company RTTURN BY MAIL TO FIDELITY NATIONAL TITLE Stephen L.Ham,III 0 INSURANCE COMPANY Matthews&Ham 1woRPo"TED 1928 38 Nugent Street � Firleli Southampton,NY 11968 ty .Meml�rh'n,Yn,i Sm,e Lord Tetle.Asaxiarim, to U LL 0 O O z 0 0 U ra tt LL 0 W N D tr O LU U a CL x F w W N W USF.ACKNOWIF,DGME:\T FOR,748F,I w wiTMNNEW YORK STATF.OM3: USF.'ACKNOWII•AGMF.rVT FORM nFi ow iv TNINNEW YORK STATF Ow.y. State of New York,County of }ss.: State of New York,County of }ss.: On the day of in the year On the day of in the year before me,the undersigned,personally appeared before me,the undersigned.personally appeared 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 helshelthey executed the same in his/herkheir 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,the individual(s),or the person upon signature(s) on the instrument,the individual(s). or the person upon behalf of which the individual(s)acted,executed the instrument. behalf of which the individual(s)acted,executed the instrument. Notary Public Notary Public ACKVOW►F.DG.%tENT FOR.t1 FOR USF W rrH1,V Nh'W YORK STATEOrVI.Y: ACKVON7FDGmE,vT FORM FOR USE OUMOF.NEN'YORK STATE ONet': IN—York Subscribing Min—Aek— kdgruanl CrrtificatrJ JDur of Stn1e or Foreign Genemt Ackno�Id men�r Ce 7ificnr J State of Connecticut I~ounty of.VAd, ^^��.t__. PWOn State of New York,County of }ss.: -.'. Y`k� ....}ss.: Wornplere Venue awh Stare,Courury.Prorurce or Municipality) On the day of in the year before me,the undersigned,personally appeared On the2AOday of January in the year 2021 ' before e t undersagn personally'appeared the subscribing witness to the foregoing nt instrument,with whom 1 aW 6r (� personally acquainted who,being by me duly sworn.did depose and perso . y known to me or proved to me on the basis of satisfactory say that he/she/they reside(s)in 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 (ifthe place of residence is in a city,include thestreet and street number, the same in his/her/their capacity(ies),that by his/her/their signature(s) if any,thereof;that he/she/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 State of Connecticut,County of KLr-r-(brd execute the sante:and that said witness at the sante time subscribed (Insert the city or other political subdivision acid the state or country or his/her/their name(s)as a witness thereto. other ce the aeknomlec(gnlent was taken). n'la_Lor JENNA CARPENTER Notary Public.State of Connecticut My Commission Expires Sept-30.2024 BARGAIN&SALF DF.F,D wrraCOVCVA..1'7SMWNm TCRAntnk•Snr.rs TiTLFNo.7404-010244 DISTRICT 1000 SECTION 006.00 Elinor O.Howard QPRT,Roger M. BLOCK 03.00 Howard QPRT,and Elinor O.Howard LOT 009.004 COunrn'OR TOWN SOUTHOLD TO Jeffrey S.Campbell and Ellen H.Campbell, RECORDFDATREQUESTOF husband and wife Fidelity National Title Insurance Company RETURN Bl'AtA1L TO FIDELITY NATIONAL TITLE Stephen L.Ham,III INSURANCE COMPANY Matthews&Ham 1,WORPORdr£D f928 38 Nugent Street �A 0r,Fidelitynvrac/' Southampton,NY 11968 .Nemd:r P'tM•Ihh Sane(.vul Tine Auxrori W U U. U. 0 O 0 2 O ¢ O U w LL 0 W N 7 ¢ O LL W U a a N N_ W ¢ W y W ¢ INSTRUCTIONS(RP-5217-PDF-INS):www.crps.state.ny.us FOR COUNTY USE ONLYt �� Now York SmallDapattlnant of C1.SMS Code Taxation and Finance C2.Onto Deed Recorded C)ffice Of Real Properly Tax Services l Lq ati T- -7 3 RP-5217-PDF /3,C9.Batik 1 C4.Paye Real Property Transfer Report(8110) PROPERTY INFORMATION 1.Property 1/A CEN'-'RAT. AVENUE Location -9,Mk rN.ILEER 'S:FEE'—L SOUTHOLD ?-sSHERS TST.ANU 06390 -CIIT(P"'Jct, M—AUF •7PCa0E 2.Bayer CAMPBELL JEFFREY S. Name FPsi INE! JL61~K.M r•4w CAMPBELL ELLEN H. 1-1 MNEA:CW— FFEI NMF 2.Tex Ild.eatt whom future Tax B as em to be sem BIIIirg ,f other than buyer addroWai bmlom of form) VS IAMIAM PAN• n mel NME Address STPCCT NYe4NAxu lwsE C•T,ria TAw4 sort ynTnr 4.Indicate the number of As ea r mnt t I J Part 01 a Parcel (Only B Part of a Parool)Check ea they apply: Roll parole transferred on Ns Wed fi d Panels OR 4A•Plonnng Board with Subdivision Aulhol7y Exists ❑ s.Deed X OR ;i.f7'1 4B.Subelvs•dn Approval was Raqurdd Tor Transer ❑ Property •vacN-Fur Irkrw Wms film 4C.Parcel Approved fir Subdivision with,Map Provided ❑ IKYWARC 101.7 QPW1 RT.TNOR 0. S.Sallee •Ma:%MR4Aw1W1 ems•tiLNF +� -�. Nemo 9IOWAP.D 2017 Qpp.,• P.CuF.R til.• "n 7. Cheek the Select the description which most Accurately describes the 5.Ownership p f use of the property at the tans of sale: 4 TTypo Ia ConCondominiumybelow an IhaY apply: ❑ A One Fdmily RcdlkndW e.Now Construction an D Vaunt Land ❑ 70A.Property Lomtod within an Agriculture!District ❑ 108.Buyer meeived a disclosure entice Entailing thin the property is in on ❑ Agricultural Distinct SALE INFORMATION 15.Check armor mom of tlNas conditions as applicable to transfer. A Sale Between Relatwe,a Forma Rolotiva 11.S■N Contract Date 12/07/202C B Salo between Related Companies or Partners In Business. C.One man Buyers is also a Solar D.Buyer or Saver Is Govonlment Agency or Landing Institution 17.Date of Salis Transfer F.Deed Type not Warranty or Bargain and Selo(Specify Below) F.Sale of Fractional nr Less than Fed arsonist(Specify Below) •73.Full Sale Price 1,850,0 00.00 G.S.gnificant Change In Property Between Taxable Stake;and Sala Dates H.Selo of BuPnoss is Inctudad m Sole Price (Fla Sale Price Is the total amount pad for tho property including pdrsonal omparty. i.Other Unusual Factors Af ecsrio SMO Price(speedy Bolow) This pnymonl may be In tho firm M cash.other propany a goods.or the assumpt on of J.Nnno mortgagee or clime obligations)Plainer round m me aeoroar whoa closer arnalyd. • Commsnl(s)on Condition: 14.Indicate the value of pinnonsh property Included In the sate 0 .� ASSESSMENT INFORMATION.Data should reflect the latest Final Assesement Roll and Tax Bill 18.Year of Aaae vvt Roll from which information taken(YY) 20 -17.Total Amounted Valle 16,350 •1e.Property Class 210 - •19.School District learns FI SHHktS 1ST-AND -20.Tri Map li omMerayRoll Idendfler(a)fit mom than Mur,stanch sheet with additional.Identifier(&)) 100C-0Cf•.CO-C3.00-005.004 I CENTIFICATION I Codlty that all of the Items of Information emend on this form are true and correct(to the beet at my knowledge and ballen and I understand that the making of any willful false sLUmem of mwin rial fart horaln subject me to tbe ha.0f the.aenat law rNative to the making and filing of Wee Instruments. ;:EL4ER$IGNA�jBE / BUYER.CQNTACT INFOgjdATION Miami r.JPmeOon for:Y kWP.Now it Iwrm Is U.C.sarmy,eesodaann,oxv I-m l.ArR Pxk awn wiv.slab w ✓ - A4 � pony Fel a n aea tp a epem m til;th w.cove■nersmW and amid.yps or d m an e irlavkuW npomale pony who can onhewer Weston neN+ti Fo wvlsbr mW ria anirl.d.Trp&«plot tlmlfy a EFL:EP NWTLRE INIF CAMPBE_L JEFFREY S. b E:.I..T•:N H. BUYER SIGNATURE •Iwai nkrE FwirwE Lr I'/en,X —3s yl •nRE.•::h'L ':1I.IYNDa•1..•JEFR.F•.'9]wRT. FR SIGMTURE DATE 2h3 M:;SRC•^•AQUTD ROAU MWF 'STREET-W j CONCORD NA 01742 1 'GM1CR-C*% slwre •r POWE R.U.YER'S ATTORNEY HAM STEPHEN a4T—W 1 W.T n 1 I (631) _283-2400 I l AREA coal. I IIFNMFNLMMRLF.N Neal