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HomeMy WebLinkAboutL 12338 P 20 . L );l )'~ ?- f 0 ~(J I Lf4 - s- -)) NY 005. R:U-C;lIn and Sale D...-ed 'l11.-ilhCovl.-n:lnI..:ai:al1 Or:anll,...... Acu, In.bviLlual urCOI~oJ:l <<Sill.le Shn:IJ I ""YBl U SUII:!) CO:"lSUI.'" l"UUI.c I.AW\'I':H KF....UHEsn;SING '1111S L'Ii':,-rRUlll-:".". nlls ISS"KU~IIo;"T SIIOll(.U III,: ll~F.U II'll' I..\WY~I(S U'I.\" TIns I""DI-;~"UKI':. rT..10e Ihe ,,,"'!!. cuy vf Augus t: , in I:~C YC;IC 2004 UETWEEI'i JAMES f. ~EEfUS, JR.. residing lit 3680 Paradi>c Poill\ Road. P.O. Box 505, Southold, New York, 11971, party of the first par., and L1ZBETH:'vI. ~EEFlJS, residing at 2.J0 West 7Jrd Sm'cl. Aparuncm lOll. New York, New York, 10023, pan)' of Ihe second pan.. \VITNI-.:......"..:rll.lhullhc IJ3.rly of the: Jirs, pOlrl. in "','n,,,"Jcr:.llinn orTen DuUurs um.1 mtk:1 \:'aluabh.. P.:tHblidcralhm )I.titl h:. I!I~' p:lny of lhe second part. dc.c~ hereby grant and reJca~ unto Ihe pan~ of the iC('(.nd po.n. the heirs 0:- \lIO:":cuor:lo :U1d O::':'lgll!_ .J! the party nf ch~ !It.~nd P.'lrl r"orcvcr, SEE SCHEDULE "Au ATTACHED HERETO AN)) MADE A I'AIH HEIU:;QF 13EING AND INTENDED TO BE the same premises conveyed 10 lh~ part)' (,flh~ tirstl"'" b~ deed dated October I, 1971 and recorded in the Office of the Clerk of the County of Suffolk 011 Oe"'~~r 12,1971 in Liber 7024 page 339. TOCI-:Tt.1o:N with 011 ri,ht, ulle :11\\1 Interest. if:.lny. or the' partyuflht fir:-I P:IIIOJ". in:.lnd lu:m)' SIIc.."Cli :.lIld ruad:. ;,lbUltilll! I h..' aoove-dt::iicritk'd rl"C'mi';C'Ilo the ccnlCT lill~ thereof: 1"O(;ETHF.K with the :spj)unenallcco;; :U1C! ~lIllhe c..',;U..h: ::lnt 11!!!!t:.l!<o.\I lb.: jJi.I:\yorlha: fan.1 pan in and toJ lt3.id premi~=-;....O HAVE ANI) 'l'U 1101.1> the preml'liC:i hcn:il: a;::nUllnl unh.thL' p:':"I). 1.11 :"~ 'il'COlld p:\J1, Ihe: he:irli or 5UCCCS50n and olliligns ur lhc: purl)' or the ~"COnd pllrt r"R:\..:r. ANI> Lhe p;lrty or thL' !ir.n pa.."1. covcnanllli that Ihe purty of the lin.t jJi.II1 ha!llUlt done nr ..:Jficred i.I:1)'I:ling. wh"::I~.hy R::..: ..!Il~ premises have been incumbC'n:d in uny WOl). \\"h:.aU:Wf, CXe:CJH a.. Ui\JI'1:."'ilicJ ,\ND the pari)' of the li~r pan. in compliance wit~ Section 13 "Cthe: Li..:nl.:l\\'. ~o\'cmll1I5 Ih..tlhe V_If'). Ortlh.' flrs.1 p,ln .".ill r""l"l:ive Ihe con:..idcr:llion for thi!li C'OIl\OCYURt:c dnd will huM (he riehllo I,.cch'c 'iu\:h c:uru.ukl :.alilJl1 01.. ;111 USI fund I,. h..: :1;'SJIh.:I: !inol :"ur the IJ!.IrroloC' of pllyin~ the C;w,1 of Lm: imprtl\'clllcJ:t i..I:c! \"II! 1IIJ'JJy Ih~ llo;n:M: Iir:.1 lu Ih.... ;:;IYIIICllI u~.I::.' ....\hot .11 :h:,: illlp:"'1.1\'euu:m. tlcru:\: u:.in:: illlY pun 1Jr" II!.: IUHlt IIr}j!c... S.I:::I.' 1",,:" any ,'Ihc.."r PUII'(lie. The wurd '.iXlfl)'" ~h~11 hl' \:un.'ilrucd :.1'1 if it reud .'(lOlrlil'S'. whl.'Iu"\,\.'r thc..' M,'I1:-L. oi 1111" in,!enlur,,' !<oIl :I.:(IIII:C:.. --- . --_/ . I~ \\'ITNt:SS \VIlEREO....\hc ;:tJriy uril;c nr:O::11t,i1:1 h:l'l..!~.lly l.~t"~t;:I.'~ Il:is I.:t:cd :!!..: ,by mill ye.l" :'"I!!<ol ;Ib.-.\ :.." ..\"1".11....1 IN I'RE.'iRS(:t: 1..-: A;~'!:~~~ l. '.'-:1: ACK.....' )\~./J;.'....;'II;..\ 7'FnR.U 11Ii.I..IJIt" \1111/I,Y Np'n" )'(JHIi .\"1"'21:0^,U": !"UIlt'flrNt-""'nrk.Connc"lIr Suffolk ) Mi.: Olll~ \~y "r ~\ugust in Ihe yc;u 2004 b::,f:lre 111t'. IhC' l.:n~c".iGned. rc~n.llnnlly aPI"C:trOJ James F. NeefuR, Jr. . i'":~n:d}y l,;no\\"n 1t' lIle nr J':'tn'L"t1 In 11M!' C1Q the bibil' I~r ,"'\li,.r~IOry t';';.:cnc.:..: (",he Ib,," iIlLli,,'uh:al(Sl w~.....: nU:':1:t'I~) i" (lire) !ouf',,,,,'ri~"(1 :1' Ihl' \, il!:h i"=-;.I~:r.:':l1I :;u:o! m.'l..11I1W:;:d!;I'I! ICI me' I~::'l hclsht"Il:,.,'y c"'c."('~:b."C.I lh.: :-:Ulk: in hlslhcrllhCII ,:"p;l.:ilytlC.OC). and th:n by hi5l'hcrllbcir ..ipl.ItUI\.1~) on (11(' In!otrunlCnl 1111: individuill(J.J. t'r lhe ~nllm illX'" :.~Irll( which the Indi\'i~u~I(J.) Xle-.J. n\."('uIOO lhc in,:tnJlnenl. EDWARDJOHNIOYD5~ ry Public SbIo at Now Vork 021100376625 Sullalk County Commission Expires Aprtl 30, 2OOq.. ,'\CA',\'OU/JUHi,tI';XrPfJRM ~"It U.....I;. W,nw,.' Nit\\" "n"K.~TAn-; 0.'\'1.)'; !s..... "U,( .'iI.,,.,,, r!&/./'l\.ulI....a Ark.'In.vlr.1rrr,.'I' C,rufl.',IIrJ ~l.Ih.' nr~e,," Ynrk. <:nlllll,' fir J SS.: ~I~ d~or in~)ew 1't.!:"II:C I1IC. I..Y undCl"iY:1Cd.I"'Cn:oo;dly 3PJ'e1R.'C.1 the ,"\Ih~,"rihinG whnCM tn the fo."'C'(:oing in.llljlrunlo;:ln. with whom lum ".::-:-onally acc:11..,inlCd. w~. bcin~ hy me duly ""'TH11, did d.:posc :md :l':t:- I!:':II ht'/ihc/lhc~ l'l,~..ide(~J in I illht. ,"!.-f;'C -U "".fif/~'/ll't' ;.0: "'" c'ity, i"dudc' 'hc' 'm.=eU and.\l''''I'' ,,,,,,,ber, if 1111.". ,1:t'IC.,!/}; Ih:l.1 hc/~'lIhc)' knQW(sl 1(' 1"(' tt.(" inc!i,'ichml tlc:sl."1;lxd in :mtl wtko, C),l.,\:ulnl Ihl.' Inn:g"illr Imlruli~r.L Ih.11 .,,-'lid ,"uI1Jl,crihina; whne!l.'I. WOI5o ~ll('!.('IU ;mll ~IW "'lid ~:('':':UIC lhe N1mC': and th.'lt ~3id WilncslIi at the "OInt' time ,"uhSC'rihed hi~lhcrlthl.~ir n.'rnc(~) :as a wilnc,:,!t mcrt"to, ".\Rt:"IS oS; S.\I,F: .)REn "" 1.,t:::,.I!....\"'I:..\I,j"IS:,I..IIA...:'('I:\.."..,,. TIT/./:.' No JANES F. :'<"!':EFUS. JR. TO L1ZDSTH ~. NEEFUS r- l FIIlEJ.ln. ~ATION^L.TITLE INSl:RANC.: ~ CO~II',\~.'I" OF NF.W YORK . W Ivr.""".",n'.'9:,1f ( 'f.A....,,;,...4I.. Fidrlit). .J6,,~ /. _...........I~'_....A,.._ I~ i :.J " e is o w c: l'i w !l l'S ~ '" o ~ iii III , i= I.~ . .. L'" U,'iH ACK.'\"(II\'I,F.'JG.\II:"T ''"(IN.'' HIU.lnr"'m,,^, I!"IiW l'OIl'...'i ''''7/:( b:,.): Slale-nfNt'!w Ynrk. (;nllnl:,.-nf I:.....: Onlhc day.)1" _ in 1111: )"":;11 bc::fl.'\f'C me, (he t1mJer..ilncd. pcr'oC1nlllly 3ppcared rCl.!'Iiionally known In me or prove'" to me Cln lhe ha..i:. IIf M111l.rltl."lrtI'Y cvidcnl."C' lu he.he il:di\'ldual(!Io1 whtJM: n:lInt..{~) I~ C3:"C'J !-uL'!..:ril......-...! If" :h: wilhi:1 in..ltunlCl~t an~ dckncm.'!edccI.IIU me It:nl hcl!:=ohcJHk:Y ~H."\.uh:l; the lIoMlC in hiw1lcrhheir t"ap.-.cirytic,,',. und Ih:u ~' IUl'J'h(olhl\\:ir signotun'(s) on thl.:' imolrUlTM:nl, the: individu3lbJ. ()I the pcr3001l lIJ'lln behalf ur which the individualb\ acted. ('}l:ccul.cd Ihe inMnl::-k'nr. ACIiI\V"'l.Ji/,c;.UF..,\prl'"UIf," nIB USI-:OL'l'SIIJI:.'N,.;u' )"(IH" Sr.'7":{),V/.,~. 10t0, O(Skllr- It. If'''''/:II C,'Irtn,/ A.~II,.\&I. .1..,..,.11' C. .,it;,~",'.1 ,C'-"""r Vrll_ wi,,. ofmlft, C""'II"}~ ,......;""'.., "'''''''';1"11,,,., ..1.....: On the da.vor in the \"('it:' tlcrol"c me, thC und~f'!Ioi.n.:d.l"Cro;anall)' aprca:'Cd . pc:Booally known to me or pro\'Cd to me on Lhc ba...is: C'r lt3lisf:"':IIIIY cvidenl."<! to be the individualUl WhnllC n:une(s) iJi (are) 'lub."lcritX'll u.. the v.-ilhin instrumem 31:1.1 ack....'wlet:.c:d 10 me thai hl.-/..h::lthcy c\.I..'c,.'';JI'',"t: .he !<IUIlK" in hivt-.crltheir CLlf,,~il)'(iC'!<I). IhMI h~ hr5W'her/lhc'l" :-il:,;lIl1ll1n:l.:-.j on lhe inSlIUII'C'Iu. l.hr indlviduul(s). or w penoon up"n hchall nl ~'hi('h lhc indivldunlls) :K'lCd. ClIIrcutoo.lhc in>lrumcnl, and lhilt "lIl..oh indivulu:tI rnade such zPJ'C:smnce before Ihr undc:n.igncd In Ihe (/n..\rrl ,ht! c:it,. or tllhcr fJtlUtir:nl.fllbdi"ision und the Slall' f'" Cflllntr'y tlr (ltller "'nce ,he U('knVU'INl,:IJV'nll""'" ,ukt.',.,. Dls.nuCT SF.c..'"TION RUl(:"K I~c.r.- COU:"oTY OR Tow;'l; 1000 144.000 05.00 027.000 Suffo~k/Southo~d RJ:.'CORlJED '" T RI::QUcS7'f IF Fidellt,., NalionnlTitle Insurance C;ompanr nr 1\1.'" \"nrk RF.rr.IRN In' MAfI.l0 EDWARD JOHN BOYD V" E::JSQ. 54655 MAIN ROAD, BOX 1468 SOUTHOLD, NEW YORK 11971 -, SCIIEDULF. "A" A LL that cenain plot, piece or parcel of land, with the buildings and improvements thereon erected, situate. lying and being al Mallituck, Town of Soulhold, County of Suffolk and State of New Vork. shown and designated as and by Ihe 1..01 No. 10 on a certuin maP emilled. "Map of Salt Lake Village." tiled in Ihe Suffolk Counly Clerk's Office on May 10, 1940 under Map No. 1310. which lot is more particularly bounded and described as follows: BEGINNING at point on the southerly side of Sailor's Needle (private) where the division line betwccn 1..01 No. 10 and Lot No.9 on the above mentioned map intersects the .outherly side of Sailor's Needle: Running thence northeasterly along the southerly side of Sailor's Needle on the arc of a curve bearing to Ihe len having a radins of 160.0 feet. a distance along said curve of78.61 to the division line between Lot No. 10 and Lot No. II as shown on the above mentioned map; Thence South 54 dellJ'C"s 40 minutes 50 second. East along said last mentioned division line, 202.68 feel to the Yacht Basin: Running thence in a general soulhwesterly direction along the Yacht Basin, 74 feetlnore or less; Running thence in a general northwesterly still along the Vaehl Basin, 100 feel more or less to Ihe division line between 1..01 No. 10 and Lot No.9 as shown on the above menlioned map; Thence North 26 degrees 31 minute. 50 seconds West along said lastlllention"d division line. 149.0 feel to the soulherly .ide of Sailor's Needle. the point of place .)fBEqINNING. TOGETHER with the private houllanding in fronl of said LoI No. 10 as sbown on said map. TOGETHER with an undivided one-twentieth (1/20) interest of, in and to so much of Lots No. 27 and 28 on "Map of Lid a Bartl"),, Mallituek, 1...1.," which map was filed in Ihe Omce of the CI"rk.of the County of Suffolk on July 27; 1922 under Number 770. as are included in th" extension of Old Salt Road from the North line of Sail Lake Village to Sail Lake Lane (s"melimes called Ro<:helle Place). subject to a right of way of other owne.. of numbered lots on tbe Map of Sail Lake Village, and prop"rty 10 Ihe North and West thereof over Ihe same and together wilh a right of way over Salt Lake Lane (sometimes called Rocbelle Place) to Bay Avenue. TOGETHER with the right of ingress and egress betwccn said lot and Salll..ake Lane (sometimes called Rochelle Plac,,) ovcr th" roads sh"wn on said "Map of Salt Lak" Village" to a width of twenty (20) feet and the ""lens ion of Old Sail R.",d 10 Sail Lak" Lan" (somelime. called Rochelle Place) and subject to the rig,ht of ingress and egress gronted or that I11::J.Y hereafter be grant~d to other owners of propeny shown on mid Map and pro~n)' to the North and \\'~stlhereofDnd together with a right of way over the palh as shown on said map from Old Salt Road to Salt Lake Village Beach and 10 Ihe usc of said beach in common with other 101 owners for bathing and boating. TOGETHER wilh the rigbl to use "The Camm"ns." Yachl Basin, Village Dock and Boat Landing, and Ih" two paths leading theretl' from Ihe nag pole circle. and subject to the use of "Tbe Commons," Yacht Basin, Village Dock and paths in eoltlmon by any and all owne.. of numbered 10ls shown on said Map of Salt Lake Village and owne.. of property 10 the North and West thereoflo whom Ihe same may be granted. TOGETHER with alllhe righe. title and inlerest of the party of tho lirst part of. in and 10 Jam.,s Creek in front of or adjoining the premises above described. S.C.T.M./I1000: 144.00: 05.00;1l27.oo0 ~2 1 Number of pages TORRENS RECORDED 2004 Au9 18 10.13.52 API Edward P. RoaIaine CLERK OF SUFFOLK COUHTY L 000012338 P 020 D1I 04-02823 Serial II G:nificale # Prior Of. H Deed I Mllrt&ag8 111Slrunu:nt Deed I Mort_e Tax St:unp FEES Recording I Filing S:mnps 4 l'llHoe I Filing Fee h lI:>ndling -~ TP-584 - - NOlation --- 1;A-52 17 (CO\,lIly) , Sob Tolal cA-5217 (Stale) -~= RJ':r.S.^. -~- Comm. of Ed. -~~ Affidavit --- ~c:nined Copy --- Rell. COP)' _LL= Sub TOIa1 Other GRAND TOTAL Mortgage AmI. I. Uasic Tax 2. Additional Tax ,#.7- Sub Total - SpecJNsit. Or Spec, I,\dd. 1'01'. MTG, TAX Dual TOWR_ Du:J.1 C LlI1lY _____ Ilcld ror ^pponionm Transfer "rax Mansion Tax. _ u_ The property covered by Ihis mo"g",,~c: is llC will be improved by a Oll~ "r tW11 i~l1:ily dwelling only. YES uc NO_ IrNO. see appropriate (:ax clause 011 pa~(" # _of this inS'nnnl"IIL /00 /~ 'I cs Keel PropnIy Tax Service Agency V...ification Disl. Section B lock Lot ConulluniLy Pn:servution F nd ideration AlnC'lInt S SIDnlp ~35012 1000 14400 0500 027000 l__. s Inilills i, hnpru\'cu X Dat. Vuctlru land 3 SatisractionslDiiCliargeslReleases-l;iifPi'opei1y UWners Mailing Add",. RECORD'" RETVRN TO: ~t:.\o,;)l'\Cb '~...:l ~'{t:> --sf' ,~ ' \?o'~D"IC \~b~ -=s;......-r""o.....t> I ~\ \,~'\ \ TO _.L/L_ TD TO 8 Title Company Information Co. Name Tltle;1 9 Suffolk- Count Recordin & Endorsement Pa e ~~ (SI'EOFYTYI'EOF INS'lltUMENT) _ IHIIfJ-:IIY: This p;lCe fonns port of Ihe attached ~ ~. ~~~" ~~<, TO \.-..,"~4.E<1'""'" ,,^, ~~"S lbo= premises It....-ein is .iluatcd in SUf/-"OLK COUNTY, NEW YORI:\.. In !he: Township of ~.........~ In lhe VILLAGE or HA:I..ILET of . 0\.....,.;.,."",,, BOXES 5 HIRU 9 MUST RE TYPED OR PRINrED IN RUCK INK ON1.Y I'IUOR TO IffiCORDING OR FILING. (OVER) 1111111111111111111111111111111111111111111111111111111 111111111111111111111111 sorrOLK COTJNTY CLERK RECORDS OFFICE RECORDING PAGE Type of Instrument: DBIDS/DDD Number of Pages: 4 Receipt Number : 04-0091673 TRANSrER TAX NUMBER: 04-02823 Recorded: At: 08/18/2004 10:13:52 AM LIBER: PAGB: D00012338 020 District: 1000 Deed Amount: Section: Block: 144.00 05.00 BXAMIBBD AND CHARGED AS I'OLLOWS $0.00 Lot: 027.000 Received the I'ollowing I'ees I'or Above Instrument Exempt NO NO NO NO NO NO Page/I'iling COB EA.- CTY TP-584 RPT Transfer tax $12.00 $5.00 $5.00 $5.00 $30.00 $0.00 Handling NiS SRCHG EA.-STAT! Cert.Copies SCTM Camm.Pres I'ees Paid $5.00 $15.00 $50.00 $0.00 $0.00 $0.00 $127.00 Exempt NO NO NO NO NO NO TRANSI'BR TAX NOIIBBR: 04-02823 THIS PAGI IS A PART 01' THB INSTRUMBNT THIS IS NOT A BILL Bdward P.Ramaine County Clerk, Suffolk County FOR COUNTY USE ONLY C1. SWIS Code PLEASE TYPE OR PRESS FIRMLY WHEN WRITING ON FORM INSTRUCTIONS, hltp:11 www.orps.state.ny.us or PHONE (5181 473.7222 0?' ?,,<?,g',?1 r.;(1i'//;:? l.::7vl ~nlh-';' Day Year REAL PROPERTY TRANSFER REPORT *.....1... . I' . C2. Date Deed Recorded STATE OF NEW YORK STATE BOARD OF REAL PROPERTY SERVICES RP - 5217 C3.Book 1/ ,2",'? PROPERTY INFORMATION <;;f'C4. P.ge I ,0,;2 ,I'.) I RP.5117 R~~ JlfJ7 ~~b\..."'- I \ \~'Sy ZIPCOD.E '2o~ "r~=:1 ... UO I ~P.\\...Ol:.'~ STIIEET~UMBEA STlleETNAME rV\~""'"'i""''-''- CITY~OWN N~~~,,"" LASTNAME/COMPANY \_ '<..l'3.E",,"'" FllISTNAMe VIUAG~ tv\, 2. Buv.r Name LAST NAME/COMPANY FIASTNAME 3. Tax Indicatewhero! future Tax Bills are 10 be sent Billing if other than buyer addre5$ (at bottom of form) I Addr..s lAST NAME ICOM~AN'f' FIRSTN"'ME STflEET NIJMaeR "'NOSTREI!.T NAME CITY OR TOWN ZlFCOOE STATE 4. Indieete ttle number of Assusmant Ron pucels tranlfefred on the deed \ I # of Pilrcels OR 0 Pan of a Parcel (Only If Part of a Par,*l Check as they apply: .fA. Planning Boerd with Subdivision Authority Exists 48. SubdivisIon Approve! was R&quired for Transfer 4C. Parcel Approved for Subdivision with Map Provided 5. """ "'oporty Size L- 1I~ Ixl FflONl ~EET ~H""'" LAST~MffCOMPANY '2.1::I<=> I OR I DEPTH ACRES A,~I ----:sA....~ ::s;:- ~g. 6. Seller Neme FI~Sl NAME LASTNAMF.iCOM~ANY FIRST NAME 7. Check the box below whi(:h most Ilccutet.'V describes the use of the property It the time of ,ele Chll(:k the boxes below IS they .pply: 8. Ownership Type is Condominium 9. New Construction on Vacant Land 10A. Properly located within an Aoricuftur~1 District lOB. Buyer received a disclosure notice il1dicBling that lhe property is in an Agricultutal District D D D D A~oneFarniIVReSidenti.1 B 20r3FamilyResidential C Residential Vacant land D Non-Residential Vacant land E~Agricultural F Commercial G Apartment H Entertainment I Amusement I ~ communIty. Service J Industrial K PublicServ!ce L Forest I SALE INFORMATION I 11. Sale Contrlct Dlte 15. Chll(:k one or more of these conditions as eppllcabre to trenmr: 1 / ~ Monlh 0., Year 't 1 \b ID4--1 Month 0., Year A Slle Be1\\leen Relltives or Former Relatives B Sale Between Rllated Companies or Partners in Business C One of the Buyers is also a Seller D Buyer or Seller is Government Agency or lending Institution E Deed Type not Warranty or Bargain and Sale (Specify Below) F 5ele of Fractional or Less than Fee Intereat (Specify Below) G Significant Change in Properly Between Taxable Status and Sele DBtes H Sale of Susiness is Included in Sale Price I Other Unusual Factors Affecting Sale Price (Specify Below) J None 12. Dete of Slllel Tran.hlt , ,,0,0,01 , , . (Full Sale Price is the tOllll amount paid for the property inciuding personal property. Tllis payment may bll in the form of cash, OIlier property or goods, or the assumption of mortgages or other obligations.) Please rouna to rh8 near8S1 whole dOHar amount. 14. lndiarte the "'alLle of personel I, ,,0, 0 , 0 I property Included In the lUle, , e ASSESSMENT INFORMATION. Data should reflect the latest Final Assessment Roll and Tax em 13. Full S.le Price 16. Vur of Assenmeot Rull from Ie::, I 7 Totet AMlllled V.lue lof .11 ..reels In trensfer) I which information tak..n ., . '\ <i; ,0 () , 18. Property CII.. L?..,' ,0 I-LJ 19. School DllrtrictName I r-J\ll.<'"-f.-...> c:.<:: 20. Tel( Mllp Identifler(s) I Rollldllntffiar{s) !If mora th." four, att...h .hut with additional Identffier(sll \000 " ,"""" ,OO"O'S.oO \ (".",.coO ---.J CERTfFICA liON [ certify that all of the iterIllJ of infonnatiou entered on this form are true and correct (to the best of my knOWledge and belief) and I understand thllt the making of any willful false statement of material fact herein wlH subjed me to the provisions 0( the oenallaw rele.ltve to the making and filing of false instruments. ~ BUYER'S ATTORNEY Jf/~,-4 <- ," --L..2Jl\",,,~,, NE".,...." ST~EET NUMBE~ SfAEH N"ME (AFTl'R SALE: ~~!) l..:t.bW,,,,.b lA$TNAME F1AST~AME 'l/3J~i OATE/ , ~~ (;3,,\ '11.~ \S'.;~ ...~E...COOE TELEPHONE NUMBU ~Cr-""r<,-f''''''<'' ~'\ \\'~( <- [ NEnORK ,"AT> COpy ClTV OR fOWN StAT~ ZIFCODE "'\'.\04- OAtE --.l D D D