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Home My WebLink About24957-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-26984 Date: 03/13/00 THIS CERTIFIES that the building NEW DWELLING Location of Property: 1155 WELLS RD LAUREL (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 126 Block 8 Lot 25 subdivision Filed Map No. -- Lot No. -- conforms substantially to the Application for Building Permit heretofore filed in this office dated MARCH 26, 1998 pursuant to which Building Permit No. 24957-Z dated JUNE 15, 1998 was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ONE FAMILY DWELLING WITH ATTACHED TWO CAR GARAGE, FRONT & REAR PORCHES AS APPLIED FOR. The certificate is issued to O'CONNOR & DOROTHEA CLARKE (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL R10-98-0020 ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED 96687 01/06/00 DENNIS FRANKS Ol/13/oo 12/04/99 ~gnature Rev. 1/81 FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Hall Southold, N.Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) PERMIT NO. 24957 Z Date JUNE 15, 1998 Permission is for : hereby granted to: O'CONNOR & DOROTHEA CLARKE 137 TREE ROAD CENTEREACH~NY 11720 CONSTRUCTION OF A NEW SINGLE FAMILY DWELLING WITH ATTACHED TWO CAR GARAGE~ FRONT AND SIDE PORCH AS APPLIED FOR. at premises located at 1155 WELLS RD LAUREL County Tax Map No. 473889 Section 126 Block 0008 Lot No. 025 pursuant to application dated MARCH 26 1998 and approved by the Building Inspector. .Fee $ 891.00 Application Fee +75.00 966.00 -Building Inspect~ Rev. 2/19/98 ORIGINAL Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HAfLL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY This application must be filled in by typewriter OR ink and submitted to the building jinspector with the following: for new building or new use: i. Final survey of property with accurate location of all buildings, property lines, ~2 streets, and unusual natural or topographic features. · Final Approval from Health Dept. of water supply and sewerage-disposal(S-9 form). ~3. Approval of electrical installation from Board of Fire Underwriters. ~4· Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of 1% lead. 5. Commercial building, industrial building, multiple residences and similar buildir and installations, a certificate of Code Compliance from architect or engineer responsible for the buildi~g. 6. Submit Planning Board Approval of completed site plan requirements. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings an '!pre-existing" land uses: 1. Accurat~ survey of property showing all property lines, streets, building and unusual natural or topographic features. 2. A properly completed application and a consent to inspect signed by the applicant If a Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. Fees 1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00, Swimming pool $25.00, Accessory building $25.00, Additions to accessory building $25.00. Businesses $50.00· 2. Certificate of Dccupancy on Pre-existing Buildin~ - $100.00 3. Copy of Certificate of Occupancy - 4. Updated Certificate of Occupancy - 450.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 New Construction...!/. ...... Old Or Pre-existing Building .......... Location of Propert House No. Street Hamlet Onwer or Owners of Property ................ ; .................................. ........ County Tax Map No 1000, Section ..... .... Block ..... ........... Lot ..... . . Subdivision ................................. ... Filed Map ............ Lot ................... Permit No....~.o..-.~ .Date Of Permit ....... Applicant. ~//~/.~.. ' App Health Dept. Approval.... ......... ... . Underwriters roval ...................... Planning Board Approval .............. ... .... ... Request for: Fee Submitted: Temporary Certificate ......... .. Final Certicate ........... APPLICANT Town Halt, 53095 Main Road P, O, Box 1179 Southo~d, New Yo~ 11971 (516) 765.1823 Telephone (516) 765-18o2 OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD C E R T I F I C_~_A T I O N Owner: ~--~-~,. ,~ (please print) (please prtn ) I certify that the solder used in the water supply system contains less than 2/10 o~ 1% lead. sworn to before me this ~ day of county ~ ~LLL~ NgTARY PUBLIC, Sta~e of New No. 5~6~758 ~ion Expir~ March F1ELD I::S~ECT~ON FOUNDATION ( FOUNDATION (2nd) ROUGH FRAME & .?LUMBING' INSULATION FER N. Y. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: Topaz Abstract Corporation I 199 Age~t for ' ~ ~i~i' BLDG DEPT. First Amertcan Title Insurance Company of N~r~w~~ OF SOUTHO~ 370 Old Cou~t~j Road, Gard~ C~ty, N~o York l I530' Phone: (516) 742-8840 F~: (516) 294-5227 -~ . TOPAZ ~ST~CT CO'OPTION Agent for: First ~erican T~tle Insurance Company of New York does hereby certify to: TOWN OF SOUTHOLD THAT it has caused a Search to be made in the Office of the Clerk of the County of Suffolk, in the State of New York, against the premises described herein and premises adjacent thereto on all sides from 11/13/57 to date to ascertain the fee chain of title respecting said premises describe herein and the premises abutting since 4/16/79 and has found only the returns as set forth herein on the following pages as they bear on record title; and DOES certify that "the owners of the premises described herein have owned the same in single & separate ownership as defined by law during this period of time, except as otherwise shown herein". THiS Company's liability is limited to One Thousand (1,000.00) dollars for negligence only. NO Policy of insurance is to issued hereunder. rSTRACT CORPORATION or: ~ ican~itl~ ~ Company of New York / J~e~h In.travaia / ~ce President ' ~Title No. Topaz 23897 Dated: 3/11/98 PREMISES UNDER EXAMINATION: District 1000, Section 126.00, Block 08.00, Lot 025.000 Katharine Baylis Tuthill to Louis A. Manzione NOTE: Louis A. Manzione died 2/26/96. Casazza was appointed an Executrix. Virginia Manzione Casazza as Executrix of Louis A. Manzione to O'Connor Clarke & Dorothea Clarke, his wife LAST DEED OF RECORD Dated: 11/13/57 Rec'd: 11/13/57 Liber: 4390 cp 586 Virginia Manzione Dated: 9/20/96 Rec'd: 10/3/96 Liber: 11795 cp 474 PREMISES ADJACENT WESTERLY: District 1000, Section 126.00 Block 08.00, Lot 026.000 Vincent Mangiamele, devisee under the Last Will and Testament of Carmela Mangiamele to Dominick Mangiamele Madaline Mangiamele, Dominick Mangiamele Madeline Mangiaraele, to Mohring Enterprises, & his wife & his wife Inc. Dated: 4/18/79 Rec'd: 5/11/79 Liber: 8623 cp 362 Dated: 5/28/91 Rec'd: 6/12/91 Liber: 11277 cp 400 Mohring Enterprises, Inc. Dated: 8/14/91 to Rec'd: 8/28/91 Leslie J. Bauer LAST DEED OF RECORD PREMISES ADJACENT SOUTHERLY: District 1000, Section 126.00, Block 08.00, Lot 024.000 Francis J. Van Manen & Lillian M. Van~Manen to Thomas Sledjeski & Joan Sledjeski, his wife LAST DEED OF RECORD Dated: 12/20/67 Rec'd: 12/29/67 Liber: 6280 cp 257 ~e~h Intravaia Vice President Dated: 3/11/98 PREMISES ADJACENT WESTERLY: District 1000, Section 126.00, Block 08.00, Lot 005.000 Katharine Baylis Tuthill to John A. Hawkins & Muriel I. Hawkins, his wife Dated: Rec'd: Liber: 1/4/58 1/9/58 4413 cp 517 LAST DEED OF RECORD PREMISES ADJACENT WESTERLY: District 1000, Section 126.00, Block 08.00, Lot 006.000 Frank Zambriski & Viola Zambriski, his wife to Philip J. Loria & Heather Loria, his wife Dated: 10/5/72 Rec'd: 10/16/72 Liber: 7262 cp 358 Philip J. Loria & Heather Loria, his wife to Michael J. Sweeney & Nancy J. Sweeney, his wife Dated: 12/3/82 Rec'd: 12/21/82 Liber: 9288 cp 11 LAST DEED OF RECORD PREMISES ADJACENT WESTERLY: District 1000, Section.126.00, Block 08.00, Lot 007.000 Aldo Fessia to Paul J. Majeski & Susan M. Majeski, his wife Dated: 6/30/78 Rec'd: 7/5/78 Liber: 8455 cp 25 LAST DEED OF RECORD PREMISES ADJACENT EASTERLY: Wells Road T'~ )h' Intravaia ce President Dated: 3/11/98 '- .... ~ONG ,.ISLANDi. ELEC~RICAL INSPECTiON~(S ~ERViCE, · j570 MJd'~le~C~ant. r~/RogO' Saint.{dm, es, Nh;;'I 1780 % r ' '"' ?';:"'r~l:'(5i~. - 265L3075 : ' : 2/;0'4/99 ,- ,, '. Application No. oh:FH,. 96687' ; ,, · ~r,,~,No., 24957, , HARTIL CONTRAC~'ING, ' ,'1155' WELLS, ROAD ' ' ,3, LAUREh , int~follow~glo~tio~; $ B~e~ D ]¢tkl. $ 2Mrs, ~ out~i~e ~c.~ 126 Bilk '8 , ' equ~p~nt are m *m~rd co~ttton. *y~ ' ~ , , , ,;' , , , , ,,-, : ~ ,Ihs ~mJs~tlnl~d,,~ ST. JAMES, NY 11780' :I,IC¢i'~68-E ' ' ~ ,., =}} ............. "-WHEe-ORIGIN~ Y'.",'~[~W-. ONDIP~CO~L ~K':A~Y. ~-O~COPY , 765-1802 BUILDING DEPT. INSPECTION [ ~ROUGH PLBG. DATE INSPECTOR FOUNDATION 1ST [ ]/,~0~UNDATION 2ND [ ] INSULATION [//']"F.~AMING [ ] FINAL / [ ~/~ FIREPLACE & CHIMNEY REMARKS: /~ ~,~C-M__/,5' 765-1802 BUILDING DEPT. [ ] INSPECTION FOUNDATION 1ST [ ],~ROUGH PLBG. [ ].~JJNI~ATION 2ND [ ] INSULATION [ ~' FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS'- ~-~~ ~. ,INSPECTOR [ ] FOUNDATION 1ST [ ] FOUNDATION 2ND [ ] FRAMING 765-1802 BUILDING DEPT. INSPECTIO : [ ] ROUGH PLBG.~) [ ]INSULATION [ ~FINAL FIREPLACE & CHIMNEY ~ - :~/ I ~ ~-.~ ~ I /I ,6/{ 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] FOUNDATION 2ND [ ] FRAMING [ [ ] FIREPLACE & CHIMNEY REMARKS: [ ]ROUGH PLBG. [,~ULATION ] FINAL DATE INSPECTOR ~*~~~ 765-1802 BUILDING DEPT. INSPECTION [ ] FO~TION 1ST [ ] ROUGH PLBG. [ ~] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ]FINAL [ ] FIREPLACE & CHIMNEY REMARKS: ~- /~ DATE~*~///~//~ ,*SPECTOR~~ /~' 7GS-1802 BUILDING DEPT. SPECTION [ "] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FI:LAMING [ ]FINAL [ ] FIREPLACE & CHIMNEY DATE ~d~ ,NSP 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION2ND [ ]~ATION [ ] FRAMING [,-*'~ FINAL ~ [ ] FIREPLACE & CHIMNEY REMARKS: DATE //~/~,~ INSPECTOR DESIGNATION Dm. 1000 Sec, 126.0£ B~. 08.00 Lot(~):025.00 ." SPANO Form 800SAW --Executor's Deed--IndlvlSu~l or Oorpor~tlon (single sheet) GONSULT YOUR ~ER BI.RE SIGNING THIS INSTRU~NT~YHIS INSTRUMENT SHOULD BE USED BY ~ERS ONLY. ~'ilSll~)~.N'llJ~made*hezA~St4q ~yof September ,ni~em hun&~ and Ninetyslx ~ VIRGINIA MANZIONE CASAZZA residing at 3884 Paddrick Drive, Tallahasse, Florida 32308 ecutor of the k~t wffi and testament of LOUIS A. MANZIONE , ~te of Queens County, State of New York who died on the 26th day of February , rdneteen hundred and Ninetysix party of the first part, O'CONNOR CLARKE and DOROTHEA CLARKE, his wife, both residing at 137 Tree Road, Centereach, New York 11720 party of the s~ond i~% V~ITN~ETI-I, that the party of the first part, to whom letters testamentary were issued by the Surrogate's Court, Queens County, New York on May 2 0, 19 9 6 and by virtue of the power and authority given in and by said last will and testament, and/or by Article 11 of the Estates, Powers and Trusts Law, and in consideration of Fortyfive thousand ($45,000.00) dollars, paid by the party of the second part, does hereby grant and release unto the party of the second part, the distributees or successors and assigns of the pa~y of the second part forever, ALL that certain plot, piece or parcel of land, with the buildings and improvements thereon erected, situate, l)~ngandbeh~kke at Laurel, Town of Southold, Suffolk County, New York, bounded and .described as follows: BEGINNING at a mc~ument on the westerly line of Wells Road, 350.0 feet northerly along said westerly line and the extension southerly thereof from the extension easterly of the northerly line of Albo Drive from said point of beginning; RUNNING THENCE south 69 degrees 13 minutes 10 seconds west 160.0 feet to a monument and land of Jas. Dunne; THENCE north 20 degrees 46 minutes 50 seconds west 200.0 feet to a monument; THENCE north 69 degrees 13 minutes 10 seconds east 160.0 feet to a monument on said westerly line of Wells Road; THENCE along said westerly line of Wells Road south 20 degrees 46 '%. minutes 50 seconds east 200.0 feet to the point or place of ~ BEGINNING. BEING AND INTENDED to be the same ~rs~;~/~ prem~s ~.sA_7~ to Louis A. Manzione recorded ~n Liber 4390 cp 586. TOGETHER with ail right, title and interest, i~ 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 also all the estate which the said decedent had at the time of decedent's death in said premises, and also the estate therein, which the party o{ the first part has or has power to convey or dispose of, whether indlvld- ually, or by virtue of said will or otherwise; TO HAVE AND TO HOLD the premises herein granted unto the party of the second part, the distrlbutees or successors and assigns of the party of the second part forever. IIAND 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. Subject to the trust fund provisions of section thirteen of the Lien Law. The word "party" shall be construed as if it read "parties" whenever the sense of this indenture so requires. IN WlTNES~ I;~-IERF.,OF, the party of the first part has duly executed this deed the day and year first above as~EIxeNIcuAt o~rN~O~e CEAsS tAaZ ~f 6) of LOUIS A. Y~NZIONE ,~.~[~ ' FOR~ NO. I 3 SETS OF PLANS ............... TOr~N OF SOUTII~OI,D SURVEY ........................ BUILDING DEPARTHENT CIIECK ......................... TONN HALL SEPTIC FOI1H ................... SOUTHOLD, N.Y. 1197 I TEL: 765- 1802 NOTIFY: ~ CAS ....... - ....... ~... ' '~'~'~~. .... . ~qq~ ~ .................... .: ............... . .................................... [ [ ~, I /A~I, IC~'ION FOR BUILI)ING PERHIT flLDG. DEPT. ~:~ Date ...... ~ ...... 19..L9 a. 'lhis application mint he canpletely filled in by typewriter or in ink and anl~nitted to the Padlding Inspector 3 sets of plana, accurate plot plen to scale. Fee according to smhedule. b. Plot plan aho~ing location of lot and of buildings on premiaes, relationship to adjoining premises or streets or areas, ,and giving a detailed description of laycait of property ,nat be drawn on tim diagran ~hid~ is part of this application. c. 'lhe ,~,ork covered by this application may not be tormented before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issue a Building Penait to the applicant. Such permit shall he lmpt en the premises available for inspection thrcughout the ;~ork. e. Bo building slmll be occupied or used in ~nole or in part for any putl~ose ~atever until a Certificate Oceepaocy ahall have been granted by the Building Inspector. AI'PLICATIClq IS 1~ ~ to the Building Departraent for the isseauce of a lluilding Pemit parsuant to the Building 7~ona Ordinance of the Toan of 8oothold, Suffolk County, New York, and other applicable Laws, Ordinances or ~S~-ulatlons, for the ccuatumtlon of Buildings, additions or alterations~ or for rc~a~al or demolition, as herein cril~l. Tim applicant agrees to cc~nply with ail applicable la~s, ordinances, Building code, housing cede, aM regulations, mvJ to admit authorized inspectors on premises and in building for necessary inspections. /a (Signature o[ applicant, or l~ae, if a corporation) (l~ailing 'a&lreas of applicant) U'~ State ~hetber applicaat is ma~er, lessee, agent, architect, engi~eer, ge~eral contractor, electrician, lfluaber or Buihler. pr,ise, .... ..... ......................... (as an tbe tax roll or latest deed) If ~py~lcati~ is a]curparation, signatnre of duly anttvarized officer. (~ne ~ad title of corporate officer) Builders I.icense Bo .......................... Plumbers License Bo..· J{~.~...~.~. ............ Electricians Licerma No...~.'J.O.~).. Z ~ ..... i. l~ation o~ l~,~ ~ ,a, icl, pr,,o~ ,,,~k will he aox........ .... ¢~.k ............. ..... ...... D.c ................. ..................... llouse Nunt~er Street ll~alet c~,ty T~ mp Bo. ,a~ s~tian ...1~..' ..... Rlock .... 0% ..... ... ~t .... O/~..~ .... Sulxlivision ............................. Filed 14ap Bo. l~t 2. State existing use and occupancy oE premises 'and intended use m~l occupancy of proposed construction: a. ¥~xisting ime ami eecupancy ........................................................................... . . b. IntervJc~l use and occupancy ............................................................................. ~. ~mnm of~ work (d~k which applieoble): ~ l~fildi~ .......... i~i~ .......... O~rip~i~) ,,. ............ .............................................. (t:o Im ~id ~ filing tlHs a~licati~) 5. If ~kmlling, ~,Imr of ~lli~ units ..... .~ ...... tt~iimr o[ (trolling traits ~m each ~r ................ If gnr~ge, ~Imr of cars ............ ~ ....................... 6. If Ixmhmss, ~rcial or mi~ ~oqm~, s~ei~ ~ture a~l ~tent of ead~ ty~ o~ u~ ...................... 7. I)i.~nsi~m of ~isting stnmmres, if any: ~t ................ ~ar ............... ~pth ................. I~i~t ~lmr of Stories Dinenaiam o~ sam atnm~re .ith alteratimm or ~Mitiona: Front ............. ~pth. ................ ILIJlL ........... . ~1 ~limrll off Storms~ ........ ~ ~ [~'1-- :..t.. ' ...... q ~/ Ii' I~i~lt ......................... ,~a~ ~1 ~ ~ ~ .~ ~i~~"tmr of Stories ..... ] ................ I I. ~m or u~ dlstrlet in ~id~ prmi~ am si=t~ .............................................................. 12. ~s propel c~st~ti~ violate any ~i~ 1~, o~i~me or regularly: ........................ I]. ~ill lot Im r~r~ .................... ~ill ~e~s fill Im rm~ .... I5. 1~ fids pm~rty within ~ [~ of a riehl ~tlm~l~ * W~ .......... P1,OT D~AGRAH l~x:ale clearly and distinctly all Ixfildings, ~ltel'lmr existing or prof~l, msl i~slicnte all ~t-l~xk dimnsions frm~ pmlmrty li~s. ~i~ st~t m~l bl~k m~,imr or ~hseripti~.~ ncco~ing to ~k~l, a~ ~l~ street ,u~m8 a~l i~lieate *dmtlmr interior or co~r lot. ,ql'^ql'.; (jr iXT',M YOlk,//,.q , 7111 I ss ............. ~ ....................... I~Hng duly ~m, del~)~s m~l m~y. thor Im i. the ~ppllcant (~mm o[ i~ividtml..ignh,g ccmtract) (C~traetnr, agent,~cor~rnto o[fleer, etc.) of imid t~mr or ~mr9, at.I is duly ~mihoriv~l to ~rfonn or h~mo {mrli)rn~ I.h~ ~[d ~rk a,~l Io n~ke n,~l file thin appl icntlou; tlmt 81 [ stat~mnt, o~tah~l in I:h[s ~ppl ieatkm am trim to the Im.L off his kt~l~g~ m~ I~il. iefg taxi lhat the ~)rk .ill Im Imr~on~l in the imm,mr ~t forth ie the applic~ti~m fil~ tlmr~ifl~. ,9,~)rn Lo before nt~ tl~{~ '1 ( / JOYCE M. WiLKINS "~ Notary Publio, State of NewYork No. 4952246, Suffolk County Term Expires June 12, 19-~ REF. ONLY: I000- IZG-O8-O25 5EG. SHD. JOB 8'/31 SUFFOLK COUHq~ DEPARTMENT OF I-IEALTH SERVICF~ p]~ FO~ AP?~OYAIG O~ CONSTRUCTION 1FOR A FAR*~Yt;t/ ONLY APPKOVED. FOR MAXIM~,~ OF ._.~ BEDROOMS EXPIP~ THREE YEARS FROM DA~E OF APPROVAL I ~ hi Gg*- '-IO"E '-,/6, C d 5~_* ce ALBO DRIVE 6URVEY OF' PROPERTY Situated q! SMITH ~ dUI, lO .... __ -protessionaT Latld 3urvFy~e I~0 MEDFORO AVE. PATCHOOUE~N,~ Phone 47~-3t92 SURVEYED: DECEMOER IR. ~997 RMR I.~LAIdD ESTATt~,S REF. ONLY: I000 50' / SURVEY OF PROPERTY Situated of 3urv,~a b~ LAUREL SMITH ' PATCHOOUE~N.~ SCALE: I"" 40' Phone 3UrVC~ CCr~i~t'cd lO: DOROTHEA OLAR~E [7~TLfl~ :AS,SLII~EO O'CONNOR : O/ P: ~OJ M 4.I. N fl O 3 ,~'70.,-td f)~ Q '7 O H .L n O ¢ .do NM '7 u n v'l AJ. H2dOHd .qO A3A SOg 3 A I bl d O Et "I V L, OI ..q~ tis I'~' l REF.,ONL¥: I000- 12-,~-08-025 ~E~ SHD. dO~ 8'/'/! I ~ ~ ~ ~ o . , '' o'"~~ ~ ~ ~ ~ ~' . . ~ ~ . 'o~,~ 5G9~13zlO'~ .1~0.00' ~ · SLEDJE~KI ALBO DRIVE ~UO VEY OF PROPERTY 5ituat~d of 3urv~d LAURELSM/TH ~ ~o~ o~ soor~oc~ .... ~~__ SUFFOLK COUNTY --Pro~,io~l ta~d *uTve~ - NEW YORK ~o MeOFOrO AVE. PATCHOOUE~N.~ 5C4LE: I" . 40' Phone 475-JI9~ 3UPVe~ Cer~i~/'cd lO: DOROTHE~ CLARKE D~TUM :ASSUMED O'CONNOR C~RHE DATE3 ~UBVEYEO:DECEM~ER 18,1997i OOLY 7, tgeZ i