My friend Elinor DeWire posted a short note on Facebook about this item which she found on ebay. In it she said:

The lighthouse is such a universal and ubiquitous symbol. While searching for vintage lighthouse postcards (one of my guilty pleasures), I found this Maltese Cross on eBay. It’s listed for a hefty $295. The concept of the Maltese Cross traces back to the Knights Hospitaller of the First Crusade, who traveled and fought throughout Europe and the Holy Land and eventually settled on Malta. The points of their cross represented the virtues of their order. Over the centuries, the Maltese Cross has been adapted and used by many groups, including firefighters and fraternal organizations. This one features a lighthouse. According to heraldry, it represents protection, watchfulness, and warning. The eBay seller offered no background information on the meaning of this particular cross. The lighthouse appears to be a generic one, though with that ladder hanging on the lower course, it does resemble Minots Ledge Lighthouse off Massachusetts.

The ebay website says that this is an:

 Antique Sterling Silver Maltese Cross Gold Wash Lighthouse Watch Fob Award Medal

Antique Watch Fob made of Sterling Silver in the shape of a Maltese Cross 

This is a sterling silver watch fob with a raised round gold washed cartouche of

a Lighthouse on the front. Intricate hand engraving on the cross.

Reverse Inscribed:”N B S C” Hallmark: Sterling Silver

Measurments: One and 1/2 Inches x One and 7/16 Inches (38 mm x 37 mm)

Weight: 16.2 Grams / 10.4 dwt / .520 ozt

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There is another watch fob listed on the same site, but not as ornate (no gold). It is listed at the same price and details are the same except the back is not engraved. Very nice item too.