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HomeMy WebLinkAboutL 12958 P 218 1111111 fill IIIII IIIII Illll IIIII IIIII IIIII IIIII IIII ILII 111111 Illll IIIII Illi IIII SUFFOLK COUNTY CLERK RECORDS OFFICE RECORDING PAGE Type of Instrument: DEED Recorded: 04/18/2018 Number of Pages: 7 At: 12 : 45 : 48 PM Receipt Number : 18--0070849 TRANSFER TAX NUMBER: 17-28547 LIBER: D00012958 PAGE : 218 District: Section: Block: Lot: 1000 010 . 00 03.00 002 . 000 EXAMINED AND CHARGED AS FOLLOWS Deed Amount: $0 .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 $0 .00 NO Fees Paid $410.00 TRANSFER TAX NUMBER: 17-28547 THIS PAGE IS A PART OF THE INSTRUMENT THIS IS NOT A BILL JUDITH A. PASCALE County Clerk, Suffolk County ❑1 121 RECORDED Number of pages 2018 Por 18 12:45.48 PM JUDITH A. PPSCPLE CLERK OF This document will be public SUFFOLK COUNTY record.Please remove all L D00012958 Social Security Numbers P 21 DT# 17-28547 prior to recording. Deed/Mortgage Instrument Deed/Mortgage Tax Stamp Recording/Filing Stamps 3 1 FEES Page/Filing Fee Mortgage Amt. 1.Basic Tax Handling 20. 00 2. Additional Tax TP-584 Sub Total Notation Spec./Assit. ll/ or �} EA-52 17(County) Sub Total L— Spec./Add. C EA-5217(State) TOL MTG.TAX Dual Town Dua ounty R.P.LS.A• Held for Appointment Comm.of Ed. 5. 00 Transfer Tax e Affidavit � Mansion Tax The property covered by this mortgage is Certified Copy or will be improved by a one or two NYS Surcharge 15. 00family dwelling only. Sub Total YES or NO Other _ Grand Total V If NO, see appropriate tax clause on page N�ofthis' strum nt. 4 Dis18008222 1000 01000 0300 002000 11 t. 5 Community Preservation Fund T [II��I�IIQ[l�ll��l�lll�ll�l�l� Real Propi R CWH Consideration Amount$ Tax Servic 19-MAR-1 'Agency CPF Tax Due $ Verification Improved 6 Satisfactions/Discharges/Releases List Property Owners Mailing Address 1 n' RECORD&RETURN TO: Vacant Land Y� First American Titlt TD Insurance Compan 666ThirdAvenue 5thP TO New York,N.Y.10017 Phone:(212)922-9700 F4x:(212)922-0891 TD Mail to: Judith A. Pascale,Suffolk County Clerk 7 Title Company Information 310 Center Drive, Riverhead, NY 11901 Co.Name www.suffolkcountyny.gov/clerk ! Title a $5 8 Suffolk County Recording & Endorsement Page This page forms part of the attached �C made by: (SPECIFY TYPE OF INSTRUMENT) The premises herein is situated in SUFFOLK COUNTY,NEW YORK. TO In the TOWN of SC5\)A �b �cX� TS �V�l II 71C In the VILLAGE or HAMLET of BOXES 6 THRU S MUST BE TYPED OR PRINTED IN BLACK INK ONLY PRIOR TO RECORDING OR FILING. over 1 yl —Bargain and Stile Deed.with Covrnanc against Grantor's Acts—I Ddiviftdor Corporation(Single Sh=0 CONSULT YOUR LAWYER BEFORE SIGNING THIS INSTRUMENT—THIS INSTRUMENTS HOULD HE USED BY LAWYERS ONLY, THIS INDENTURE,made theday of in the year 201$ BETWEEN John S.Burnham having an address at 88 Olie.Middletown,Rhode Island 02842, Stephen T.Burnham having an address at 11.8 Parker Street,Newton,Massachusetts 02459, ✓ Louise B.Packard having an address at 26 Dexter Road,Lexington. Massachusetts 01354 and Paul H. Burnham having an address at 239 Thunder Hill Road, Wilton CT 06897 ASTENANTS IN COMMON party,of the first part,and Goose Island Overlook.LLC,a New York Limited Liability company,having an office at PO Box 434,2678 Peninsula Road, Fishers Island,New York 06390 party of the second part, WITNESSETH,that the party of the first part,in consideration of 1.00 dollars \v 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, the total 314 interest of the part'of first part (18.75 percent each) interest in such premises as described as follows: ALL that certain plot,piece or parcel of land.with the buildings and improvements thereon erected,Situate,lying and being O iii the County of Suffolk, Town til'Southhold, State of New York and more particularly described on Schedule A attached hereto i Being the same premises acquired by Deed [Wade by Paul H. Burnham as Ancillary Executor of the Estate of David C. Burnham to John S.Burnham,Stephen T.Burnham,Louise B.Packard and Paul H.Burnham dated as of the date hereof and ` recorded i immediately prior to this Deed. v TOGETHER with all,right, title and interest, if any, of the party of the first pan 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;'1'O HAVE.AND TO HOLD the premises herein granted unto the t parofithe second pari,the heirs or successors and assigns of the party of the second part forever. AND the parry 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. A ND 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 die 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 die 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. I I [ IN PRESENCE OF: AA (CAOLkI qr+mac a�I fJ.���w ✓ n S.Bunt m Stephen T.Arnham F �.�YrWRNCt1 E rttl+�"a—��+tam Louise B.Packard r aul H. Burnham �?awr � SLh►ter�f�r ,�,t h,,.Ia I '. t , i r, t ACKNOWLEDGEMENT TAKEN IN NEW YORK STATE ACKNOWLEDGEMENT TAKEN IN NEN'YORK STATE State of New York,County of' ss: State of New York,County of ss: On the_day of in the year before me,the On the day of in the year 5,before me,the undersigned, undersigned,personally appeared personally appeared ,personally known to me or proved to me on the basis of .personally known to the or proved to me on the basis of satisfactory evidence to be the individual(s)whose name(s)is(are) satisfactory evidence to be the individual(s)whose name(s)is(are) subscribed to the within instrument and acknowledged to me that subscribed to the within instrument and acknowledged to me that a he/shelthey executed the same in his/her/their capacity(ics).and that by helshe/they executed the same in his/her/their capacity(ies),and that by his/her/their signature(s)on the instrument.the individual(s),or the bis/her/their signature(s)on the instrument,the individual(s),or the person upon behalf of which'the individual(s)acted,executed the person upon behalf of which the individual(s)acted,executed the a instrument. instrument. .r e ,t ACKNOWLEDGEMENT BY SUBSCRIBING WITNESS TAKEN ACKNOWLEDGEMENT TAKEN OUTSIDE NEW YORK IN NEW PORK STATE STATE art lu State ol'New York,County of ss: 'State of Cb County of FA. ss W I L 0 Ai '(Or insert District of Columbia,Territory,Possession or Foreign On the, day of in the year before me.the County) undersigned,a Notary Public in and for said State,personally appeared aA1� the subscribing witness to the foregoing instrument,with whom On the Ip day ofk Zyq in the year 2011 before me I am personally acquainted,who,being by me duly sworn.did depose the undersigned personal]),appeared and say that helshc/they reside(s)in pk Ui5a e-,.j�A k-" Personally known to me or proved to me on the basis of satisfactory (ii the plate of residence is in a city,in the street and street numbs ifany,thereof); evidence to be the individual(s)whose name(s)is(are)subscribed to the that he/she/they know(s) within instrument and acknowledged to me that be/she/they executed the same in hislher/their capacity(ies), that by his/her/their signature(s)on to be the individual described in and who executed the foregoing the instrument,the individual(s)or the person upon behalfof which the insiru nemt thnt said subscribing witness was present and saw said individual(s)acted,executed the instrument,and that such individual make such appearance before the undersigned in the execute the suttee:and that said witness at the same time subscribed lU n D L VJ t,L_-f 0 tl)t CWV1 I y OF PA(R-Cl r_L b hislhcr/their name(s)as a witness thereto AN p rj-f•*—�f_ op aIVltl, zLTtC LT (add the city or political subdivision and the state or country or other place the acknowledgement was taken). Dawn J. Schneider "suuSCi/ ,Bargain,and Sale Deed 30 Courtland Drive ;��N''••""'Nell11 With Covenants Shelton, CT 06484 `O�'O`DRYPue�'•F� = MY n' - SECTION:010.00 =N COMMISSION F ,a. EXPIRES :J BLOCK:03.00 % jP'.. 9J30/2019;AtiC+`�` �✓v�✓ - I • Tide No. r � � LOT:002.000 ' ', �rtCdiN��G`%' COUNTY OR TOWN:SOUTHOLD Burnham/Packard TO a Goose Island Overlook,LLC RETURN BY MAIL TO: DISTRIBUTED BY • y ACKNOWLEDGEMENT TAKEN IN NEW YORK STATE ACKNOWLEDGEMENT TAKEN IN NEW YORK STATE State ofNew York,County of' ss: State ofNew York,County of ss: On the_day of in the year before me,the On the day of in the year S,before me,the undersigned, undersigned,personally appeared personally appeared personally known to me or proved to me on the basis of personally known io me or proved to me on the basis of satisfactory evidence to be the individual(s)whose name(s)is(are) satisfactory evidence to be the individual(s)whose name(s)is(are) subscribed to the within instrument and acknowledged to me that subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their capacity(ies),and that by he/she/they executed the same in his/her/their capacity(ies),and that by his/herltheir signatum(s)on the instrument,the individual(s),or the his/her/their signature(s)on the instrument,the individual(s),or the person-upon behalf of which the individuat(s)acted,executed the person upon behalf of which the individual(s)acted,executed the instrument. instrument. ACKNOWLEDGEMENT BY SUBSCRIBING WITNESS TAKEN ACKNOWLEDGEMENT TAKEN OUTSIDE NEW YORK IN NEW YORK STATE STATE I� State of New York,County of ss: *State of m County of�IGWW�ss:Nom' *(Or insert District of Columbia,Territory,Possession or Foreign On the. day of in the year before me,the County) undersigned,a Notary Public in and for said State,personally appeared rr��,,,, the subscribing witness to the foregoing instrument with whom On the 910 day of�4Ax. in the year 201 before me 1 am personally acquainted,who,being by me duly sworn,did depose the undersigned peersonall?appeared and say that he/shtlthey reside(s)in J Ohm pU f►� m Personally known to me or proved to me on the basis of satisfactory (ifthe Mace of residence is in a city,include die street and street number irany,thereat): evidence to be.the individual(s)whose name(s)is(are)subscribed to the that lidshe/thev knows) within instrument and acknowledged to me that he/she they executed the same in his/herltheir capacity(ies), that by his/her/their signature(s)on to be.the individual described in and who executed the foregoing the instrument,the individual(s)or the person upon behalf of which the instrument;that said subscribing witness was present and saw said individual(s)acted,executed the instrument,and that such individual make such appearance before the undersigned in the execute the same;and that said witness at the same-time subscribed ^ dlzotD^ SA-'LX hislhedtheirname(s)as a witness thereto ackose fs (add the city or political subdivision and the state or country or other place the acknowledgement was taken). Df Jillian L DiPiro Notary Public yM1w1, Bargain and Sale Deed ® COMI lv+enLrrlo�uassnalusa My Commissivn Ex fires �, .�_ �-. y With Covenants March 30, 2023 dyv r a� ` SECTION:010.00 ✓� ¢7, •.�i+li l� L A7yyV BLOCK:03.00 '•.;+r/� �a�r" y . Title No. /n���/.0 n� �Q _`�.�����•_� 5001 ��C� LOT:002.000 COUNTY OR TOWN:SOUTHOLD Burnham/Packard TO Goose Island Overlook,LLC RETURN BY MAIL TO: /DISTRIBUTED BY ACKNOWLEDGEMENT TAKEN IN NEW YORK STATE ACKNOWLEDGEMENT TAKEN IN NEW YORK STATE State of New York County of` ss: State of New York,County of ss: On the_day of in the year before me,the On the day of in the year 5,before me,the undersigned, undersigned,personally appeared personally appeared personally known to me or proved to me on the basis of personally known to me or proved to me on the basis of satisfactory evidence to be the individual(s)whose name(s)is(are) satisfactory evidence to be the individual(s)whose nahne(s)is(are) subscribed to the within instrument and acknowledged to me that subscribed to the within instrument and acknowledged to me that he/shelthey executed the same in his/her/their capacity(ics),and that by he/shelthey executed the same in his/her/their capacity(ics),and that by his/herltheir signature(s)on the instrument,the individual(s),or the his/her/their signature(s)on the instrument,the individual(s),or the person'upon behalf of which-the individual(s)acted,executed the person upon behalf of which the individual(s)acted,executed the instrument. instrument. ACKNOWLEDGEMENT BY SUBSCRIBING WITNESS TAKEN ACKNOWLEDGEMENT TAKEN OUTSIDE NEW YORK 1N NEW YORK STATE STATE �p State ofNew York,County of ss: `State of Iv" County ofA'AJJ' ss: *(Or insert District of Columbia,Territory,Possession or Foreign On the day of in the year before me,the County) undersigned,allotary Public in and for said State,personally appeared r( the subscribing witness!to the foregoing instrument,with whom On the day of JUd0pM in the year 201!before ma I am personally acquainted,who,being by me duly sworn,did depose the undersigned personal! appeared and say that he/she/they,resides)in S hPC I lr�fkn 1 Personally known to me or proved to me on the basis of satisfactory (ifthcptace or residence is in a city•include the street end street number i fany,thereof); evidence to be.the individual(s)whose name(s)is(are)subscribed to the that helsh/thev know(s) within instrument and acknowledged to me that he/she/they executed the same in his/her/their capacity(ics), that by his/her/their signature(s)on to be the individual described in and who executed the foregoing the instrument,the individual(s)or the person upon behalf of which the instrument;that said subscribing witness was present and saw said individual(s)acted,executed thcc instrument,and that such individual make such appearance before the undersigned in the execute the saint;and that said witness at the same time subscribed '�r3v�n O{ pf �1G Sit his/her/their names)as a witness thereto (add the city or political subdivision and the state or country or other place,thee a�cckyn�owledgement was taken). Jillian L DiPiro Bar ain,arid Sale Deed Notary Public b COMMO WFATH OF MASSACHUSETTS With Covenants. _ Lot My Commission Expires •,dr:_ ->'' �•`~ March 30, 2023 SECTION:010.00 BLOCK:0.00 No. Title ��c�D' ,� �a t.- ].OT:002.000 fir" X COUNTY OR TOWN:SOUTHOLD f' r Burnham/Packard TO I Goose Island Overlook,LLC RETURN BY MAIL TO: /DISTRIBUTED BY ACKNOWLEDGEMENT TAKEN IN NEW YORK STATE ACKNOWLEDGEMENT TAKEN IN NEW YORK STATE State of New York,County of' ss: State ofNew York,County of.ss: On the_day of in the year before me,the On the day of in the year 5,before me,the undersigned, undersigned,personally appeared personally appeared personally known to me or proved to me on the basis of personally known to me or proved to me on the basis of satisfactory evidence to be the individual(s)whose namc(s)is(are) satisfactory evidence to be the individual(s)whose names)is(are) subscribed to the within instrument and acknowledged to me that subscribed to the within instrument and acknowledged to me that he/shelthey executed the salve in his/her/their capacity(ics),and that by he/she/thcy executed the same in his/her/their capacity(ies),and that by hislherltheir signature(s)on the instrument,the individual(s),or the his/her/their signature(s)on the instrument,the individual(s),or the person upon behalfofwhich the individual(s)acted,executed the person upon behalfofwhich the individual(s)acted,executed the instrument. instrument. ACKNOWLEDGEMENT BY SUBSCRIBING WITNESS TAKEN ACKNOWLEDGEIVIENT TAKEN OUTSIDE NEW YORK I.N NEW YORK STATE STATE State ol'New York,County of ss: 'State of f1 A County of n,jd Irr,r ss: '(Or insert District ofColumbia,Territory,Possession or Foreign On the day of in-the year before me,the County) undersigned,a Notary Public in and for said State,personally appeared the subscribing witness to the foregoing instrument,with whom On the Q2AA day of 6—in the year 2011 before me I nm personally acquainted,who,being by me duly sworn,did depose the undersigned personally app(�tred and say that helshe(thev reside(s)in l Qty IASL �J I t n"t4WZ2e ) Personally known to me or proved to me on the basis of satisfactory (if the place of residence is in a city,include die street and street number if any,thenmo; evidence to be.the individuals)whose name(s)is(are)subscribed to the that he/she/they know(s) within instrument and acknowledged to me that he/she/they executed the same in his/her/their capacity(ies), that by his/her/their signature(s)on to be the individual described in and who executed the foregoing the instrument,the individual(s)or the person upon behalf of which the instrument;that said subscribing witness was present and saw said individual(s)acted,executed the instrument,and that such individual make such appearance before the undersigned in the execute the same;and that said witness at the same time subscribed ToU u or= t_f pct/tc�oJ his/her/their name(s)as a witness thereto 51 A9`E �E nh r�A C av J F S (add the city or political subdivision and the state or country or other place the acknowledgement was taken). JONATHAN A.CAMPBELL _ 'Bargain and Sale Deed ;( '= Narrty Public �= Commonwealth o1Massachusetts With Covenants / MyCpmmissiortEwpue;May05.2022 r SECTION:010.00 BLOCK:03.00 TAN No. ��©•�j� 1,01:002.000 COUNTY OR TOWN:SOUTHOLD Burnham/Packard TO Goose Island Overlook,LLC RETURN BY MAIL TO: DISTRIBUTED BY SCHEDULE A ALL THOSE CERTAIN plots, pieces or parcels 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, as more particularly described as follows: PARCEL 1: All that certain lot, piece or parcel of land, situate, lying and being in the Township of Southold, County of Suffolk and State of New York, known and designated as and by Lot Number Thirty-One (31) on a certain map or plan of the peninsula at Fishers Island, comprising Ninety (90) lots owned by Charles W. Hedge and Frances G. Thorp, located on Fishers Island in the Township of Southold, County of Suffolk and State of New York, surveyed by Chandler and Palmer, Engineers and Surveyors, of the Town of Norwich, County of New London, State of Connecticut in the year 1913, which map was filed in the office of the County Clerk of Suffolk County on the 11th day of March in the year 1913 as Map Number Two Hundred and Twenty Three (223) and more particularly described as follows: running from the westerly side of a twenty (20) foot right of way to the high water mark of Great'Harbor an average distance of One-Hundred Twenty-Six and One- half (126-%) feet, more or less, being fifty (50) feet wide. Being the same premises conveyed by Charles W. Hodge and Belle Hodge, his wife, to Ernest J. Jones by Warranty Deed dated March 13, 1913 and recorded in the Suffolk County Clerk's office in Liber 842 of Deeds, page 301, on the 271h day of March, 1913. r PARCEL 2: All that tractor parcel of land situate on Fishers Island, County of Suffolk and State of New York, known as Lot Los. Thirty and Thirty-two (30 & 32) on "Pian of Peninsula at Fishers Island, owned by Charles W. Hodge and Frances G. Thorp, made by Chandler & Palmer, Engrs., Norwich, Conn., 1913", filed March 11, 1913, No. 223, in County Clerk's Office, Riverhead, N.Y. N f f INSTRUCTIONS(RP-5217-1213F-INS):www.orpe.stalemy.us Fv)R COUNTY USF ONLY• Now York Slate Department of C1.SYNS Cede L Taxation and Finance Lq C2.ate Dead Rsorted ,I`1 , i Once of Real Property Tax Services - "" RP-5217-PDF Ca.Book ( G.Papa Rosi Property Transfer Report(Viol PROPERTY INFORISATION e 1•Property ROW oi,,r PENINSULA ROAD ation SOUTHOLD FISHERS 7SLAND _ 60390 -07T OR Imes - vsa.eea •tetonEE 2.Barn GOOSE ISLAND OVERLOOK LLC Home _ •wv veesxxay-ew rwae+Pae I/Mr eearvooraexr F eM'new 7�Ta■ bed xft adhere future Tax Bills aro to be sent Slls"a It other than buys,addroso(albottom ofform) Address almTyerweyrvOr reierw,w eram:earem[v exO nye cm tan lam neP�L' 7P COOE 4.IndMnb the number of Assoumem' 1 Ped d e Parcel (0*If Part of a Pascal)Cheek as they apply: Rd!parents transferred an the dead e d groats ties 4A.Planting Bord with Subdivision Adheply,Exide El Loved X OR 0.4 3 1B•Subdlwabn wm R properly •Peet.hlELr -L.�w .KOM APpr eQWreafarTsanlhY ❑ Bib 4C.Pnedal Approad to Subd ision*11h Math Provided It.Adler8-k, hA->"J -- -- •wr Neec�erJa'een ""rwae wvw Name + r nye. •yr rwsr. 7.select the description which most 4acurdely describes the Check she boxes bale.n they apply: use of the proparp at am time of sole: L Ownership Type Is Condomlibua ❑ A.One Family KesidenUal a.Nes'Construction an a Vaxnt Land 0 10A.property Located wllNn an Agricultural Dintdcl LJ 108.Buyar.ecelved 9 Nadmure h ci a IndlcNbhp theithe pecpnny ts In an Ap13rtasloral DAM SALE INFORMATION IL Check one or more ofthsos condcarms as applicable to transfer: A Sale Between Raledvea or Former Roladvee 11.Sale Cordran Dab B.SW between Related Companies or Partner In Business. C.ono d the Buyaue M vim a Saar 01/20/201191 D.Buyer Or SOW b Owtommonl Agency as Lenore Inedlutian 17.Deb dtabffmnelM -- E.Dead lyn net warranty or Bergain need Sale(Specify,Solar) - r Sale of Fmdlldnal of Lees then Fee Idered(Speory Below) •17.Full Boo Fria .tip G.Signaean!Chanpo o Pmpody Batpieen Taxable Status and Slse Dams Full Sale Price Is the loll amnud paid for the property lndud H.Sale of Rualneaa Is Included in Sala Pyla ( rat permnal property 1.Other Unusual Fanan Afanding Sale Pdoe(Spedry Below) 71ao payment may be In the corm at cook other property or goods.or the assumption or — J.wane mangagso Of der obligations)gease.owd to tin nearest words dblaremamd. 'Commort(al on Condilbn: 11.Indicate the value o1 germinal. property Included In the sob r .00 ASSESSMENT INFORMATION•Data should reflect the latest Final Assessment Rol and Tax BIS 1e.Year of Avowwwwnl Rall tom which Inlmmmlon tai ml(YY) 16 •17.Told Assessed V91w 39,001) •18.Propanyaim 210. _ �..- •19.School District name FISHERS ISLAND M.Tax Nap Idedlfiens)IRen Idalhuaw(s)pf mom than bur,wench sheat wM addtlonal MonlMello)) 1000-OLO.00-CO.03-0002 CFRIIFtCATt N I Coldly ted all deg Rama of lnrarmatlon entered on this form are true and comes("a bat of my anowhdae end bdleq and I understand mat the mebleg of any wlllfop false slabmand ofmaWal bet hwWn subject me btlryrgrldgtt flLlhe�OtWtltlNatve to the making and Sling of 19108 Inahumema. a(IALUBE 111MARSONTACIJNFORMAIIM ([mer 10wafm For h inow.t9le;9bhhyr is LLC.neeep•,wevdnwL crep.ot■L)ew mem hxmm-ly.We"w wrier est Is rnr on kdmdcw nerd w rdxiwy van a nems wm mMea wmne:v or an trhawx.berpmrmae prN eaw.n erhxw 8aeerene neeawew L'Ie esnerw hew)be OMaa ryew m print elewlr.) aahoyeiuep a /F� �• I', /�. 91LYFliSIGNAIUBE 9t;RBHAN PAUL H• t}WYr (Sly C%qD W01k LRC— ` _ •wlvyi-. .• AMrruw e'�/�-• yF 1 Rn— ` --•Na11 CODE 4NAAde,•4MRF err hwwaWl RJPEeelaayMw • r 239 THUNDER LAKs. ROAD er4NTmiump •aTeEEr Ne1w I WILTON _ CT 06897 •CIIY'JP loupe YUR •aeOOOp Burew's eTTef:mEy 4 WT WIIa - POST-1 1 -ewvh as rsue•.a.luhn riff.NNW" 1 1 e 1 i i ADDITONAL SHEET TO RP-5217 2. SELLER!NAME PACKARD eOUISE B. BURNHAM PAUL H. I r I ' I