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SY =..I;'i. U~11 oIlnl s.:..i~ DeN Wllh C"'I.:':I:U-d. .IS;"i:b.1 (]~II'''''.. .\:u InJi\i.h...I..r C":'pvl":"'u" ISlutllr.: Sh..'l:III:rooYUllJ Kl:JJ.:!1
CU~UI.T l:'OL:w. I.AWY~R BF:FURE Slc;SISG TillS 1:\lI'TW.l;MI",Sr - TillS 1:"t~"TRL:~"::"II"T SIIU":I.I) nil: li..'iJr..1I Ill" LAW\"Jo.:it.... USI.""
TillS IN'OJ.:,.,.URJo:. made the .,;.orcL UU)' ur December . in Ihe )'c.1I' Z003
1II,:TWt:t:N
I\1ICIIEI.F.NA REAI.E. individually, and as sun"""or or JAMES REALE,
I rl'sldlng at 71145 Skunk Lane, Cutcbogue. J'llew Y..rk 11935
k,l.'
ili.lrl) "f 1tll: fll:-lpo.aIl. ;.an..J
1.1:\:1),\ ,JEFFARES. ....sldlnl: at 15 Rlve"lew Court. Oakdale. :'IIew York 11769;
ROIU:RT t:. Ht:AL, residing at 1645 Louis Kossuth Ave,. 80h..mla, J'lle.. York 11716;
EI.I.E"I: POMPOI\IO. r..sidiug at 24 :'olor......d Dr,. Blu.. Point, New York 11715;
O'\RLI::I\I:: BIFONI::. rl'Slding al 21142 Rh'enid.. Dr.. Wantal:h, 1\.... York 11793:
WF.:-IOY :\'IAltAF"lJ'llO, residing at 1300 Jackrabbit Lan... P..rt Rlcb..)", Flurida 34668; and
GIJ'llA HOLLOWAY, R'Sldlnll at 62 Grandport Road. O....an ~.s.l\1al"!'illnd 21811
p:.any or the M:~\lnc.l part. ~n~
"'IT!'Iiit:SS":"H~ Ihullhe purl)' (If'he firM pan. in ,'un...id,,'r;ali,~n ur-r",'n O\)U..r..:and uthcr '..~dllabt~ con~id~rntiol\ paid hy the
poU"ty l'l"lh.... s....".ur.t.I putt. aJe.cs ~reh)' t!ralll and rcl....:bC unln the pari)' .lrl~ Mo-c.maJ pan. lhc hcin..u liiU"'\.'"C',,:~ONo and ..~illl1~ Ilf
01.... p~U"ty l,r lhe !k."\:und pun r"rC\'er.
re....rving a life estate to the pi!lrty of thefirst pi!lrt.
AI.I.lh~1 L"Crtair. pJlll. pi......:.: lor ~d..f lant.l. wilh the t'lJil~lin~.. ami Inlpru\"CnlenL'Ilhcn....1O cn.....1.L-d. "iluah.',I)'ing WkI N-in~ in the
St:t: ..\TT,\CIU:I) SCIIEl>ULE "A"
I T()(;F.THJ-:K With all riA;lu.lit!e ;.and interesl. il'ar.y. "f tin: party vrllll: IiDI ~n ot in ;.and lo un)' Sll\.!....l" and r.ws: ahuning lhe
I :lb,'\.I.:-I!"'~.rih....! pn:mi:-cl'i I.' lhe ,:enter line5IhC'n'Of; 1'OGt:TIII~K wilh the uPl:tUrlL:nanc."C1i Wld alllhc ....!Wile and riGhtll ,'If the
.,arl>'llrlh~ f1r:ot 1~U1 ill :1I:d 1.0 Nlid premu..c:o: TO HAVE '\~DTt) 1101..0 Ihe prcllliw:')' herein Kranlcd unlu lhe part)' oflhe
!,.1,'I,,:ond part. tth.: lu:il'h or :6.UCI.:I:R~ and wUiigns of lhe party of lhe SL.'Cund pun fUfC\1:r.
,\I'iU II..... l~nY ,.1' Ih.... lirsl rarl \,",wl.:'nanl!li Ihallh..: pan)' l,Ir 111... nn..l pan hw. n." "k,n". ,'r ,"urrercd wtythinl whereby Ihe SOli'"
pR.'mi!'ol.'" ha\..... ~cn in,,'umhc:rcd in any way wlualc\.c:r. !:"c......rl...'" ..fun'Sili....
A:\n Ihe puny (lrlh~ Iir!Ol pun.. In ,,'Ompllance willi Sc.:lion 13 nflhc l.icnl..aw, c....t\'cnanls lhallh..: pan)' "rille liD! pari will
r~..:~h'c lhl.: ".ll1u.idcmti'\,!l for lhi:loCODveyum.:c Wid will fluid the rig,hllo n."(.....~ivc Iouc.'h ""<IIbiderulion UlIo II. trust fund IV be applied
fir,..1 (l.r ll:I.' l'urpllsc uf 1J3)'in, the CCbI of lhe inll'n'vcmenl and will upply lbe :loWnc firsllO the puymcnl of lhc ,,:vSll,lf Ih....
:;llIIJIO\ClllCnl b".r"...... Ul'oll1g :;&11)' part (,flhc luli.ll "fthe :-ame ror an)' ulh....r I'urpn~.
"fb,,' ".ur..! '.[la11Y.' s:mll b... ,"~,.truct.l 3" if il I"l:ad "p:artles'. WhL'I",-,vcr Ih.... 1oCm.c ,,,f thi~ indenture IoU I'CLJuircs.
.' ,
. ,:..
1~ \\'I1"NI-:SS 'Vllt:KI~OF'. Ihe pllrt)' uf the- fir..l ;t:1n hail dul). execuled thi. uc.:d Ihe ..1:1)' :loll year nr!<ol. nbu\"C wrillCn.
l~ I.KI::....f_'l....: 0"';
__~7~- ~ e. <-
MICHELE:"!A REAI.E
~
., AU. that c~n~n plot. piece or i"'rcei oi ::'rid. with lh. ~uildin!l's and impro\'eml!:1ts thereon er..:ted. sitWlte,
lyinr and bcin( ilKI1Kt near Nassau. Po~nt, in the Town of Southold, County of
Suffolk and State of New York, known and designated as part of Plot
. Number 150 on a cer-tain map entitled, "Map of Nassau Farms, situate
at Peconic, Suffolk County, New York," and filed in Suffolk County
Clerk's Office March 28, 1935 in File No. 1179, which part of said
plot is more particularly bounded and described as follows:
BEGINNING at a point where the d~~ision line between plot number 150
and Lot Number 7 on said map intersects the northeasterly side of
Skunk Lane (for.merly Bay Avenue), said point of beginning being dis-
tant 400 feet westerly, when measured along the northerly side of
Skunk Lane (formerly Bay Avenue), from its intersection with the
westerly side of Pine Tree Road;
RUNNING THENCE South 75 degrees 46 minutes 30 seconds West along the
northerly side of Skunk Lane (formerly Bay Avenue), 100 feet to other
land of Petrucci;
THENCE North 02 degrees 13 minutes 50 seconds West along said last men-
tioned land 257.09 feet to land now or formerly of Garrett;
THENCE North 77 degrees 42 minutes 00 seconds East along said last men-
tioned land 23.33 feet to land now or formerly of Cordes;
THENCE North 85 degrees. 46 minutes 00 seconds East along said last men-
tioned land 66.67 feet to the division line between Plot Number 150 and
Lot No. 49 on said map;
THENCE South 04 degrees 08 minutes 40 seconds East along said last men-
tioned division line 42.85 feet to the division line between Plot No.
150 and Lot No. 7 on said map.
THENCE South 04 degrees 10 minutes 40 seconds East along said last men-
tioned division line 200.00 feet to the northerly side of Skunk Lane
(formerly Bay Avenue), at the point or place of BEGINNING.
BEING the same premises conveyed to the party of the first par~ by
deed dated November 28, 1966 and recorded in the Office of the Clerk
of Suffolk County on December 5, 1966 in Liber 6079 cp 495.
.'
iJ.'iE ,1CKJ\"OIt'U:'It";.UI!N;'I'fJ/tM lili.I.tJM" mnll.v I\'I:.~,. )"URK ST...TK(J....'I.t~
'SlaICI.r~L"""'urk.CllUnt"'lr SUfFOLK I!L.~:
On Ih.:g~:I) ~lr J)eccmher. in (he year 2003
bcJillC 1~.I!';C' un~k:l"!.i;nc'.!. p.--.,,;on:III)' i1ppc-ared
MICHF.J.ENA KEALE .
pc"lSCIl1:.dl)' known III me Clr proved b'l II1C' "" the: bu..li;i!ll of !iDLi!forill.....lI')'
C,"idc'I1I."(.'ln he I~ indl\'nluaK~) wh~c 1\311lL'"(S) e:. (are) :r.ub5cribcd 10 lhc.'
",'ilhin In!oLnllncnl an..l iu:kl'lt.\w"-.,JgL-d 1.0 me thai. heIshcIIbcy excculL'\.I
thC' Nunc in hi!Jhcrllhcir CDpa.:it)'1 ies J. and 1M' tJy hiN1lcdthl.-lr
!Ioigni.ltul'C'{SJ 011 dx: in""rulllC'nl. the individual(.!iii). ur lhc- perM", ulxm
__ hchalf uf which Ihe indi\'iuu:al(sJ :lCtfd. CKCalted the- in51ruII"iC'IU.
r IlI!LLY L _Ell. .
, -.yPu.....
f ...alN__
Q-- , In .- c:auntr
c...-.' . . 011l111ClG1l87.
...or . . ..-ApdIlIlI,lIlI"CtJ
~'Zc/1~lf
N\.' V ,q/~
..l,'/UWIn".}.:lIt...,f:'\-" "'c.HI.It FOR US,.: IVn'III,VNHW )"(JRK ST,'THO,....'.)...
IN..... ...orA, .~ ,.w"lt WII'''"" .\dIJal,,-It'llltlMlII "fo,,((",,"1
SUllL'urNtm \'urk.Cullnl),..r Iss.:
On Ihe ,by uf in Ihe YCW"
b..rnl'" 1I11.'. th,,' un&:o.i}U:..:J", 1""'1'~,nnally app..'an-.J
Ihl." 'l;ubo.c.'nhin.:. ""'11I11.'''''' to II.... r~going ilW.ruRa.."ru. wid, whom I ::un
~n;oll::ally aL-qlJi.l.ink.'\S. whu", hcing hy I~ duly swum, did c.1epo:sL.! :1nrJ
su)' that he/:llohdLhcy n",':lloidL-(SJ ill
f i/,IIt! I'ltlc.~' ry."',dJ,',,r:r!;s ;'1 U dly. ;JJ("lId&'lh~ ,,,'rn-IIJ,,J SI'HI IIIuIINr.
if ulI)'" Ilrrrrflji: Ih:n ~/,;bcll.hry knuw(5)
lU be Iht: in.JlviduaJ dcK-ribctl in anU \\otx) eJtl"C.'UIcd Ihc run:~i~
imlrumenl; ilial ~id liUbsc..TihinS WiUll:):" W:J..'I; present and HUW said
""",'(.~U1,,~ dk' :\allll:, allLl dull !>:liJ witn...."s al the ~WIJe lime liUh!l(;rihL'1.I
hi!Jhcr/lhcir mllnc:I~1 ..... a \'.llI1l'S:I 1Ik."R.'tll,
HAK(.AI~ &r SAI.f. 1>":":1)
":111 1..''''liMOCl'lC...I;.\IN!i;""ltA:''III!.1O AC"'UI
7'rrIL'vrl.
IU:AL.:
TO
JE.-FARES, HEAL, POMPONIO.
O...-ONE. MARAFIl'"O and HOLLOWAY
I'~II)I':I..IT\' NATIUN'AL Tll'LK INSURANCE
~ <':1I~1I''''N\' IIF N~:w YORK
'W' lJoa..."'.....',.."/u..'IJf
c,.w.........AI.. f'i,Mit}' ~~"
M"""',"II. _-,-,-.lrw..,",__
U,'iRACK^""Il'U'~V/.;}t.T nJIl." lJP.,WWM7THIo''' NEW}'DRA" S'rATEO^"'I.I':
Slaleul'New Yurko Cnunl)'"or
I...:
~'l~ ~~r in~~
hcli.tre IIIC. 01\: unc.lcr.-igncd", pcr'"':tl1all)" :ippcan:d
pt'r..t.H101Uy knO\\'11 tu me ur pnn.'ed 10 mc 00 the basis ,"t( 1oOllisfW:lnry
t:'\'idelK,,..lu b: the iooividuaIU..) wh<\SC ~I)l) i,,(urc. .ubscribcd k) Ihc
\\idon inslnunenl and ik"'knuwk'llUL'CIlu me that hcIsheAhcy executed
lhe 53mc In hlWcrll~ir c:apac:il)'liesJ, and lh3J: by hisIhL'dlhcir
)i~nalul\.'(5) (HI Ihc in:ilrul11CnI, the individualCs), '1r the p:1'5On upon
heh:lIf of whi..:h thl.: individunl(5) aclt:Cl. cxcculc."d lhc iruclnJmenl.
",-lC'K.\'tJII'I.ElJG.UF.AT /'-OIl..""VII U.'tJo:OUTSIIJ,.: NA'M' YOIt.K STATE 0;..'1.)':
IOMJ uf~""aI~ D' Joill.illl. r_II:'.,I....rf;"'~ (mrjk"llWl
......... ....... ................................ ..I....'
'C'''''Ilkl~ V,.,..... wllh ,s.,I&', C_uy, P,."...;...n Dr M_it:ipalir,"'
~~ ~~"Ir ~~~
bl."run: lIIe, Ihe unr.k.",ign",.,J. pcM'llally appcW\.od
11CDOI1aIly kllown 10 lilt:' or pI\.I'..'c.'fJ 1.0 In.: on Lhc boL...i,; (\( ..uisf..anry
t"vklcna: 10 be the individual()l) wht1GOC nam,,:(.M) i. (are) MJbl;cribcd 10 the:
wilton illilJUnu:nl W1d DI.,'knuwlcd.-d 10 me:' lh:u. hcJshallbey CM.'Cuted
lhc s:un&:' in hiwbc:rll.hcir ,.:up;IC'ily(iel). lhat by hislhed Ih:ir siynal.UR:'lllo)
~1 the irullUlnenc. lhe indh'idual(s). or Ihc: person upon bc.:'haIf or whic::h
lhe individual(s) ac1Cd, c:<ccucoo the: ilNl'URlCnL and tluu )iiuch individual
IIIaI.k: such appc:ar:II1C1.: bcfi.1R: 1M unc.lcrs.ilncU in lhr
I/n,<it ,., 1IJl' III",' II' tJlhr,./Jfl/;Iic.-u/ ,,,,dJcIi"'S;IH, tU'll/IIJ,' ."'Uff! "' t',II"m,"""
,'Ihl'r pldC"l.' Ilk! e.....k"uw/l...lgII/t!IIl "US '1Ikf!llJ.
I)I~'TRI(."T
Sa'"TIOS
SUleK
IAYr
Comn.,.oRTow:< SUFFOLK
HE.CORlJEUAT REQUEST OF
FIck:Ilty s.a~ Title I............ Compony ~ N.... YwI<
RATUR/II BY M....II. TO
11<I5. Ellen Pompunlu
24 Norwoud Drh'e
Blue Point. NY 11715
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Numhcl" of pay,C's
TOKRENS
S"...i.11 II
C".rClil".;ltC,.#
Pri'1r etr. #
Dc,,',1 . ~1l'rtga8e Instrumenl
Deed' Murlgagc T.." Stamp
3
I'EES
P;'I!;C I Filin2! Fcc
1.lill\l,llin~
, ..lllL
TP-5S4
Nnli.lli'ln
EA-5217ICounty)
Sub To'al
EA-5~17 (Stale)
R.P.T.S.".
.~-
Comm. or Ed.
5. ..!llL
Affu.lavit
Ccni ficd C,)py
Ke~. C:opy
Sub Tu\,,1
/:;1
O,,",r --
Grand Tutul
4
L'lt
Se".ticll1
Ulock
Real
I~'opc..ly
Ta.1I: Seryic..~
Ag.ency
Verification
04007280 1000 10400 0400 025000
.-:r--
r;,;,PDTy ~~)
\ ~(;)JIt1~\
-.....:----.
,. S;llisf;'K:lion/nls~hargC'slRC'lea$C List Prop.:-ny Owners: Mailing A..Jl!rcli~
Rfo:CORD & RETURN TO:
4'/,;1>4 rGP,{'AI2G--S
IS- ,Ri~ee.,/'ie~J ~/l'-
OItKb4le-, NY (17(..9
7
CU.:"l:UIIC
.litlco #
RECORllEr>
21)04 R:JQ 31 ()6: 20: 20 p~
EdI"3rd P. P.o:flalne
CLERK Cf'
S1JFFOLk; CQIJrlTY
L ['00012341
P 186
Nt .)4-0:5343
"-
R<<:ordinl; I Pilinl; Sunup.
Mortg.age Anll.
I. Ba....ic'l':lx
2. Acklitional Tax
Sub To\al
Spe..:. I Assit.
or
Spec. I A"''''.
TOT. MTG TAX
Dual Town Dual CounlY _
He.'" r'')fAI''PointD1cnt~
Tr.n"",, Tax !.fL-
Mansion Tall!;
v
TIle property covered by this Inotguge is
,.,r will be improved by a one ur (Wl,)
family dwelling only.
YES or NO
If NO. ~c appropriote UlX clause on
I paKe II uf this ~rumen[.
: /. -.~.C-LS
Communlt" P"""'rYutlon .und
s
Coru;idcralion Amuunt S
CI:)t" Tux Due S
::---
I mprovcd V"
//./ Vacant L::md
TD
{// TO
TO
Title Cumpuny Inronnlllion
This page fonn$ pari of the attached -..tl~ed
8 Suffolk County Recording & Endorsement Page
m3dc: b)':
(SPcCII'Y TYPE OF INSTRUMENT)
R....\I!"
The prcmisi", herein is situated in
TO
SUI'FOLK COUNTY. NfiW YORK.
In the Tuwnship ur Southold
.n:FFAliI~.nt;AI.~IPONIO 8J1o"ON~' III ,he VILLAGE
MARAFI"O and HOLLOW A 'V or HAMI.ET or t1~~ 1..Jc=.--
BOXES 6 THROUGH 8 :\1UST BE TYPED OR I'RINTED II' BLACK INK ONLY PRIOR l' ECORDlJl:G OR FILING
(overJ
1111111111111111111111111111111111111111111111111111111
1111111111111111111111111
SOFFOLK COlJNTY CLERK
RECORDS orrICE
RECORDING PAGE
Type of Instrument: DEEDS/DDD
NUmber of Pages: 4
Receipt Number : 04-0096795
TRANSFER ~AX N'D'MBER: 04-05343
Recorded:
At:
08/31/2004
06:20:20 PM
LIBER:
PAGB:
D00012341
186
District: SectioD: Block: Lot:
1000 104.00 04.00 025.000
EXAMINED AND CHARGED AS FOLLOWS
Deed AmoUJ1 t : $0.00
Received the Following Fees For Above Instrument
Exempt Exempt
Page/Filing $12.00 NO Handling $5.00 NO
COB $5.00 NO NIS SRCHG $15.00 NO
EA - C'l'Y $5.00 NO EA-STATil $50.00 NO
TP-584 $5.00 NO Cert.Copies $0.00 NO
RPT $30.00 NO SCTM $0.00 NO
Transfer tax $0.00 NO COIIIIII.Pres $0.00 NO
Fees Paid $127.00
TRANSFER TAX NUMBER: 04-05343
THIS PAGE IS A PART OF THE INSTRUMENT
THIS IS NOT A BILL
Edward P. Romaine
County Clerk, Suffolk County
.
FOR COUNTY USE ONLY
C1. SWIS Code
. PLEASE TYPE OR PRESS FIRMLY WHEN WRITING ON FORM
INSTRUCTIONS: hltp:11 wWw.orps.state.ny.us or PHONE 1518) 473-7222
1'-1,7,.3, g, g, 11
g 1 .3 /it; L/I
MQnlh Day Yur
;,&,b
REAL PROPERTY TRANSFER REPORT
w.'.....,...
)8
cz. Date Deed Recorded
STATE OF NEW YORK
STATE BOARD OF REAL PROPERTY SERVICES
RP - 5217
j-Jill'
CJ.Book I r ~UI"7 I 1C4.Pagel
PROPERTY INFORMATION
RP-s217RevJ/97
,. r:::~ I
7845
ST~EETNUM6E1I
I Skunk Lane
STIlEETNAM~
S6'(mht..b
r
llQ~"
ZIFCDE
t/'/e /4) <1 (/(=-
VILLAGE ,,':;7
Linda
2. Buyer
Name
CITY~ ~
1-JEFFARES
2~~JtE/COMPANY
3-I'a'1PClNIO
FIRST NAME
Robert fl.
Ellen
Fr~ST NAMEDarlene
Wendy
<:;i...l.
LAST r.lAME ICOMPANY 4-BlFONE
3. TilJt Jndiclitewherefl.ltureTlIx BilIs~INO
Billing if other than buyer address {al bottom of form) I 6-HOT..LOOAY
Address lAST NAME I COMPANY
FIASTNAME
STREET NUMBER ANIl STllEET NAME
CITVOATOWl'l
STATE
Z1PCODiE
4. Indicate the number of Assessment
Roll parcels transferred on the deed
# of Pilrcels OR 0 Part of a Parcel
IOn'" if Part of . Parcel) Cheek as thuy apply:
4A. PlaMing Board with Subdivision Authority Exists
48. Subdivision Approval was Required for Transfer
4C. Parcel Approved for Subdivision with Map Provided
o
o
o
5. Deed
Property
Size
Ix I
lOR I
.4 9
FRONTFEH
DEPTH
AC~ES
6. Seller
Name
XIWOOtIOOIX REALll
L/lST NAME I COMPANY
MICHELENA
FIRST NAME
indivioually, and as survi/vor
of JAMI'.S RF..Af.E
LAST NAME I COMI'ANY
~IRST NAME
7. Cheek the box below which most accurately describe. the use of the property et the time of sail:
Check the boxes below as tney apply:
8. Ownership Type is Condominium
9. New Construction on Vacant lilnd
lOA. Property Located within an Agricultural District
108. Buyer re<:eived a disclosure nOlice indicating
that the propeny is in an Agricuttural District
o
o
o
o
A~onlFamilYReSidential
B 2or3 Family Residential
C Residenlial Vacant land
o Non.ResidentialVacantland
E~Agricultura'
F Commercial
G Apartment
H Entertainment I Amusement
I ~ Community Service
J Industrial
K Public Service
L Forest
SALE INFORMATION
15. Cneck one or more of these conditions q applicable to transfer:
A Sale Between Relatives or Former Relatives w/o consideratb
B Sale Between Related Companies or Partners in BUliliness
C One of the Buyers is also a Seller
D B....yer or Sellar is Government Agency or Lending Institution
E Deed Type not Warranty or Bargain and Sale (Specify Below]
F Sale of Fractional or Less than Fee Interest (Specify Below)
G Significant Change in Property Between Taxable Status and Sale Dates
H Sale of Business is Included in Sale Price
1 Other Unusual Factors Affecting Sale Price (Specify Below)
J None
11. Sale Contract Date
'/l/a 1
Month Do, Vw
121 0,3 1 03
Monlh 0., Yu,
12. Date of Sale J Transfer
13. Full Sale Price . . n, 0 . 0 I
, , .
IFull Sale Price is the total amount paid for the property including personal property.
This payment may be in the form of cash, other property or goods. or the assumption of
mortgages or other obligations.l Please found to rhe nearest whole dollar IImount.
14. Indicate the value of pe~lllI] I ("J I 0 I 0 I
property Included in the sale, , .
ASSESSMENT INFORMATION - Data should reflect the latest Final Assessment Roll and Tax Bill
16. Velu of Assessment Roll from I 1"\'" 1"\"; 17. Totel Auessed Value lof all parcels in tren$ferl I
which information taken ~
LI. ., ("l ('I
,
18. Property Class
1/2/ .0 I-LJ 19. School District Name I
MRt:t i t:tl(~k
20. TlIlt Map Identifierl,} I Rollldentifier[sl [If more than four, attach sheet with additional identifier[.))
\.
0;6i
/000'
Section: 104
BIsek 4
CERTIFICATION I
I certify thai aD or the Items of infonnatlon entered on this form are true and correct (to the best of my knowledge and belief) and I unden:tand that thl: making
of any willful false statement or material fact herein wiD subject me to the provisions of the penal law relative to the making and filing of false instnIments.
1et: 29
BUYER
BUYER'S ATTORNEY
LASTfoIA,O,.",
(r~'
NONP,
103
RSlGNAT....RE
ELLEN POMPON 0
FIIISTN"""E
24
NorYJ'ood Drive
STREETfoIAME\~FTEIISALEJ
TElEI'HONENUMaEII
HREHNUM8ER
A~EA cooe
BJ.ue Point
CITVQRTOWN
NY
STA~
11715
11~COOE
SElLER
NEW YORK STATE
COPY
II.
12/ 03 /03
SElL.ERSlGNATUIlE
MICIIELF:NA RllALll
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