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HomeMy WebLinkAbout249 Zion St, Cutchogue PUBLIC HEARING(RECONVENED) SOUTHOLD TOWN BOARD OCTOBER 10, 2000 9:10 A.M. IN THE MATTER OF VIOLATIONS OF CHAPTER .90 OF THE CODE OF THE TOWN OF SOUTHOLD. UNSAFE BUILDINGS.BY ALMA WILLIAMS. Present: Supervisor Jean W. Cochran Justice Louisa P. Evans Councilman William D. Moore Councilman Brian G. Murphy Councilman Craig A. Richter SUPERVISOR COCHRAN: This is a hearing, these was recessed two weeks ago, in order to give the home owner and tenants an opportunity to make arrangements for the occupants. REVEREND DOZIER: I visited the home last week and attempted to get them out, but they just won't go because they don't want to split up. We are working on trying to make suitable arrangements to keep,the family together. SUPERVISOR COCHRAN: Ed Forrester, Code Enforcement Officer, perhaps you could give us a background on it? EDWARD FORRESTER, BUILDING DEPARTMENT HEAD & CODE ENFORCEMENT OFFICER: It was declared an unsafe building on August 28, 2000. The inspection was made by myself and Building Inspector Gary Fish. In addition, we also took emergency measures to vacate the occupants to the best of my knowledge. I would like to request the Town Board to take action to declare the structure unsafet. The findings of my report are that the ceiling, roof and the floor are unsafe structurally, the electrical instrumentation panel is hanging off the wall as are the electrical outlet boxes,the kerosene fuel from the floor space has spilled onto the floor and is soaked into it. It should be boarded up to make it unsafe. It is a 450 square foot square in existence prior to the minimum 850 square foot requirement. It should be able to be rehabilitated and brought up to code, but it will take a considerable amount of money. DAVID BLADOS, CHIEF, CUTCHOGUE FIRE DEPARTMENT: I have been dealing with this problem for eight (8) years. The floor and walls of this structure are soaked with kerosene. The space heater is located so that it blocks the entrance and exit door of the structure, a very hazardous situation. The fire department has been there on many many calls over the years. Not, only is the safety of the occupants a grave concern, but also the safety of the members of the fire department. There is a 275 gallon tank of kerosene outside that they use a garden hose running into the house to fill the space heater with instead of going outside to carry fuel in from the tank. Again a very dangerous situation. The space heater goes out and the fumes consume the inside of the house making it very hazardous for the children and the adult occupant who has a diabetes condition. The house is overrun with cockroaches, garbage strewn all about, and the kerosene soaked floor and walls make it a very unsafe building which should be boarded up,burned down, or gotten rid of. The best thing would be to help the people relocate and get on with their lives. SUPERVISOR COCHRAN: We have Officer Henry Santacroce, Jr. here from the Police Department to make a report also. OFFICER HENRY SANTACROCE, JR., SOUTHOLD TOWN POLICE DVEARTMENT: I work on the Cutchogue Sector, so I also have been down there many times. The people can't breathe because the kerosene fumes are so thick in the air. I contacted adult services, Edward Forrester, Code Enforcement and C.A.S.T. The occupants don't want to leave the house. It is such a dangerous situation with the kerosene heater fumes, fuel soaked floor and walls, garbage all around the house. I did look up some of the past occurrences at the house, since 1995 there have been over 26 calls,most of them health concern related. FRANK LePRE, BRIDGE LANE, CUTCHOGUE: Approximately a year ago I was teaching Sunday School at the Baptist Church in Cutchogue is when I became aware of the child Corell Hilbrawall and their problems at this house. He is Maggie Wells great grand child. I went down to the school to see Ann Smith about it to see how we could help him. We have been helping him with his reading and inducted him into the scouting program. He is currently working towards' his "Arrow Of Light" which is the highest honor in scouting. The Mattituck-Cutchogue school district is aware of his situation and is very helpful. in -r The Town Board of the Town of Southold hereby makes the following Findings and Determination IN RE MATTER OF DECLARATION OF UNSAFE BUILDING LOCATED AT 249 ZION STREET,CUTCHOGUE,NEW YORK ALSO KNOWN AS SCTM#1000-96-1-11.1 , PURSUANT TO TOWN CODE CHAPTER 90 IN RE MATTER OF DECLARATION OF UNSAFE BUILDING LOCATED AT 249 ZION STREET, CUTCHOGUE,NEW YORK ALSO KNOWN AS SCTM# 1000-96-1-11.1 ,PURSUANT TO TOWN CODE CHAPTER 90 FINDINGS AND DETERMINATION HEARING BODY: TOWN BOARD OF THE TOWN OF SOUTHOLD: PRESENT-SUPERVISOR JEAN W.COCHRAN; COUNCILMAN MURPHY;COUNCILMAN RICHTER; COUNCILWOMAN EVANS; COUNCILMAN MOORE ABSENT: COUNCILMAN ROMANELLI PROCEDURAL HISTORY: On October 10, 2000 at 9:00 a.m., a hearing pursuant to Chapter 90 of the Town Code was reconvened following an adjournment of the hearing originally schedule for September 26, 2000. The owner of the premises, despite due notice, was not present at the initial hearing. The Town Board adjourned the initial hearing until October 10, 2000 to provide the owner with another opportunity to be heard. In attendance were: Town Supervisor Jean W. Cochran, Councilman Moore, Justice Evans, Councilman Richter, Councilman Murphy, Town Attorney Gregory F. Yakaboski, Town Clerk, Elizabeth A. Neville, Mary C. Wilson, Assistant Town Attorney, Rev. Fulford, Rev. Dozier, Fire Chief Blados, Police Officer Santacroce, Ruthanne Woodhull, James McMahon-Director of Community Development, Frank LePre, Bob Gerdts-Suffolk County Department of Health Services, Edward Forrester-Director of Code Enforcement, various press representatives. TESTIMONY/WITNESSES: The following individuals testified at the hearing: Edward Forrester, Director of Code Enforcement David Blados, Chief, Cutchogue Fire Department Henry Santacroce, Officer of Southold Town Police Department Frank LePre, community member Bob Gerdts, Suffolk County Department of Health Services FACTS: On August 28, 2000,the Director of Code Enforcement Edward Forrester and Inspector Gary Fish performed an inspection at: 249 Zion Street, Cutchogue, New York after proper notice to the owner of record. It was the opinion of the building inspector that this building located at 249 Zion Street, Cutchogue,New York is unsafe and dangerous to the public and thereafter issued a formal report pursuant to Chapter 90-4(A) of the Southold Town Code. Said inspection report is attached hereto and incorporated by reference.(See Attachment A) Inspection of the property revealed the following hazards: kitchen roof leaks; kitchen ceiling is collapsed; kitchen flooring unsound; porch steps unsound; electrical wiring placed on walls; electrical boxes hanging; electrical switches loose from boxes; main electrical panel hanging from main feed; gas heater against furniture; overloaded sockets with extension cords; the smell of kerosene permeating the building. On August 28, 2000,the Director of Code Enforcement, subsequently to determining that the building was unsafe and dangerous, promptly served a notice to the owner as provided by Chapter 90-5 and 90-6 of the Southold Town Code.(See Attachment B & C) In addition, said notice was filed with the Suffolk County Clerk's Office pursuant to Chapter 90- 7. (See Attachment D) On August 28, 2000, the Director of Code Enforcement also determined through his inspection of the building that there is actual and immediate danger of failure or collapse so as to endanger life and therefore required the premises by vacated and not reoccupied until specified repairs are completed. The Director of Code Enforcement then caused an"Emergency Notice to Vacate" notice be posted on the premises pursuant to Chapter 90-8 of the Southold Town Code. In addition, the Director of Code Enforcement personally notified the record owner of the property and the tenants of the building. The Director of Code Enforcement, during the course of the above procedures and thereafter, remained in contact with various social service agencies in reference to the housing of the tenants residing in the unsafe and dangerous building. A hearing was convened by the Town Board of the Town of Southold on September 26, 2000 but adjourned to October 10, 2000. On October 5, 2000, the Director of Code Enforcement as well Reverend Dozier, personally notified the record owner of the property of the Chapter 90 procedure and the various outcomes which may result from the Town Board hearing on the matter. On October 10, 2000,the Town Board of the Town of Southold held a hearing pursuant to Chapter 90 and received documentary evidence as well as testimonial evidence. The following individuals testified regarding the unsafe and dangerous conditions at 249 Zion Street, Cutchogue,New York: Edward Forrester, Director of Code Enforcement David Blados, Chief, Cutchogue Fire Department Henry Santacroce, Officer of Southold Town Police Department Frank LePre, community member Bob Gerdts, Suffolk County Department of Health Services Reverend Dozier, Unity Baptist Church Reverend Fulford, Cutchogue First Baptist Church According to Chief Blados, the Cutchogue Fire Department has responded many times over the past several years to medical calls at this address and he has witnessed the following: kerosene soaked walls, floors and upholstery, and the use of a kerosene heater which blocks the ingress and egress to the building. In addition, Chief Blados stated that in the winter months, the occupants use a garden hose (with a valve on the end of the house inside the home) leading from a 275 gallon kerosene tank outside into the house to fill the kerosene space heater. He stated the building is very unsanitary with an apparent infestation of vermin and he testified that the EMS personnel do not want to enter the structure. Chief Blados also stated that medical calls relating to respiratory problems were responded to and involved several occupants. He also observed wires hanging from the walls within the building. Officer Santacroce of the Southold Town Police testified to responding to the address on"aided calls" involving medical emergencies. He testified that the medical calls were for several different individuals, not the same individual again and again. Officer Santacroce felt that this clearly indicated that there was a problem with the premises rather medical problems of a particular individual. He stated that the ingress and � c egress are blocked and submitted a compilation of police incident reports dating to 1995.(See Attachment E) Frank LePre testified to the need to make sure a minor child whose main residence is at this address be permitted to remain within the Cutchogue-Mattituck School District and also testified that the minor child resides at his home at this time due to the unsafe conditions. Bob Gerdts, of the Suffolk County Department of Health Services testified to 18 visits to this address by County inspectors who noted rat infestation, unvented kerosene heater use and the accumulation of garbage. Both the Reverend Dossier and the Reverand Fulford spoke of their involvement in this issue for several months and the responsibility of both the occupants and the landlord for the condition of the building. Reverand Dozier stated that he has discussed the Chapter 90 process at length with the owner of the property and she understands what is occurring. Reverand Dozier and Reverend Fulford have visited the property. Both Reverend Dozier and Reverend Fulford stated that they conveyed to the occupants that the Town was addressing issues of a dangerous building and the occupants health and safety. DETERMINATION: Based upon the facts as presented, testimony and documents presented, pursuant to Chapter 90-6(F), the Town Board herebyt determines that the building located at 249 Zion Street, Cutchogue,New York(SCTM# 1000- 96-1-11.1) is unsafe and dangerous to the public. The Town Board further orders the following pursuant to Chapter 90-6(F): 1. That the building located at 249 Zion Street, Cutchogue, New York be secured by the Building Department and the Police Department effective Thursday, October 1�i 2000 at 1:00 P.M. 2. That the building located at 249 Zion Street, Cutchogue, New York York(SCTM# 1000-96-1-11.1)be taken down and the materials removed by the owner or the owner's representative's no later than October 25, 2000. In the event the owner or the owner's representative's have not removed the building by October 25, 2000 the Town Board authorizes the demolition and removal, the cost of which is to be levied according to Chapter 90 of the Town Code, by November 1, 2000. 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. t [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY 6^t"H+&jz- CULosocFe 42,bc-� REMARKS: _yA O oAs O XIS Yl� tv� s4d-,-o--s CA A. }•� , L Vk. 0.S ' Glc r3 � . �v e- t� DATE l 2� l a I NSPECTO l ATTACHMENT A EDWARD FORRESTER �o�pS�FFO(,�coG Southold Town Hall Director of Code'Enforcement c 53095 Main Road co Z P.O. Box 1179 p Southold, New York 11971 Fax(516) 765-1823 O Telephone(516) 765-1802 BUILDING DEPARTMENT TOWN OF SOUTHOLD t NOTICE Pursuant to Chapter 90 Southold Town Code DATE: August 28, 2000 TO: Alma R. Williams 533 Third Street Greenport N.Y. 11944 A. The last Assessment rolls of the Town of Southold shows you are the owner of the following described premises; Located on Church Lane Cutchogue NY., bounded on the north by Town of Southold property, on the east by a Private Road, on the south by the Baxter property, on the west by the Mason property. The above described premises are the same described in a deed recorded in the Suffolk County Clerk's Office in Liber 11900 Page 924. Also referred to as Suffolk County Tax Map Designation : District 1000, Section 96, Block 1, Lot 11.1 B. The single family dwelling located on the property is structurally unsafe and dangerous and as such constitutes a hazard to safety by reason of; In particular: The roof of the structure is deteriorated causing the ceiling to collapse in the kitchen area, the flooring in the kitchen is unsound, the porch and front steps are unsound, the circuit breaker panel has fallen away from the wall supporting it, exposed wiring on the surface of the walls, open switch boxes with loose outlets and switches hanging from same, extension cords powering appliances located outside the structure, a wall mounted gas heater with a bed placed against it. C. You are hereby ordered to ; make the building safe and secure or demolish and remove the debris D. The above work shall commence within ten (10 ) days from the date of this notice and shall be completed within thirty ( 30 ) days thereafter. �l ATTACHMENT B r r E. In the event you fail to comply with the above, a hearing will be held before the Southold Town Board concerning same at 9:00 AM on Tuesday September 26, 2000 at Southold Town Hall, 53095 Main Road, Southold 11971. F. In the event that the Southold Town Board after the hearing herein shall determine that the building or structure is unsafe or dangerous to the public, the Town Board may order the building or structure to be repaired and secured or demolished and removed. G. In the event that the building or structure shall be determined by the Town to be unsafe or dangerous and in the event of the neglect or refusal of the owner to repair or remove same within the time provided, the Town may remove such building or structure by whatever means it deems appropriate and assess all costs and expenses incurred by the Town in connection with the proceedings to remove and secure, including the cost of actually removing said building or structure, against the land on which said building or structure is located. Edward Forrester Director of Code �)Orcement i i i ! ! ! ! i �I �I �I SEP 2 0 2000 : ' L iN ATT RI' IEYIS O F-FICETOWN OF SOUTHOLD � ! ! AFFIDAVIT OF PERSONAL SERVICE ---------------------------------------------------------------------X STATE OF NEW YORK) COUNTY OF SUFFOLK) ss.: I, the undersigned, being sworn, say: I am not a party to the action, am over 18 years of age and reside at 1114 Sipp Avenue, Medford, New York; On August 28, 2000, 1 served the within NOTICE Pursuant to Chapter 90 Southold Town Code by delivering a true copy to Alma R. Williams at 533 Third Street, Greenport, New York. I knew said person served to be the person mentioned and described in said papers. Edward Forrester Sworn to before me this 25th day of September, 2000 Not4 Public LYNDA M.BOHN NOTARY PUBLIC,State of Nftyo* No.01 B06020932 Qualified in Suffolk County Term Expires March 8,20 f ATTACHMENT C 1�066PP5 25 EI 2 3 RECORDED Number of pages ' TORRENS 00 AUG 29 PM 12: Serial# [ DIMRD P. ROMAlt CLERK OF Certificate/I SUFFOLK COUN1_ti Prior Ctf.# Deed/Mortgage Instrument Deed/Mortgage Tax Stamp Recording/Filing Stamps 4 FEES Page/Filing Fee K Mortgage Amt. Handling _ 1. Basic Tax TP-584 2.Additional Tax Notation Sub Total EA-52 17(County) Sub Total Spec./Assit. EA-5217(State) Or Spec./Add. R.P.T.S.A. �S Cs�� �Y�. TOT.MTG.TAX Comm.of Ed. 500 ?t, Dual Town Dual County ` Held for Apportionment Affidavit Transfer Tax ,NO Is DZ,C Certified Copy ��il � Mansion Tax The property covered by this mortgage is or Reg. dpy will be improved by a one or two family Sub Total r� dwelling only. Other YES or NO GRAND TOTAL 4 If NO, see appropriate tax clause on page# of this instrument. ;1nit' Real Property Tax Service Agency Verification 6 Community Preservation Fund supfw Dist. Section B lock Lot Consideration Amount $ CGWTY CPF Tax Due $ Improved Vacant Land 71 Satisfactions/Discharges/Releases List Property Owners Mailing Address TD RECORD&RETURN TO: TD TD 5-3 09 - - - �� �1 8 Title Company Information Co. Name t V ( / Title# .2j Suffolk �,ount Recording & Endorsement Page This page forms part of the attached made by: (SPE&Y TYPE OF STR The premises herein is situated in q. U]�Adz SUFFOLK COUNTY,NEW YORK TO In the Township of I _ i I _ -ATTACHMENT D BOXES 5 THRU 9 MUST BE TYPE _ CORDING OR FILING. l CASE VUM9,RC.�.�� INCIDENT REPORT REPORTED q 0 3 DATE t/ �r HRS p,ACTIVITY NUMBER Southold Town Police Department Route 25 OCCURRED Peoonic,New York 11958 ASE DESCRIPTION ' 1 516-765-2600 FROM T / HRS 0 �.i I EoR m A7lot0 CLASS CODE O CASE ❑CRIMINAL CASE TO HRS ❑ NON CRIMINAL DESK OFFICER HOW RECEIVED ❑ CALL FOR SERVICE fQ OFFICER INITIATED / PA ROL OFFICER C�] ❑ COUNTER REPORT PAGE ` OF �T , �Z /U V _,SKI c�C5 L INCIDENT LOCATION �• c ��✓✓ /� A NBR STREET NAME TYPE DIR APt SECTOR T ❑ BLOCK ❑ COMMERCIAL BLDG ❑ PUBLIC BLDG. ❑ SCHOOL ❑ COUNTRY CLUB/GROUNDS O ❑ INTERSECTION ❑ INDUSTRIAL BLDG. ❑ PUBLIC PARK ❑ BANK ❑ OTHER N Er-PRIVATE HOME ❑ MULTI DWELLING ❑ PARKING LOT ❑ CHURCH i PERSON INVOLVEMENT CODES C-COMPLAINANT F-FINDER M-MISSING PERSON R-REPORTING PERSON V-VICTIM D-DRIVER I-INJURED/AIDED O-OWNER S-SUSPECT W-WITNESS E-EMPLOYEE J-JUVENILE P-POUCE OFFICER U-UNKNOWN Z-OTHER PERSON LAST NAMEFIRST MI DRESS] t U-) YC H E /,nRGG! r9 CODE HOME PHONE BUSINESS PHONE OCCUPATION Z '7'3y-5a31 RACE SEX DOB AGE HGT WGT EYES HAIR COMPLEXION RACE CODES P A-ASIAN/ORIENTAL B-BLACK H-HSPANIC I-AMERICAN INDIAN O-OTHER W-WHITE E PERSON LAST NAME FIRST MI ADDRESS R y-o LLD (4J I}`� Ui4 RJ ESS A S /� s CODE HOME PHONE BUSINESS PHONE OCCUPATION N Z 73 q-57,�23 s RACE I SEX DOB AGE I HGT WGT EYES HAIR COMPLEXION E un 9- PERSON LAST NAME FIRST MI ADDRESS CODE HOME PHONE BUSINESS PHONE OCCUPATION RACE SEX D08 AGE FHGT WGT EYES HAIR COMPLEXK)N Narrative_(Print a Type Only) Pa/i0I~-U -7G 1-Qo�� L-(sl cr9 rovIS ,o 1 P r fl f I T 7H E ,2 r ff(LQ 12--a-ti jj--2t�_- tf-T_r/cy G ll�To 07P�kP7150PL S PR0FE2_( I4A� b Td PRvPE2L ,5UPtE:2vi5E CH ILA kEfN OP FvPTf a� 4c—ri6 !U L-k-VULt2i >= —MKETN &-mit-E A-r 2tE5IDE1uCE F6WjD ©FPL-62A6t--c 0K)s 4 k) i TA 2 U C o M Q M c Y S . 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SECTOR T ❑ BLOCK ❑ COMMERCIAL BLDG. ❑ PUBLIC BLDG. ❑ SCHOOL ❑ COUNTRY CLUBIGROUNDS O ❑ INTERSECTION ❑ INDUSTRIAL BLDG. ❑ PUBLIC PARK ❑ BANK ❑ OTHER N ,M PRIVATE HOME ❑ MULTI DWELLING ❑ PARKING LOT ❑ CHURCH PERSON INVOLVEMENT CODES C-COMPLAINANT F-FINDER M-MISSING PERSON R-REPORTING PERSON V-VICTIM D-DRIVER I-INJURED/ADED O-OWNER S-SUSPECT W-WITNESS E-EMPLOYEE J-JUVENILE P-POLICE OFFICER U-UNKNOWN Z-OTHER PERSON LAST NAME FIRST MI ADDRESS i - A-w t-i S ev CODE HOME PHONE BUST SS PHONE OCCUPATION .a' 72 Ll .512 RACE SEX DOB AGE HGT I WGT EYES HAIR COMPLEXION RACE CODES P A-ASIAN/ORIENTAL B-BLACK H-HISPANIC I-AMERICAN INDIAN O-OTHER W-WHITE E PERSON LAST NAME FIRST MI ADDRESS R S o CODE HOME PHONE BUSINESS PHONE OCCUPATION N S RACE I SEX DOB AGE I HGT WGT EYES HAIR COMPLEXION PERSON LASTNAME FIRST MI ADDRESS CODE HOME PHONE BUSINESS PHONE OCCUPATION RACE I SEX DOB AGE I , HGT WGT EYES HAIR COMPLEXION Narrative:(Prtn or Type On SrFi-�'l2iUb r/Z,�m S6W&,6i =5 4 (JANE 1--Vt4roa�y. �vR.T73'w TLi[.pamp �.J CSD aQS��L 01WO__T&4,v1A-,'4W TO 14DSA!T9L VJ,4 SamE PDTS-1 A CASENUMBc•R (/ c INCIDENT REPORT REPORTED ®� — _7 7 7 DATE � Z 7`, ACTIVITY NUMBER Southold Town Police Department HRS Route 25 OCCURRED Peconic,New York 11958 CAS;7/,o SCRIIPTION �t 516-765-2600 FROM HRS .0 (/y iTJn�:_ CLASS CODE ^n /f CIE TYPE ❑ CRIMINAL CASE TO HRS (`/�/f/f�l C3"40N CRIMINAL DESK OFFICER HOW RECEIVED ❑ CALL FOR SERVICE ❑ OFFICER INITIATED PATROL OFFICER PAGE / OF [ICOUNTER REPORT L INCIDENT LOCATION A NBR STREET NAME TYPE DIR APT SECTOR T ❑ BLOCK ❑ COMMERCIAL BLDG. ❑ PUBLIC BLDG. ❑ SCHOOL ❑ COUNTRY CLUBIGROUNDS 1 ❑ INTERSECTION ❑ INDUSTRIAL BLDG. ❑ PUBLIC PARK ❑ BANK ❑ OTHER RIVATE HOME ❑ MULTI DWELLING ❑ PARKING LOT ❑ CHURCH N PERSON INVOLVEMENT CODES C-COMPLAINANT F-FINDER M-MISSING PERSON R-REPORTING PERSON V-VICTIM D-DRIVER I-INJURED/AIDED O-OWNER S-SUSPECT W-WITNESS E-EMPLOYEE J-JUVENILE P-POLICE OFFICER U-UNKNOWN Z-OTHER PERSQN 'LAISTNNAME FFIRR T MI ADDRESS CODE HOME HONE BUSINESS P14ONE OCCUPATION RACE SEX DOB AGE HGT WGT EYES HAIR COMPLEXION If RACE CODES P A-ASIAN/ORIENTAL B-BLACK H-HISPANIC I-AMERICAN INDIAN O-OTHER W-WHITE E PERSON LAST NAME FIRST MI ADDRESS R S O CODE HOME PHONE BUSINESS PHONE OCCUPATION N S RACE SEX DOB AGE I HGT WGT EYES HAIR COMPLEXK)N F PERSON LAST NAME FIRST MI ADDRESS CODE HOME PHONE BUSINESS PHONE OCCUPATION RACE I SEX DOB AGE HGT WGT EYES HAIR COMPLEXION Narrative:(Print or Type Only) re fQ PDTS-1 A CASE NUMBE`ri INCIDENT REPORT REPORTED l/ • C�' lS�c� DATE %JXJIN/�� til. — HRS ACTIVITYNUMBER Southold Town Police Department Route 25 OCCURRED Peconic,New York 11958 CASE DESCRIPTION 516-765-2600 FROM HRS CLASS CODE CASE TYPE ❑ CRIMINAL CASE TO HRS �v1V/ IJ NON CRIMINAL DESK OFFICER HOW RECEIVED ; X CALL FOR SERVICE PAT OFFICER ❑ OFFICER INITIATED PAGE OF ❑ COUNTER REPORT /H — _ i L INCIDENT LOCATION I O C L 4C/O kL) yT4oy bag A NBR STREET NAME TYPE DIR —WT -SECTOR T ❑ BLOCK ❑ COMMERCIAL BLDG. ❑ PUBLIC BLDG. ❑ SCHOOL ❑ COUNTRY CLUB/GROUNDS O ❑ INTERSECTION ❑ INDUSTRIAL BLDG. ❑ PUBLIC PARK ❑ BANK ❑ OTHER N PJ PRIVATE HOME ❑ MULTI DWELLING ❑ PARKING LOT d CHURCH PERSON INVOLVEMENT CODES C-COMPLAINANT F-FINDER M-MISSING PERSON R-REPORTING PERSON V-VICTIM D-DRIVER I-INJURED/AIDED O-OWNER S-SUSPECT W-WITNESS E-EMPLOYEE J-JUVENILE P-POLICE OFFICER U-UNKNOWN Z-OTHER PERSON LAST NAME FIRST MI ADDRESS CODE HOM PHONE BU NESS PHONE OCCUPATION S -.J RACE I SEX AGE HGT WGT EYES HAIR COMPLEXION Q NI o y L RACE CODES P A-ASIAN/ORIENTAL B-BLACK H-HISPANIC I-AMERICAN INDIAN O-OTHER W-WHITE E PERSON LAST NAME FIRST MI ADDRESS R S O CODE HOME PHONE BUSINESS PHONE OCCUPATM N S RACE SEX DOB AGE HGT WGT EYES HAIR COMPLEXION PERSON LAST NAME FIRST MI ADDRESS CODE HOME PHONE BUSINESS PHONE OCCUPATKMi RACE I SIX F DOB AGE HGT WGT EYES HAIR COMPLEXION Narrative:(Nita Type Onryq ZC4�)va 261202r Or 11n0XL int 94900- ARL; IOC47k-0 49V,a1V),J1, ;009AJ AQVISVO SV4,F1ZT 7-D A)7 /)L)7 SOIMI WtIICH HE DID. PDTS-1 A r/ CA,RE NUMBER ff INCIDENT REPORT REPORTED ,^, 1, �j ci� I I�� Southold Town Police Department DATE 10�l Qi b 0 HRS ACTIVITY NUMBER Route 25 OCCURRED Peconic,New York 11958 C E D SCRIPTION 516-765-2600 FROM HRS (_'�(\) CLASS CODE cas TYPE ❑ CRIMINAL CASE TO HRS m NON CRIMINAL DESK OFFICER D HOW RECEIVED m ❑ CALL FOR SERVICE OLOF Z ❑ OFFICER INITIATED PATA PAGE OF ❑ COUNTER REPORT03 L INCIDENT LOCATION M OC ALAC� 2-A \7AOL— A NBR STREETNAME TYPE DIR API SECTOR p T ❑ BLOCK ❑ COMMERCIAL BLDG. ❑ PUBLIC BLDG. ❑ SCHOOL ❑ COUNTRYCLIEMROUNDS I 1 ❑ INTERSECTION ❑ INDUSTRIAL BLDG. ❑ PUBLIC PARK ❑ BANK ❑ OTHER N PRIVATE HOME ❑ MULTI DWELLING ❑ PARKING LOT ❑ CHURCH PERSON INVOLVEMENT CODES C-COMPLAINANT F-FINDER M-MISSING PERSON R-REPORTING PERSON V-VICTIM D-DRIVER I-INJURED/AIDED O-OWNER S-SUSPECT W-WITNESS E-EMPLOYEE J-JUVENILE P-POLICE OFFICER U-UNKNOWN Z-OTHER PERSON LAST I E FIRST MI ADDRESS< 114 HOM PqNE BUSINM PHONE OCCUPATION P KE SEEXAGE HGT WGT EYES HAR COMPLEXION I 1 - RACE CODES P A-ASIAWORIENTAL B-BLACK H-HISPANIC I-AMERICAN INDIAN 0-OTHER W-WHITE E PERSON LAST NAME FIRST MI ADDRESS R S O CODE HOME PHONE BUSINESS PHONE OCCUPATION N S RACE SEX r DOB AGE HGT WGT EYES HAIR COMPLEXION PERSON LAST NAME FIRST MI ADDRESS CODE HOME PHONE BUSINESS PHONE OCCUPATION RACE SIX DOB AGE HGT WGT EYES HA6I COMPLEXION Narrative:(Print or Type Only) CA)e. ' PDTS-1 A I CASE NUMBEF: C/Q 7 (� !-7 INCIDENT REPORT REPORTED f� 9 / 0 l 12 7 / DATE l LLI?1�r'SJ L� HRS 'ACTIVITY NUMBER .SOlItt101d TOYIrtI Police D@FI8ft7T10f1t Route 25 OCCURRED Pe0onic,New York 11358 CASE DESCRIPTION 516-765-2600 FROM HRS Po//(e =hveJ><� 4"1i0y CLASS CODE !ff / CASE TYPE ❑C-R-UNAL CASE TO HRS 6 ?J-BION CRIMINAL DESK OFFICER HOW RECEIVED «< c ALL FOR SERVICE /❑ OFFICER INITIATED ` r ROL OFFICER ❑ COUNTER REPORT PAGE OF )�n ,S r(h nom ` i L INCIDENT LOCATION C2� 2/1011 S ee C4 k4or, -X4 A NBR STREETNAME I TYPE DIR APL SECTOR T ❑ BLOCK ❑ COMMERCIAL BLDG. ❑ PUBLIC BLDG ❑ SCHOOL ❑ COUNTRY CLUB/GROUNDS O ❑ INTERSECTION 13 INDUSTRIAL BLDG. ❑ PUBLIC PARK ❑ BANK ❑ OTHER N yPRIVATE HOME ❑ MULTI DWELLING O PARKING LOT ❑ CHURCH PERSON INVOLVEMENT CODES C-COMPLAINANT F-FINDER M-MISSING PERSON R-REPORTING PERSON V-VICTIM D-DRIVER I-INJURED/AIDED O-OWNER S-SUSPECT W-WITNESS E-EMPLOYEE J-JUVENILE P-POLICE OFFICER U-UNKNOWN Z-OTHER PERSON LAST NAME FIRST MI ADDRESS 1 Li ct, �k / e 2yq 2;0S4ie-el Cu1e-4o 4e CODE HOME HONE BUSINESS PHONE OCCUPATION Z � 3Y- sa3� RACE SEX DOB AGE HGT WGT EYES HAIR COMPLEXION a r` ftg/vim s3 RACE CODES P A-ASIAWORIENTAL B-BLACK H-HISPANIC I-AMERICAN INDIAN O-OTHER W-WHITE E PERSON LASTNAME FIRST MI ADDRESS R S O CODE HOME PHONE BUSINESS PHDNE OCCUPATION N $ RACE I SEX DOB AGE I HGT WGT EYES HAIR COMPLEXION PERSON LAST NAME FIRST MI ADDRESS CODE HOME PHONE BUSINESS PHONE OCCUPATION RACE I SEX DOB AGE HGT WGT EYES HAIR COMPLEXION NwraOVe:(Print or Type Only) —HQ v-ecer`,e.1 cc cr/( hong uP F..au �bov-L o'--/L . Seakc 4-y P/ Luho s44,-.r hem qA-¢«� q�ctn�Sdot trQs p/ay,;nC_ No ga,-OF, PDTS-1 A I Agenc 2 Division/Precinct New York State 3 ORI 4 Ong 5 6 Incident No /' / fri z-- INCIDENT REPORT NY /sf 01 Supp `> 3 SC 7.ReportDay 8 Date 9 Report Time Occurred 10 Day 11 Dale 11 Time Occurred 13 Day 14 Date 15 Time I:..' 16 Inade Typr 17 Business Name IS Weapon(s) A W s� 19 Incident Address(Street No,Street eye,Bldg No.Apt No 20 C,icy,Slatp.Z (❑C E] 21 Location Code T ❑V) B Z L 22 OFF.NO LAW SECTION SUB CL CAT DEG ATT NAME OF OFFENSE CTS 23 No of Victims C - 1 2 24.No.of Suspects 0-01 3 Q :e nail" ='ci0 ,t S e :CO Ortl ainant OT=Off e'r,' rsonlisi end FR,Pe Repo titgl�A-VlfitiiafHl Notlnte(rlewed Vl y=zVlcUm s 26 Victim also complainant ❑Y❑N - u,S .�.,. --= _ _ E TYPE/NO NAME(LAST,FIRST,MIDDLE,TITLE) Y Date of- - STREET NO..STREET NAME,BLDG NO.,APT.NO,CITY, STATE, ZIP -- Telephone No. Z Birth, o.91- kk C/J� n rj 7--J fI�{./J W 72W-76 43 1 CL G UJI Q - V H O to Ln Q I 27.Date of Birth 28 Age 29 Ser 30 Race 31 Ethnic 32 Handicap 33 Residence Status ❑Temp Res -Foreign Na[ ❑ M ❑ F ❑ White❑ Black❑ Other ❑ Hispanic❑ Unk ❑ Yes ❑ Resident ❑Tourist❑Student Other 1 7 ❑ U C]Indian El Asian[I Unk ❑Non-Hispanic ❑ No ❑Commuter❑Military ❑Home ess❑Unk 34 Type/No 1 35 Name(Last,First,Middle) 36 Alias/Nickname,maiden Name(Last.First Middle) 37 Apparent Condition K Z ❑ Impaired Drugs ❑ Mental Dis ❑Unk. 0 ❑ Impaired Alco ❑In3/III❑App Norm V1 w 38 Address(Street No,Street Name,Bldg No,Apt No.City,State,Zip) 39 Phone No C] Home 40 Social Security No L a ❑ Work F—uj w wy~j 41 Date of Birth 41 Age 43 Sex 44.Race 45.Ethnic 46 Skin 47 Occupation M NU! r, El ❑ F ❑ White C] Black❑Other C1 Hispanic ❑ Unk ❑ Light ❑Dark ❑Unk =)W ❑U ❑Indian❑Asian❑Unk ❑Non-Hispanic []Medium❑Other ViQ 48 Height 49 Weight SJ Hair 51 Eyes 52 Glasses 53 Build 54 Employer/School SS Address N ❑ Yes❑ Contacts C]Small C]Large Z Z ❑No C] Medium IA 56 Scars/Marks fTattoos(Describe) 57.Misc So.Victim or Property Property Quantity/ Make or--'i, Description `'':y'�=3 Y Value,,' Su No. Status`, Type measureUru T Model Serial No. r* 2 B. zE 3 c' EF-. �- 59.Vehicle 60 License Plate No Full 61.State 62 E■ Yr. 63 Plate T w; ❑ P• Type 64 Value a•• Status Partial❑ 5 cr� 'w C, 65.Veh.Yr 66 Make 67 Model 68.Style 69 VIN yV 6 W 70 Color(s) 71 Towed By 72 Vehicle Notes 7 To B /' 8 r^�S �/z � r��S 7•,/-eat �.. /1s ;�es-(� W� F— � 12 Q Z 13 w 74 Inquiries(Check all that apply) 75 NYSPIN Message No 76 Complainant Sign B > ❑ DMV ❑ Want/Warrant ❑Scofflaw F ❑ use cover Crim History ❑Stolen Property ❑Other Q sheet 77 rtirig Officer Signa r4(In ude Ranx) 78 ID No / 79 Supero 's Sign re(Include 7;L---- Sl 84 Z_ 'L Status ❑Open ❑Closed(if Clos d check boc below) ❑Unfounded 82 Status Date 83 Notified/TOT Of f O E]Vict Refused to Coop E]Arrest C]Pros Declined ❑warrant Ad.-sed Q ❑CBI ❑lug NO Custody 0 i '-'0 render Deed El c rtrld vec'n _vn•n).•n ^i7 c nr-i, , ,tr ern r. -r Ai Cc CTA TGnACrnlTC Ar- ai iylSi-i ARI F AC A CRIMP PUPSUANT TO THE NEW YORK STATE PENAL LAW I Agency >> 2 Dtvision/Precinct New York State 3 ORI -_� 4 W70rig 5� a[{on _L 6 In Iden[NR I sG�� INCIDENT REPORT NYa3�4 Supp 7 Report Oay 8 Date 9 Report Time Occurred 10 Day I Late 12 Time Occurred 13 Day t4 Dace 15 Time onrF—rom. I T� . F 16 Incide/ntj�pe, f, O t7 Business Name t8 weapon(s) A z W 21 Location Code V 19 Incident Address(Stmt No,Street Name,Bldg NO,Apt No) 20�} .State,Zip(❑C ❑ T ❑V) _ B Z oc ji//G+ �rrjs ,� /'t�L� �.C,s. 22 OFF NO LAW SCECTION SUB CL CAT DEG ATT NAME OF OFFENSE CTS 23 No Of Victims 1 2 24 No.of Suspects 3 25`PersonType:CO=Com`plainant0T=0therPt'-PersonlnterviewedPR–�ersonReportingWl=tlKttieszNl=Notthte`rviewedVl=Victim 26Vtatmalsocomplamant ❑YQN E TYPEINO NAME(LAST,FIRST,MIDDLE,TITLE) Date of STREET NO.,STREET NAME,BLDG NO.,APT.NO,CITY, STATE, ZIP Telephone No Z Btiirrth(.,n ON Cr F'_/ AX �. 0 �/ S/x ,f oZ?/ F G W (L G 0 W h Q V H O LA I Q 1 i f 27 Date of Birth 28 Age 29 Sex 30 Race 31 EIhn,C 32 Handicap 33 Residence Status ❑Temp Res -Foreign Nat v= White Black 0ther Hi anis Unk Yes Resident Tourist Student f]Other 1 v ❑ M ❑ F ❑ ❑ ❑ ❑ 'span ❑ ❑ ❑ ❑ ❑ r 7 ❑ U ❑Indian ❑Asian❑ Unk ❑ Non-Hisoanic ❑ No ❑ Commuter❑Military ❑ Homeless❑Unk f34 Type/No 35 Name(Last,First.Middle) 36.Ahas/NicknameiMaiden Name(Last,First,Middle) 37 Apparent Condition K Z ❑ Impaired Drugs ❑ Mental Dis ❑Unk. : O ❑Impaired Alco Q In)/III ❑App Norm N ! cc 39 Phone No Q 40 Social Security No to 38.Address(Street No,Street Name,Bldg No,Apt No,City,State,Zip) Home L n Q Work O u w uJ in 41 Date of Birth 42 Age 1 43Sex 44.Race 45.Ethnic 46 Skin 47 Occupation M Nw ,� s E] M ❑ F ❑ white Q Black❑Other C] Hispanic❑ Unk ❑ Light C1Dark ❑Unk- Q U C] Indian❑Asian❑ Unk. ❑Non-Hispanic ❑Medium C]Other toto Q 48 Height 49.Weight 50 Hair 51 Eyes 52 Glasses 53 Build 54 Employer/School SS Address N Z C] Yes E] Contacts Q Small ❑large N C)No C]Medium V1 S6 Scars/Marks/Tattoos(Describe) 57 Misc ❑ 1 :58.Victinior= =Property Property QuarihtyL - Make ora: `-M� Serial No. Description Vahie;E ❑ S N ;Status Type -Meaiur r Dr T` T:P:.-- -.n _ ,-E "U Tac ❑ 4 59.Vehicle 60-License Plate No Full❑ 61 State 62 Exp Yr. 63.Plate Type 64 Value �[ r❑ a Status 5 Or i ARL i. Partal❑ r cc W E d•t YttJ 65 Veh Yr66 Make 67 Model 68 Style 69 VIN 70 Color(s) _T1 t Towed By 72 Vehicle Notes 7 L7 73. To / ❑ a-e��, r � ❑ 9 10 W` 11 F=' Q W- W_ 12 Z E3 to 74 Inquiries(Check all that apply) 75 NYSPIN Message No 76 Complainant Signature B > Q DMV ❑ Want/Warrant ❑ Scofflaw use cover. �- ❑Crim History p Stolen v•ooerty ❑ Other sheet Q 77 po t Officer Siynat• (i�c e Ra ) 78 ID NO/ /9 iuper or's Sign dude Rank) 30 ID No 34 / V) (J (r Z a Bt Status ❑o,- ,fiL¢Iosed(I Closed check bor below) ❑Unfounded 82 Status Date 33 NoufiedROr []Vitt Refused t0 C^cO rJ nrrest f1 Pros DSI - n`atrrar• :r. .ted )J I 7 S I Gf Q l h l y„s CBI ❑luv. NOC-sto-, 'i]Arrest luv ❑Offender Dead [•trid SUPPLEMENTARY I Southold Town ntePolice Department Incident Report No.'s INCIDENT REPORT Pecortic,New 25 York 11958 516-765-2600 Page Of Pages Narrative:(Print or Type Only) P.r xr'h Q 't em- re-c I?I z *kp- (fit' zt 'I'"� �'! � �`1LG � 4T•�2 T1i/ �l/�-+GIr�JZ'�-ir h1w /D o'1 , 1 S O J����- -S-a4- e o f L aj ,re-ce. 4v44`,r- ,•cA (e7 V V1x 4. CCr tib v4- Xo.-� /V, a-- kX,ts etu 4. G Lu / V4 /`.z k Gey c. 4n V4,0 VIA hit m E�kj a(dtd We CBCs 104- 4,14 i541 A. /07,Aj, a�3- ;i,3'' as JJ wet, as Ed ro'-es k-- 7���r8ai ✓-(� �s°. �,. .� �d; G�.r�.✓(a� /0"v-. %^ Cat- O#�ghQir.+�'r C�,c �.��.�� S4C-e-,/4;r•-% !/r a4 d;J O ^ ec St.- Q vx *h.-S S r �C�zl•-► _, Signatureof Inv tiggting Officer � tx� i Name last �`�'� 2 First 3 Rank //V' a Date. L) Ieco 15Time �`� Hrs R �C R c nuLv E INCIDENT A — Under Inv- F =Ref.to Chiefs Office K— Report to be Resubmitted ❑ P STATUS 8— Cleared by Inv. G — Ref to Chief of Operations Reason — K o R CODE C — Clea e:: by Ar st H — Ref to Traffic Div T D — File I — Ref to Det Div L — Other -- --- S E — Inciden nfounded J — Re to Youth Div T A Status Code Reviewing O Date __t_I_ 1 Forward Copy to 2 3 4 SUPPLEMENTARY Southold Town Police Department Incident Report No.'s Route 25 07=42 4:5:1� INCIDENT REPORT Peconic, New York 11958 Page _Of � Pages 631-765-2600 Narrative:(Print or Type Only) ❑ Signature of Investigating Officers / J 1 Name.last 2 First 3 Rank: 4 Date 7/// / /�UJ 5 Time rs R FOR OFFICE USE ONLY K-Report to be Resubmitted INCIDENT E A-Under Inv: Ref.to Chiefs Office: E [Kj STATUS B-Cleared by Inv: G Reason: G-Ref.to Chief of Operations -- C-Cleared by Arrest H-Ref to Traffic Div. R CODE D-File I Ref.to Det.Div L-Other T E-Incident Unfounded J-Ret.to Youth Div. S n T �� Date /�'/J(_/�� Forward Copy to T is Code Re��Vo L - 4 G/L� 3 U .. �� n-,-[, T.n,n COUNTY OF SUFFOLK ROBERT J.GAFFNEY SUFFOLK COUNTY EXECUTIVE DEPARTMENT OF SOCIAL SERVICES JOHN B.WINGATE COMMISSIONER DATE: 2/15/00 RE: Henry & Maggie Wyche Dear Officer Santacroce: In accordance with Section 457 of the Social Services Law, we are writing to inform you that we have completed our assessment for Protective Services for Adults (PSA) with regard to your referral on the above individual. We have determined that he/she: ® Meets the criteria for PSA eligibility and a PSA case will be opened. ❑ Does not meet all of the three conditions for PSA eligibility as listed below: Physical and/or mental disability which renders the individual unable to obtain services essential for his/her own care and protection; In need of protection from actual or threatened harm, neglect, or hazardous condition(s); and No one willing or able to assist responsibly. ❑ Does not meet the criteria for PSA, however, a case for other services will be opened. Should you i have any question, we can be reached at 853-22.45 . Very truly yours, / r Caseworker AuL ervisor dult Services Bureau/Unit 046 PSA RSN03 (3/94) BOX 18100 HAUPPAUGE.N_Y 11788-6900 (516)854-9935 I Age9fy 2 Division/Precinct New York State 3 ORI a Orig 5 Case No 6 1 -dent N Thr,+,o /,.r,.�,( l INCIDENT REPORT NY(�;/✓� Supp j'iayy3 D� 7.Report Day 8 Cite 9 Report Time Occurred 10 Day 11 Date ,2 Time Occurred 13 Day 14 Date t5 Time On/From• To. 16 IaCiderijjype �/ 17 Buaness Name 18 Weapon(s) A ZCCT yis/y• VW -/ 19 Incident Address(Street No.Street Name Bldg No Apt No) 20 Ci y,State.Z,p(❑C l3 T ❑v) 21 Location Code a y o 2- a..r s:.. G�� � , - �, r✓ .s J7 e 22 OFF NO LAW SECTION SUB CL I CAT DEG ATT NAME OF OFFENSE CTS 23 No of Vtc'.+ms C 1 2 24.No of Suspects 3 b/ f25yPersortT C0= ntOT_ ' ype: Compta:na =OtfierPI=Personln[ervirwredPR=Person ReportingVVlf=WitriessNl=NotlntervlewedVl=wiCti '"' 2¢Victim also complainant ❑Y❑N E v1 TYPE/NO NAME(LAST,FIRST,MIDDLE,TITLE) Date of STREET NO.,STREET NAME,BLDG.NO.,APT.NO.,CITY, STATE, ZIP Telephone No. Z Birth O I r W fl O G W F _Q V H O N N Q , I 27 Date of Birth 28 Age 29 Sex 30 Race 31 Ethnic 32 Handicad 33 Residence Status ❑Temp Res -Foreign Nat ❑ M ❑ F C] White C] Black E]Other ❑ Hispanic❑ Unk ❑ res ❑ Resident C]Tourist[]Student QOtner / j ❑ U ❑Indian C]Asian C] Unk E] Non-Hispanic ❑ No ❑Commuter❑Military ❑Homeless❑Uric 34.Type/No 1 35.Name(Laszz.First Middle) 36 Alias/Nickname/Maiden Name(Last.First.Middle) 37 Apparent Condition Z C] Impaired Drugs C] Mental Dis [3 Una K O ❑Impaired Alco ❑In)/III ❑App Norm to 2 38 Address(Street No-Street Name Bldg No,Apt No,City,State,Zip) 39 Phone No C] Home 40 Social Security No L �p ❑Work w� 41.Date of Birth a2 Age 43 Sex 4.t.Race 45.Ethnic 46 Skin 47.Occupation M CA W ❑ M ❑ F ❑White❑ Black❑Other ❑ Hispanic❑ Unk- ❑ Light ❑Dark ❑ Unk. j� f" ❑U ❑Indian ❑Asian❑ Unk. ❑Non-Hispanic []Medium❑Other u1 Q 48 Height e9 W-ght 50 HairT-Y es 52 Glasses 53 Build 54 Employer/School 55 Address N Z ClYes❑ Contacts ❑Small ❑Large N (-)NO El Medium N 56 Scars/Marks 7Tattoas(Describe) 57 Misc 1 %58`Victim or Property ,s, Serial Na. Quantity/ _M_ake or besmptiors - - ;;.cc;, Value Stiipect N Status T Measure T F', Model _ C a, '< 59 S[a�use 60 License Plate No Full❑ 61-State 62 Exp Yr 63 Plate Type 64.Value O- Partial Cr W 65 Veh Yr 66 Make 67 Model 68 Style 69 VIN 'V. 6 =i _> 70 Color(s) 7 t Towed By 72 Vehicle Notes To !CP73. 8 r, /� 9 0'JtJ mss— ` r A vl� �"�-L 1 r N lC y >' A 13-41 f) If f l�n/,}I 2<<vo .� -�A?C n/✓rt�I3 a W' Q t4l�l ow J/4/V (,v./1� /tea �d/t le�.�r!%'� J% Lr./b�wS ,z z ,3 W 74 Inquiries(Check an that apply) 75 NYSPIN Message No 76 Complainant Signature B > ❑ DMV ❑ Want/Warrant ❑Scofflaw 1-- ❑Crim History r3Srolen P•operty C]other use cover Q sheet cc rti 71 R F.., gHice•i• gn0ture(rsch,de Rank) 78 ID No 79 Su isoratur (Include Rank) 80 ID NOL, 34/ 2 81 Status ❑Own Closed(if Closed checi�D,below) ❑Unfounded 82 Status Date 83 Notifted7TOT f 0 ❑Via Refused to C-[O ❑Arras• ❑P,;, Dt�' ed ❑Warrant d, _ ) r /P Q [ CBI ❑lu. r.:':�st_ar ]Arras ,u+ ❑Off=-Off—el ❑E.trad _c'�n -'Unknown 12 IJ �/ Pdgn•, I Agency 2 Dwision,PrecmCt New York State 3 ORI 4 m Ong Case No 6 Irent:+3 Z INCIDENT REPORT NY ❑ Suppay 8 Date 9 ReportZ7 Report Day 8 Date 9 Report Ti a Occurred 1 10 Day II Date 12 rime CYcurred 13 Day 14 Date 15 rime Onfflrom To: 1a2 I 16 Incident Type 17 Business Name 16 Weapon(s) A Z �Ij ve, W v 19.Incident Address(Street No.Street Name.Bldg No Apt NO) 20 City. Stat :a(0C E! T ❑V) 21 Location C-de B Z vl_ 7C. +✓ _ 22 OFF.NO. LAW I SECTION SUB CL CAT DEG ATT NAME OF OFFEh CTS 1 23 No of lItctims C 1 2 24 NO of Suspects D 3 25.PeriOrlType:CO 'ComplainantOTr=)Ot eyPIcPehonIMCrvieweQPR='�eisonR tity Yl-lAfttilesN1�=H0tIttteiviev+a!•;I=victim '- 2C1,Victimalso complainant ❑Y❑N E rr TYPE/NO NAME(LAST,FIRST,MIDDLE,TITLE) Date of STREET NO_,STREET NAME,BLDG.NO.,APT-NO,CHIN, STATE, LP Telephone No Z Birth 0 F VEc d 71 CL. O G W F ' Q _ V H 0 V1 to Q tl 1 27 Date of Birth 28 Age 29 Sex 30 Race 31 Ethmc 32 i-iaraic 33 Residence Status ❑Temp Res -Foreign Nat ❑ M ❑ F ❑ White ❑ Black❑Other ❑ Hispanic❑ Unk ❑ fl Resident ❑Tourist❑Student❑Other 1 j ❑U ❑Indian ❑Aslan❑Unk- ❑Non-Hispanic ❑ N: Commuter❑Military ❑ Homeless❑Unk 34.Type7No 35 Name(Last,First,Middle) 36 Alias7Nickname7Matden Name(Last,First 4tiddle, 37 Apparent Condition K Z ❑ Impaired Drugs ❑ Mental Dis ❑Unk 0 ❑Impaired Alco ❑In)7 III ❑App Norm V1 a38 Address(Street No.Street Name,Bldg No,Apt No,City,State,Zip) 39 Phone No Home 40 Social Security No L FO ❑ Work U.1 41 Date of Birth 42 Age 43 Sex 44.Race 45 Ethnic 46 Skin 47 Occupation M ZAiu ❑ M ❑ F ❑ White❑ Black❑Other ❑ Hispanic❑ Unk Q Ligh; ❑Dark ❑Unk. �W ❑ U ❑Indian❑Asian ❑ Unk- ❑Non-Hispanic Di Medium❑Other to Q 48 Height 49 weight 50 HairSt Eyes 52 Glasses 53 Build 54 Employee-Schacl SS Address N Z _ C1 Yes❑ Contacts ❑ Z Small ❑Large ❑ NO ❑Medium LnN 56 Scars)Marks/Tattoos(Describe) 57 Misc ❑ . 1 58 Vidl_mor. Property Property••"a .•Quantity7. _ Make or; >: Serial No_ ^�'o^''n.` ��• '` � Value 2❑ S N Status Type," '.Measur O T` 'Model _ - 3 } o W 59 Vehicle 60 License Plate No Full❑ 61 State 62 Exp Yr 63 Plate Type 6t Valuie tu ❑ a Stas 0 Partial C] 5 I W a '-J65 Veh-Yr 66 Make 67 Model 68 Style 69 Vit ❑ v_ 6 S W 70.Color(s) 71 Towed By 72 Vehicle Notes a 70 8 73. Q /I," c. W 11 H Q K12 Q Z El W 74 Inquiries(Check all that apply) 75 NYSPIN Message No 76 Complainant Signati e B > ❑ DMV ❑ Wantt'Warrant ❑ Scofflaw ' f- ❑C m Histo ❑ SIOI Property ❑ Other oseCWer Q sheet or I 7 po n ffic i ure de Rank) 78 ID c 79 upery or Sign u.(In-,ice -Rana 80 ID No r 5z ut Z Li T� 1 Status ren p losed I f Cl sed cheat iTO+bel w) �Urfo.nded 192 ;:a•us�ire 83 Noul�ed7TOT if C1 V. Refused to C ❑Arr2 f'°^s ?ebe ed wa•rant-c sea - Arre Z , Q Cel E]J.,; -NO Custody ❑ tt lir, (✓'0"e'•der Dead "'i.tratl Ge'� -1 Unk�Or,n 1. Agency 2 Divisvon/Precinct N"YOrk State 3 ORI s Ong 5 Case No 6 inti _ [No �f� U�� 8pZ INCIDENT 11 NY O��j r ' ❑ Supp 00 - 4-122- ,SO Is 7.Report Day 8 Date 9 Report Time •OcSiirred 10 Day 1 1 Date 12 Time _I—T ay 14 Oate I 15 Time 'OnlFrom- Ta" ff F-- 16_Incident Type / r 17 Business Name 16'weapon(s) W cq-)c C T y 21 LocationC e 19_Incident Address(Street No,Street Name,Bldg No_Ap-t/No) 20 City,State,Zip(❑ ❑ ❑ ) B Z;p QN GLi�CLv ye /U Y &OFF_NO. LAW _ SECTION:g - SUB ,,CL CAT DEG ATT NAME OF OFFENSE ;CTS,:. 23 No of Victims - - C_ I 2 24.No.of Suspects Axr•trta'3`r»"sgt;•^rc%+.?^�w.�, WT "I- ma_ Ao:;a': ..,v= 'i?*r 's.:•- -- scsss:cp Uz i '25BersonType:CO=Co�rtplamantOT,-,OtherPl=Perso_n_LitervlewedxPRgPersonftepoKingWl'-WCnessNI=iVOflntetVlewedVlLL=VicOta 261lictlmalsocomplainant ❑YQN E N; -TYPE/NO _,�=;NAME-(LAST;fIR57,<MIDDEE itTLEpn--' _ DatG'of. ST!tE !NO-`,-STREET4NAME BLDG:NO.;APT_NO.;CIiY�STisTE :27P;;'=, -^' J�IeptsorteNO_ �r«M.Y=rL� .,:.site.,- -•r;-x:dat?`�,.x.xr- .:r5,- � p•t '�< F_ �` p �/ (J W. Co W � Ae"- I-6-3 r sd A G_ lJ H_ to N V1 Q - 1_ 27-Date of Birth 28 Age 29 Sex 30 Race 31 Ethnic 32 HandicapYCIResdent nce Status ❑Temp Res -Foreign Nat v ❑ M ❑ F ❑White❑ Blacc❑ Other ❑ Hispanic❑ Unk ❑ Yes ❑Tourist❑Student Q Other j- U ❑Inian❑Asian❑Unk ❑ffon-Hispanic ❑No uter❑Military ❑Homeless❑Unk 34_Type/No 35.Name(Last,First,Middle) 36 Alias/Nickname/Maiden Name(Last,First,Middle) pparent ConditionZmpaired Drugs ❑ Mental Dis ❑Unk 0 _ mpaired Alco ❑Inj/III❑App Norm N Cr U, 38-Address(Street No.Street Name,Bldg No.Apt.No..City,State,Zip) 39.Phone No Q Home 40.Social Security No. CL ❑ Work �W .I- tion 41.Date of Birth 42 Age a3.5ec 44-Race 45 Ethnic 46.Skin 47.Occupation M N W i i ,r ❑ M ❑ F ❑ White❑ Black❑Other ❑ Hispanic❑ Unk. ❑ Light ❑Dark ❑Unk. 7� ❑U ❑ Indian❑Asian❑ Unk. ❑Non-Hispanic ❑Medium❑Other rJf Q 48.Height 49 Weight 50 Hair 51_Eyes 52 Glasses 53 Build 54 Employer/School 55 Address Z ❑ Yes❑ Contacts ❑Small ❑Large ra" to - ❑NO ❑Medium %n 56.Scars/Marks/Tattoos(Describe) 57.Misc. ❑ 1 SOfS �+PTOperpOpe ty f'Pt _ `+Quao" r .N,..p., ta I, el';;•' <,-;1 .7r..�c,SMf51N 'iA"- t - Oescript�O[rr, "❑ SS Ifiii TABLES TABLET --- to=LE V — - — - � 3 }: E lyr ,� 59.Vehicle 60 License Plate No Full❑ 61 State 62 Exp Yr 63 Plate Type 64 Value � ay Statin Partial❑ - 5 O, y TABLE d3 ❑ 65_Veh.Yr. 66 Make 67 Model 68 Style 69 VIN ; 6 70.Color(s) 71 Towed By. 72.Vehicle Notes 7 To: ,moi := ;.ams ,ts11 BUI 73. Yc t'\ I r -,j j&�7/c ->�c) CsN y Q. ocr Al2 CC 7 Qe, Z 13 W 74 Inquiries(Check all that apply) 75 NYSPIN Message No 76 Complainant Signature Bz� >- ❑ DMV ❑ Want/Warrant ❑Scofflaw 'TW 9 ❑Crim History ❑Stolen Property ❑Other Q sheei. 77 Reporting Officer Signature(Include Ran-) 78 iC.No 79 Sue(Include Rana) 80 ID No 34 Z 81 Stat ❑Open �XClosei(If C1Dsed check box below) ❑Unfounded 82 Status Nate 83 Nonhed/TOi ( Of / 0 ❑Vict Refused to Coop C]A--eit Prot Declined ❑warrant A / I / Q ' Pages CBI 0 luv -No Custody ❑A••est- •�Offender Deas 7 E xtrad Declin L7 Unanown l .1 �- 1.Agency 2 Diwsion7PreanR .�• �, QW O(rCa to E ;i,_,� 3 ORt q 5 Case No 6 Innd /tf'� La IGS eO Z D'€NT=EtEPORT4 3 O S S7 - y2 3 r �- 7.Repo(rrt�Day &Date f, 9 Report Time �•O[ 10 Day 11 Date 12 Time (ay�Zdw 13.Delto Date 15 Time I I� 106 �U�Z .0=< i;�w. I ,A•':Td"� -- - : Di; Ir a' -f �•o�c s,t�� 161ricident Type 17 Business Name t8 Weapon(s) A aW ♦��( C�(je ¢ 19.Incident Address(Street No.Street Name,Bldg No Apt NO) 20City.State,Up(❑C ❑T ❑V) 21 Location Code B. �•��1 2%opt R CL4,1CL3 4t N ode ?tt? 2'2.OFFa1V0'' `,[AW- SECTION*; SUB r Q: ���iCgT,?*ni"C1EG;` IgTTi'/��s'^`• iNAHtEOFOFFENSE%4;n• ;i;?J` �[7�<� 23 No of Victims - - - C- . 1 2 24.No.of Suspects !tt 3 DO� .,.e.. �t40�tE�lwed? r (cHtt)- 26.Yrmmalso complainant ❑Y❑N E Nxj @161A 7w'�'�/fAMEaAST$HRSYt3T(iLE)� �IHDate,ofr;':S;�TREET,NO:`-STfiEEfNAM '71DCiNO�APT:lt07;QTVry,55TA u7JPc,,�:g:.� `4„�-- ��es�.''�.`:-�'• Z _ �>nc x A Ta re w r; a •et- gyp -- - z t �7�s (�prtn h=" -= -w -F{�'SbA` d✓�.+.` 81Rft.(r � '?A"-`�.t.�`�=a ..cz-•'.c~t�Y' v'�`!�. �.�ei C'r�'•i. �,..•_a.- t�+`.Y 3.5^✓±rs*�:..sA.�';.� tf a BUSINESS F. W, Lie Mir Zk2 -4 SA4 RVIU.CI: Sa3 aw °I'?� 2,JSINESS G 1W_'• RESIDENCE Q% 9VSINESS H. 0= �5d RESIDENCE fA- .ai' �•;s�NE55 I ft 27.Date of Birth 28 Age 29.Sex 30.Race 31 Ethnic 32 Handicap 33 Residence Status ❑Temp Res.-Foreign Nat J. .So C- ❑ M ❑ F ❑ White❑ Black❑Other ❑ Hispanic❑ Unk ❑ Yes ❑ Resident ❑Tourist[]Student Other U ❑Indian❑Asian❑Unk ❑Non-Hispanic ❑No ❑Commuter❑Kalitary ❑Home ess❑Unk f� 34.TypefNo 35.Mae(Last,First,Middle) 36.Alias7Nickname7Maiden Name(Last.First-Middle) 37 AppareraCondit ion :Z ❑ Impaired Drugs ❑ Mental Dis ❑Unk. K Marne '1C TABL.G ❑Impaired•iko ❑Inj!III❑App Norm SS38.Address(Street 140.,Strm eet Nae,Bldg No,Apt No,City,State,Zip) 39-Plane No Q Home 40_Social Security No. L !-� ❑ Work aviry~j 41.Date of Birth 42 Age 43-Sex 44.Race 45.Ethruc 46 Skin 47.Occupation aC] ❑ ur ❑ M F White❑ Black❑Other ❑ Hispanic❑ Unk ❑ Light []Dark ❑ M. Unk. TABLE? ?cc Mo :!j 11U ❑Indian❑ Asian❑Unk. C]Non-Hispanic []Medium❑Other V4`Q, (9 48.Height 49 vreight 50 Hair 51 Eyes 52 Glasses 53 Budd 54 Employer/School 55 Address N -7'zR G _-- a E] Yes❑ Contacts []Small ❑Large ;H ❑No ❑Medium ;rte 56 Scars!Marks/ia toos(Describe) 57.Misc. �• _ a � d YtfQ4a�tityls M?�C�ACt`A � ��e.ode `l2 TABLES TABLE T TABLE U TABLE V4 ` 59 S� 60_License Plate No FuR❑ 61.State 62.Exp Yr. 63.Plate Type 64 Value yD� ¢• TAF-1- W Partial❑ 5 J- :d2 tiV GS Veli Yr. 66_Make 67 Model 68.Style 69 ViN 70.Color(s) 7t- Towed By 72-Vehicle Notes 7 To a73. 0 11,19 W� { IT U�r °OCr 12 �13 ri Total 74.Inquiries(Check all that appty) 75.NYSPIN Message No 76 Complainant Signature B ❑ DMV ❑WantfWarrant ❑Scofflaw `{- ❑Crim History ❑Stolen Property ❑Other Q s(ieeY 77.Reporting ucer Sigature(include sank) 78 IDN _ 79 Supervisor' na nclude Rank) BO ID NNoo Z_ libfl(�: 8a�ag� 81 status Ll ❑Open J�Qosed pf Closed check box below) ❑Unfounded 82 Status Date 93 NOafied/TOT of 0 C1 VKt.Refused to Coop / ❑Arrest Q Pros Declined Q Warrant Advi Q i ❑luv -No Csstody ❑Arrest-j uv ❑Offender Dead ❑Extrad DeCiin nkno+,n I I /-[ I Pag - '-_- _ -- __ �_ .t.._„�, _.. ..._ .,. . c,i�n•r ,.r ,. .-n ..r ninciinr,ir rr�ruc ar•. ..env rr�- nr.•�i •inr � t r 1.99enCy / / 7 2 Division7Precinct New York State 3 ORI 4 e.-eng 5 Case No rao INCIDENT REPORT Nv OSj_ y ❑ Supp 7 Report Day 8 Date 9 Report Time Occurred 10 Day I1 Date 12 Time Occurred 13 Da, 14 Date :5 Time W� Cil I I�n /b// On/From: To: ► -� WE �y �ov 16 1 -den T 17 Business Name 18 Wea n(s) A F. Y PO W a CaS� 0 V 19.Incident Address(Street No,Stre t Name,Bldg No Apt NO) 20 City,Stat ,Zip(�❑T V) 21 Loca7on Cod, B O�irze AlIn3A 22.OFF.NO- LAW I SECTION" SUB CL CAT DEG ATT NAME OF OFFEN CTS 23 NC of V5¢tims C 1 2 24 ho-Of Sruspeccs D , 3 25JretsotT�peCO COaptaji`n�antOT; �P1=Pe on lntervie`FiedrPR=`Pesot-pepOrtitigYlll .WittiesiM-NotlritervleyviedVl= CNmc� s 26.Victmakocomplamant ®Y®N E N TYPEINO NAME(LAST,FIRST,MIDOLE,TRLE), '�• Date of STREET NO.,STREET NAME,BLDG.NO..-APT.NO.,QTY;STATE;ZIP �r,• Z . _,yµ Birth,: ,. ;,- - - - TeleorleN� O W -1 fir ckJ��J T Mo - A�{ F -- a SAA zw-'12 / 0 G W I-- Q O H — Vt V1 Q 1 27.Date Of Birth 28 Age29 Sex 30 Race 31 Ethnic 32 Handicap 33 Residence Status C]Temp Res-Foreign Nat- C3 M ❑ F C] White E] Black C]Other C] Hispanic❑ Unk ❑ Yes ❑ Resident F]Toirist❑Student C1tch Oer / > ❑U C]Indian El Asian❑ Unk C] Non-Hispanic ❑ No ❑Commuter❑Mlitary ❑Homeless❑UrA 34 TypelNo 35-Name(Last,First,Middle) 36 Alias/Nickname/Maiden Name(Last,First,Middle) 37.Apparent Condition K Z ❑ Impaired Dugs ❑ Mental Dis I-]Um. O ❑Impaired Aco ❑In)/III❑App Norm V1 Lu 38.Address(Street No,Street Name,Bldg No,Apt No,City,State,Zip) 39 Phone NO C] Home 40 Social Secinry Nin L �C ❑ Work w 0V.N 41 Date of Birth 42 Age 43 Sex 44.Race 45 Ethnic 46.Skm 47 Occupation NW wV E] M ❑ F ❑ White❑ Black❑Other C]Hispanic C] Unk ❑ Light []Dark ❑Urx M` :)o: C] U C]Indian❑Asian❑ Unk E]Non-Hispanic ❑Medium C]Other VIQ 48.Height 49 Weight 50 Hair 51 Eyes 52 Glasses 53 Build 54 Employer/School 55 Aoaress N ❑ Yes C] m Contacts ❑Sall ❑Large Vf -� ❑ No ❑ Medium 56 Scars/Marks/Tattoos(Describe) 57 Misc ❑ 1 58.vkdoof Property Property 'Quantity/, Make or ` -r" < esaptoit N •Statin" J pe..'r Measur Dr T Model Serial No .., `. D i t-t - - value _ TAB--E 1 t8•L U E ❑ 3 F a. _ 59-5� e 60.LicensePlate No Full❑ 61 State 62 Exp Yr 63 Plate Type 64 Value us O - ;SLE .. Partial❑ 5❑ cc W CL 65 Veh-Yr- 66 Make 67 Model 68 Style 69 VIN ❑ V_ 6 W f 70-Colors) 7 t Towed By 72 Vehicle Notes 7❑ TO 73. ;c 4(vi /l �lST a 9 7�c� -❑ 9 i P ary W F 11 Q cc 12 Q Z t3 W 74 Inquiries(Check all that apply) 75 NYSPIN Message No 76 Complainant Sign > ❑ DMV ❑ WanVWarrant E]Scofflaw QE]Cnm History ❑Stolen Property ❑Other sr!e;;t I 77 Ring ONi<er Signat (I ank) 7B IO NO 79 Supervis s Sign tare(Includ nk) 80 ID iv- u 81 Status []Open Closed(If Closed check t)-ox below) ❑Unfounded 82 Status Date 6: No:ified7T0- Of ❑Vict Refused t0 Coop CI Arrest E]Pros Declined C]Warrant Advised Q C]CBI 0lu. -No Custody -Arrest luv ❑Offender Geaa ❑E.trad Decun �o.hn I I Pag - - 11.- .1.1 11 r-,.rte..-...I r—.—r.i no. r nc nrn"nr min'.inn -rrl ru C ,i r.n r v_0✓c r,rr n r n i n i . .• /� I.A ency 2 Division/Precinct New York State 3 ORI 4.KSl wig 5 Case No 6 Inodent�lp JO-Z— INCIDENT REPORT NYDSIS ❑ Supp oo_ 7 Report Day 8 Date 9 Report Time Occurred 10 Day Tt Date 12 Time Occurred 13 Day 14 Date t5.Time �U 0� 1,ol 10Q 3 S o ro 03 ,o co 1 S r°: f.. 16.Incid t Ty 17 Business Name t8 Weapon(s) &x A W x t+ T V 21 Location Code v 19 Ina en[Address(Street No.Street Name,Bldg No,Apt No) [20 G State,Lp(❑C ❑ ❑ ) e z 0 G�� L 12 ''5 2,S • 22.OFF.N0. LAW SECTION SUB CL CAT DEG ATT NAME OF OFFENSE :�CTS':, 23 No of Victims C 1 2 24.No.of Suspects QQ 3 O� S:Person Type:CO�Coinplai t"t L'=Ocie%r1=Pe+son'tttgivtweyweQ.,PR= iso_ii tI1N=yYitiiessN[e 't1 >� V< "Viiwr r 26 Victim also complainant ❑Y❑H E- TYPEMO _ 'NAME(IAST,flttST.MIOOLE.TITLE)~ Date of STREET NOI_STREET NNAE, -s: Tele . -t - --- _- -s_ -_.:7�•h':_�_,. - _- a.: = 7.,'.'�,,, PhOf?O No�'. _Birth Z .,r_ - 81151�i(i> F. SW.. C.(i I ""v"�7. Or� '1.(/� ��'��• bG� i Y1' Z-3 CL p Bus;r:_ G W I.- RES�F"tL Q H O $A H 27.Date of Birth 28 Age 29.Ser 30 Race 3t_Ethrvc 32.Handicap 33-Residence Status ❑Temp Res -Foreign Nat ❑ M ❑ F ❑ White❑ Black❑Other ❑ Hispanic❑ Unk ❑ Yes ❑ Resident ❑Tourist❑Student❑Other > - ❑U ❑Indian❑Asian❑Unk- ❑NorHiispanic ❑No ❑Commuter❑Military ❑Homeless❑Unk 34 Type/No 35.Name(Last,First,Middle) 36 Alias'Nrdcnamie/Maiden Name(Last.First,Middle) 37.Apparent Condition K z ❑ Impaired Drugs ❑ Mental Dis ❑Unk O ❑Impaired Alco ❑In)/III ❑App Norm rn W 38.Address(Street No,Street Name,Bldg.No.,Apt-No.City,State,Zip) 39 Phone No. 40 Social Security No. 9- ❑Home L �p ❑Work wN 41 Date of Birth 42 Age 43 Sex 44.Race 45.Ethnic 46 Skin 47 Occupation M n-W , ❑ M C] F C] White[I Black Cl Other ❑Hispanic❑ Unk. [-]Light []Dark ❑Unk �cc Ds' ❑U ❑Indian❑Asian❑Unk. ❑Non-Hispanic ❑Ijedium C]Other IA Q 48.Height 49 Weight 50 Mair St Eyes 52 Glasses S3.Build 54 Employer/School 55 Address N z _ - ❑ Yes❑ Contacts ❑Sma1i []Large N ❑No ❑Medium 56.Scars/Marks/Tattoos(Describe) 57.Mmc a :58.victim ai aoPertY ==P< h.' .Quantity/ "Malebr- = - y,iv:=- ra<i` - 4> loci•w r "' 'value ❑ N aStatus: ;�,' ,Type "Me .'D T Model -- �erwl"No:,ry: t..,,•- , fix•,• - 2 TAE_?i TABLE' - _r h• _� 3 }: 4 K 3 59.Vehicle 60 License Plate No Full❑ 61.Stale fit.Exp_Yr. 63.Plate Type 64.Value " a' `: Status O: i BLE V: Partial❑ 5 65 Veh.Yr. 66.Make 67 Model 68 Style 69 VIN. Va V W 70 Color(s) 71. Towed By 72.Vehicle Notes ;a _ - To �a 6 73. - J dwvL01 s cLF r e2t.tyr F J a VA,-.i 11PAA111 u41 It, 10 W F 1t Q CC 12 Q z 13 W 74 Inquiries(Check all that apply) 75 NYSPIN Message No 76 Complainant Signature > ❑ DMV ❑ Want7Warrant ❑Scofflaw a— ❑Cnm History ❑Stolen Property ❑OtherCr ustK ' Q sheet, 77 R� ng Officer Signe(Include RanK) r8 N v 79 visor's Si na re n<lu>?Ran 80 I o yt J �`71�j 84 z_ 2- 81 Status ❑Open X]Closed(,'Closed.check box below ❑UMour.]ed 82 Sta-.,Date 83 Notified/TOT 0 Q E]Vlct Ref to Coop F]arrest ❑Pros Declined C]war•a-t ae.•�s _ I to D ps CBI )uv No Custody ❑:rros. luv QOffender:ead ❑t ,,,c " Unklown tr IS-�7U i 17/971 'FALSE STATEM=NTS ARE PUNISHABLE AS A C'1'-1= �'_'�SI_-NT TO THE NEW YO^,"STATE PENAL LAW • 1 Agency 2 Di s on/Precinct NeW YOfk State '- 3 ORI4CMg 5 Case NO _ _ 6 Ina n[rtA. SQ,L�^aCd� YOsu+ ��ZOdZ 31NCIQENT,REPORTx, NY © Supp ae`Sysr/O$ 1/l r U --- 13 Da 14 Date 7.RtportDay B Date 9 Report Time ,{f)ri[irted�4 10 Day t 1 Date 12-Time - y 15 Time Z0 On,F �/J 03 t 3 Ir - i��'Kms' t�we�p«>l:) 16.Incident 17 Bus+ness Name A W S a, 21 Location Code Z,f 19.Incident Address(Street No,Street Name. dg No.Apt No 1 20. ty,S te, ip(❑C ❑T 11V) B- Oaq 9 J^�/_�Q.�7L (.(tom ��• ,� 2LOFF-NO_ - ;LAW SERION .;SUBr„ ACL, _CAT' DEG ,ATTY) ;NANIEOEOfFENS L RS - 23 No oiviRims C 5 1 2 24 No of Suspects 3 -,�: �."a�'M. it!,.`xc U�'gx�-:v'• kTrtS:ac�,+-n:�Y tiv' •K-�.:�+•..>r-.�� may.-a,. ;s^-y'{.vrxr:;fi%.t-vaarrt#',-" ',t-c3--ra.""+z""';*tE 25 Person Type CO=Corttp[a[naritrO7=0therPlcPeerrlonlnCeewed PR-PerionHeportiny,W1?wt+iess-NItlTitteVl;;-1r_n4s=" 26Victim also complainant ❑YQN N iYPEMO= 0. E ;7.NAME(LAST,FIRST;MIDDLE;i1TLE)'�;;i i Dateof; STREETNO:;STttEETNAME_,BLDGNO:!IFi;NO�r.CfTY:STAit:,aP } ,",t, _ elephoneN Z•. {.>_: '_ ',.: - 8.9_1=': K W a G. F a �, • H V O v1 ' V1 27 Date of Birth 28 Age 29 Sex 30 Race 31 Ethnic 32 Handicap 133 Residence Status ❑Temp Res -Foreign Nat ' ❑ M ❑ F ❑ White C1 Black C1 other El Hispanic❑ Unk ❑ Yes ❑ Re-wdent [:]Tourist C]Student f7 Other r 7v In ,.n J- 1-j— r-I e.,. link C1Non-Hispanic ❑No ❑Commuter❑Military ❑Homeless[]Unk 1a i ypo 0 » Nameµas[,nn[ m,.,..�ci 111-ndme/Malden Name(Last,First,Middle) 37.Apparent Condition K Z Q Impaired Drugs ❑ Mental Dis ❑Unk O Q Impaired Alco ❑In)/111❑App Norm N CC 38 Address(Street No,Street Name,Bldg No,Apt No,City,State,Zip) 39 Phone No 40.SocialSecurity No tl ❑Home L- 0 ❑Work 1-W wN 41-Date of Birth 42 Age 43 Sex aa.Rate 45 Ethnic 46 Skn 47.Occupation a W Q M ❑ F C1 White C] Black C]Other ❑ K Hispanic Unk. ❑ Li31t Q Dark []Unk. M. ❑U ❑Indian ❑Asian❑ Unk. ❑Non-Hispanic []Medium ElOther � iA a 48.Height 49 Weight 50 Hair 51 Eyes 52 Glasses 53 Build 54 Employer/School 55 Address N Z ❑ Yes Q Contacts C]Small ❑large H ❑No C]Medium Lin 56 Scars/Marks/TattOOs(Describe) 57 Mlsc ❑ 1 SB.Victimar- '!,Property Property -Mas / DMakTor :Model''''1 :.t<, SeiialNo`it _"7tpd°;t a - - - Value - TABLE' TA91` -:5 •- ❑, 1- 59.Vehicle 60.License Plate No Full 61 State 62 Ex Yr 63 Plate ❑ p Type 64.Value fl O, o Status V/ Partial❑ S K_ ..W o: =v 65 Veli!Yr 66 Make 67 Model 68 Style 69 VIN '❑ 6 .a 70 Colors) 71 Towed By 72-vehicle Notes - 7 T a . 73. r 9 �s • G 6 `c coli d�oc:� �. / ��-r. - UP 10 1-; a - Z t3 s W, 74 Inquiries(Check all that apply) 75 NYSPIN Message No 76 Complainant Signature $ Q DMV ❑ Want/Warrant ❑Scofflaw .rf➢e��Dt�flri8 1-- ❑Crim Hrstory ❑ Stolen Property ❑Other sheet'e r: K 77 R mg Ot cer Signature ude nk) 78 ID 79 rviso S nal (Incir nkh�\ BO ID No e4 �— 2 `L 81 status ❑Open C]Closed(If Closed check bow below) C]Unfounded 82 Sta:_ti Dace 83 Notified/TOT of ) Q ❑Ver[ Ry+used to Co Do 0 Arrest []Pros Declined ❑Warrant Advised ) Pages a ❑CBI Q luv NO Cuslodv ❑Arresl )uv 0 Offender Dead D E•trod Declin ]unknown I ) *Business 1.Agency 2 Dmvon/ YOrk StiftE:�° 3 ORI 4 Ongse No 6 Incident N �'uNTREPORT NYS ❑ Supp7 Re rtDay B Oa[e 9 Repdrt T,meay tt Dace 12 Time Otturred?;; t3 Day to Date t5 Time �Z- 16 Incident T d I /'1 18 Weapon(s)W �v E3 21 Locatio e V 19 Incident Address eet No,Sh t t NZ NO,Apt No) 20 State Zip( C ❑ T ❑V) B Z 22 OFF.NO LAW SECTION SUB CL CAT -DEG ~-ATT NAMEOFOFFENSE _ _ CTL 23 No of Victims C 1 2 24_No.of Suspects D 3 25.PersonTyperCO Cortt�tamartOCttfieC$f��Pe(sonlnterviewed�PR;SPersoriRepoigWl NfitNl=.NotlntervlgwedVl=Vet1m"• ;^ ; 26Vlcumalsocomplainant ❑YQN E - .:�a,.. 1 ''fix _ N TY-P-EMO " iNSTREETNAME,B.D_G.NO_ANO " A-TE.._-.DBb „ No. rth+ T Z O of :+ F iA XW O G W F Q H V O in ILA a I f 27.Date of Birth 28 Age 29 Sex 30 Race 31 Ethnic 32 Handicap 33 Residence Status ❑Temp Res -Foreign Nat White Black Other Hispan Unk Yes Resident Tounst Student Other I v Q M ❑ F ❑ ❑ ❑ ❑ spa ❑ ❑ ❑ ❑ ❑ j ❑U ❑Indian[]Asian(]❑Unk- ❑ Non-Hispanic ❑No ❑commuter❑Military ❑Home ess C]Unk 34 Type/No 35.Name(Last,Fust,Middle) 36 Alias'Nicknane/Maiden Name(Last,First,Middle) 37 Apparent Condition K Z ❑ Impaired Drugs ❑ Mental Dis []Unk. O ❑Impaired Alco ❑In17 III❑App Norm Cr 38 Address(Street No,Street Name,Bldg No.Apt.No,City,State,Zip) 39 Phone No Q Home 40.Social Security No. L a O I C] Work Us—F- W iUJI 41.Date of Birth 42 Age 43 Sex 44.Race 45.Ethnic 46 Skin 47 Occupation M &tA y Q M ❑ F ❑ White❑ Black❑Other ❑ Hispanic❑ Unk. ❑ Light ❑Dark ❑Unk. :)K Q U ❑ Indian❑Asian❑ Unk ❑Non-Hispanic ❑Medium❑Other sAQ � 48.Height 49 Weight 50 Hair 51 Eyes 52 Glasses 53 Twild 54.Employer/School 55 Address N Z - C] Yes❑ Contacts ❑Small Q Large N C]No ❑1,11fedium N � 56 Scars/Marks 7Tattoos(Descnbe) 57 [.tisk ❑ t 58.Victim Or- rs� tf i5rtY Quantity/ Dr Or. Model y' S"I No: S, �' f)esption - Value S N Pe Measur - `- - -- TAi:_E S TARLc”T :S,E U - -❑ a W 59.Vehide 60.License Plate No Full❑ 61 State 62-Expi Yr_ 63 Plate Type 64.Value a0 •Sr Status 'Y Panial❑ S d rv. 67 Model 68 Style 69 VIN. 6 W 65.Veh.Yr. 66.MakeI [:7:, � 70 Color(s) 71 lowed By 72.Vehicle Notes 7 ' To C8 73. 9 s t7 5c 10 W 11 Q OC, 12 K" Q4 Z E3 W 74 Inquiries(Check all that apply) 75 NYSPIN Message No 76 Complainant Signature B > ❑ DMV ❑Want7Warrant ❑Scofflaw use cover H ❑Crim History ❑Stolen Property ❑Other sheet Q 7 eportng ffI<er Si� re(Inch a Ra a/ 78 If 79 Supe sor's at (Include Rank) fs�_—�4 84 I VkAz 81 Status []Open < osed(If Closed check box below) ❑Unfpunde-:Q 82 tacus Date 83 Noz,fred/TOT o�❑Vict Refused to Coop E]Arrest Q Pros Declined Q Warrant=d+ a,, Pages ba�CBI Qluv -Vo Custody ]Arrest luv �]OHender Dead ❑E.trad E)Unknp.vn I I , r,�Ir „r`c 1,/07 1,.I CC CTATC+ACNITC AOC pI mncHARI F Ac A(-RIM' = IPSI)ANT TO THE NEW YORK STATE PENAL LAW 1.Agency 2 Dw+s+on/PrecinR - (1(eyy YOfRsstat "}" 3.ORI q- r+g 5 Case No. 6 Inc-dent No. 'r ![�CCiDEN EPo NY O p Sapp ���' 800 7.Report Day 8 Date 9 Report T+me kOCor 10 Day 11 Date12.Time 13 Day 14 Date 15.Time ONFrOm: _TO: 3` 16.Incident Type 17 Business Name 18.Weapon(s) A - 19.Incident Address(St r t No, tree[Name,Bldg No,Apt No) 20.City,Stat ,Z+ (❑C ❑T ❑V) 21.Locat,on Code B C. `� 2_2h QIO 1LA{N q:SEC[(ONk,�i y5UEi. �Y�. :�;C: `J -OEGv' •`-ATTt:' e'r SJfP1AME0EOFLENSov�� Y,isf _,GTS>' 23 No.ofVicrims 2 24.No-of Suspects D 3 ; "' ".:7. - ¢� :,s r"t' iv,:, d' ..nt�'-'t`y'ti-O.r- x�t""-•--az-,-��� h�$iY .CP, �-��1, T�O_ei�PJ, P,e tMvi �it' etsonRe�OGQ9•Q1fl?�Witn�.NlwOtlnt ICwea,V(; ,�viOPrt!yg� "� 26Victimalso complainant ❑Y❑N E. �+ ME(L"ASf;F1RST"MIDDLE;'•TITLE"= 7 Date` 'STREET NOx�STRE .NAME;BL'DGsNO�'PT-"NO;.'UiY'ssSTATE,�ZIP^ x�`x�` =R-s�`�'``--"'�'h^•.�w4 VI �-� -r_i w^^rt s r...wa�:Ke� �"-g?+.r ti'J•..v zi�� -m _ •�.,�. ,r "p�:,� �_ '".-� eta .NO:"-->_ J'L ��'S-.. 'tp .SA'�� �l��l rle'.a...S• '�=eSxeiT���' �',. iR7�SSivd ��Y..�C:'c2:�.i�f O BUSIt.;;S yl _ F. U` / �.• BUSLciS G. L- V. BUST-c;S H TAT f 27.Date of Birth 28 Age 29 Sex 30.Race 31 Ethnic 32 Handicap 33 Residence Status ❑Temp Res-Foreign Nat- M.0 at `lo y, ❑ M ❑ F ❑White❑ Black❑Other ❑ Hispanic❑ Unk. ❑ Yes Q Resident Tourist❑Student Q0"a er 3 4 '" ❑U Indian❑Asian❑Unk. ❑ Non-Hispanic ❑No ❑Commuter g Military ❑Homeless❑Link 34-Type/No 3S_Name(Last,First,Middle) 36.AliasfNickname/Maiden Name(Last,First,Middle) 37.Apparent Condition K z ❑ Impaired Drugs C] Mental Dis ❑Unk- Q TABLE G [1 Impaired Alco ❑1nj/IB❑App Norm tiN _;Y 38.Address(Street No.,Street Name,Bldg No,Apt No,City,State,Zip) 39 Phone No. ❑ Home 40 Social Security No- L d ❑ Work W will- 41.Date of Birth 42 Age 43.Sex 44.Race 45.Ethnic 46.Skin 47.Occupation ra/1W Mo Oav Yr g ❑ M ❑ F ❑ Wfiite❑ Bladk❑Other ❑ Hispanic❑ Unk ❑ Light ❑Dark ❑Unk M �� ❑ U ❑Indian❑Asian❑ Unk. ❑Nori-Hispanic C]Medium❑Other w!Q 48.Height 49 Weight 1 50.Hair 57 Eyes 52 Glasses 53 Build 54 Employerrctwol 55 Address N ❑ Yes❑ Contacts []Small ❑Large Y. .n T.:BLE (: TABLE ? ❑No ❑Medium _N 56.Scan!Marks/Tattoos(Describe) 57.Miu 1 .tx oPe(A� ' ,tQuaniityf'xM'15 4.2p � �'`F"� '��t�vs?+ �-yail�tie`' �- ttmdasd TABLE S TABLE T r Tr BLE U STABLE V n 3 ' z 59.Vehicle 60 License Plate No Full❑ 61-State 62 Exp Yr 63 Plate Type 64-Value To*al Status TABLEW Partial❑ 5 d? I 65.Veh Yr_ 66 Make 67 Model 68.Style 69 VIN :6] F nY1 �4 70.ColorW 71 Towed By. 72.Vehicle Notes To 8 73_ / aAA 901 jesk /J /C � 10 .cau I1 I 12 C;i .Y •ebe� q rt tj74_Inquires(Check ali that apply) 75 NYSPIN Message No 76 Complainant Signature❑ OfV ❑Want/Warrant C]Scofflaw, ❑Crim.History ❑Stolen ProjOerty er e'- 77 Reporting Offrjer, atu In a 78 10 No 79 u rv+sor' +g ature d Ra ) 60 [ONO 841 81.Ste_. ❑4n RkJosed(If Closed check bo.below) ❑Unfounded 82 Status Date 83 NOtifiedrTOT �f �O ❑Viet.Refused to Coop ❑Arrest ❑Pros Declined ❑Warrant Advised /� 2:CAL ❑ y ❑ ❑ ❑ ❑ v I k I W Pages Jw--NO Custody Arrest Offender Dead Extrad Oeclin Unknown I Agency 9 ry �- 2 Drvn onlPrecmct �11etfV YOIIESta te- 3 ORI q pn9 5 Case No 6 Inode [ INCIDENT-n?PRT I Nr b.—,XS--q ❑ supp 7.ReportDay 8 Date 9 Report Time Otturred,:,X10 Dar t 1 Date 12 Time Occurred,' 13 Day 14 Date 15 Time of I a� K� 3 --►.. �S o� {�� --► F.. 6. cadent Type 1 17 Business Name 18 Weapon(s) Z aSC/{] A W V 19.Incident Address(Street No.Stree0jaa Bldg NO.Apt No) ity, ate, ip(❑C ❑ T ❑V) 21 L tios>„�de 'Jt r 23 No VIC[Ims 22.OFF.N0. LAW`' '.'SECTION SUB' CL' eAT DEG,`' ATT G NANIE•OF OFFENSE_ _ CTS: C t 2 24.No.of Suspects 3 D6 Z-S-Ptersoitt,•T+'ry-='x-�,�,, I;..' �:•s'v��+[�j�SYtec--a�_„.---",�,`,:;.'r'2._'s..7s'�_-•."a�n.;�Bin3�i,M^-r�/Q{. +.';c.� Q=_Y !v_ y-H= �,.=..i:` _ _-�: i�,�.;'_.'_• a-,:': Tn �r- E_ _e26- Ietim alsocom airwnt Y Np40� e0.TYPE/NO- 2 F LLI 6 Vv�c J t rS G_ Q/” J l S R ACL 5- G us V H O Vf VI Q 1 f 27 Date of Birth 28 Age 297�1 30-Race 31.Ethnic 32 Handicap 33 Residence Status ❑Temp Res--Foreign Nat El E] White C] Black[ICtther ❑ HispanicE] Unk- ❑ Yes ❑❑ Resident Q Tourist❑Student�Other 1 iQ UE] Indian Asian E]Link ❑Non-Hispanic ❑No ❑Commuter[]military ❑Homeless❑Unk 34 TypelNo 35 Name(Last,First,Middle) 36 Ahas/wdcnarne/Maiden Name(Last,First•Middle) 37 Apparent Condition K Z ❑ Impaired Drugs ❑ Mental Dis ❑Unk O - Q Impaired Alco ❑Inl/III ❑App Norm V1 a38 Address(Street No.Street Name.Bldg lino.Apt No,City,State,Zip) 39 Phone No ❑ Home 40 Social Security No L F-� ❑ Work w uviIA 41.Date of Birth 42 Age 43 SeK 44.Race 45 Ethnic 46 Sbn 47 Occupation M aw ❑ M C] F F] white E] Black F]Other ❑ Hispanic C] Unk- ❑ Light []Dark ❑Unk_ ancc 7tY ❑U ❑Indian❑Asian C]Unfc_ ❑Noh-Hispanic []Medium❑Other to Q 48.Height 49 Weight 1 50 Hair St Eyes 52 Glasses 53 Scale! 54 Emplo/er/School 55 Address N Z ❑ Yes❑ Contacts ❑Small []Large N - ❑No ❑Medium 56.Scars/Marks/Tattoos(Describe) 57 M*K ❑ 58.Victim or: irnwMakew p _ Value: 7t Suspect N ea -Dr T mel ;Seria IAKE S a } .a CC -�: 59.Vehicle 60 License Plate No Full C] 61 State 62 EKp Yr_ 63 Plate Type 64-Value CL Status ❑ O vt;' TABL,W Partial❑ 5 a' W. a 65 Veh Yr. 66 Make 67 Model 68.Style 69 VIN ❑ v_ 6 W ' 70 Color(s) F-10 wed By 72 Vehicle Notes - 7 F3. To T- s e- to O " Q.y, v T- tt a ati. � c� R s c. a Z t3 LU 74 Inquiries(Check all that apply) 75 NYSPIN Message so 76 Complainant Signature 9 ❑ DMV ❑ Want/Warrant ❑Scofflaw e 'L •`1 F- C]Crim History Q Stolen Property ❑Other sheeetet i I Q sheet Fes- 7 ehporung Hicer g a Incl„eev•-,k) 78 No 79 u rvisor'sSigne a lude'ank) 80 I Z pal 2 81 Status (i Open used�i Closed check bo.below) ❑Unfo—dc8 tarot Date 83 NOtified/TOT I Q ❑Vict Refused to Coop � rest ❑Pros C•lined Q War•3nt=dvned I /!�1 Pages ❑CBI ❑luv -No Custodi Arrest iuv ❑Offena�r Dead ❑E.tr3a D-oin ❑Unknown e U 1:Age cY // 2 Di- niPrecinct New York State 3 OR 4�Ong S-Case No ZV.41p� �yl.lri �✓ � f�L INCIDENT REPORT NY �� ❑ supp ].ReportDay 8 Date 9 Report Time Occurred 1 10 Day I I1 Dat k�T ime Occurred 13 Day l4 Date 15 Tine �S !id /.�s� on7F�o m7 Og p� T—► z 16 Inciden ype, S J 17 Business Name 18 Weapors(s) A Z CUSA*,.f -ST W t' V 19.Incident Address(Street No,Street Name Sldg No Apt No) 20 Ci State Zip(❑C ❑ T ❑V) 21 Location Codi Z 9 Zl� �ib` � � 0_-Qe-'� 22.OFF.N0: LAW . SECTION SUB CL CA DEG ATT--,:. - NAME OF OFFENSE CTS 23 No of vic,ms 2 24.NO_of Suspects 3 1 8 ! S i7pe.COrComplainant-0T, Other P(=Pe�sotti tertncwedPR Personttelsort�t�g M�YI(�Ores6Ni=Not/n`teiriewedl/1=victim �; 2E%rKtimalso complainant ❑Y❑N E N IYPEJNO; NAME(LAST,FIRST,MIDDLE,TITLE) - Date of STREET NO.,STREET NAME,BLDG.NO.,APT.NO.;CITY;STATE;stip - }, Telephase N0. Z Birth Y`'- cc — oC�� Z-8 b 6.� i�(,l o 1-�- F Lu , a _ G W F - Q i V - H 0 in N Q ' I f 27 Date of Birth 28 Age 29 Sex 0-Race 31 Ethnc 32 Handicap 33 Residence 5=atut ❑Temp Res -Foreio- Nat- v C) �1 ❑ F hate❑ Black❑ Other Hispanic❑ Unk ❑ Yes resident 0 rourrst❑Student Ot!w 1 > (/ d L� U Indian❑Asian❑ Unk cr-isp— o Commuter❑Military ❑Homel[junk 34.Type7No 35.Name(Last,First.Middle) 36 AliaslNickname7M6den Name(Last,First Middle) 37.Apparent Condition K Z C] Impaired Impaired Drugs Mental Dis []Unk- o - " �,,. 1G� �C!/Lj fiJ;lrnpair-dAlco ❑In)/RI p App Norm W 38.Address(Street No Street Name,Bldg No,Apt No.City,State ip) 39 Phone No 40.Social Security No d I 7� �rd 3 2 "Lfw-r d�"fI'� L II N 41.Date of Birth 42 A a3 Sex 44.Race �45_Ethnic 46 Skin 47 Occupation A� `� O �O ) y M ❑ F ❑ White j8lack❑O[her Hispanic❑ Unk. ❑ light Dark [Unk- _ M. l/ ( ❑U ❑Indian❑Asian❑ Unk -Hispanic ❑Medium❑Other �a I 48 ht�(� 49 Wei ht 50 r+pi 51 yes 52 Glasses 53 Build 54 Employer7School SS address ZP S S ❑ Yes❑ Contacts mall []Large N G N"NO ❑ Medium H - 5 .Sw Marks7Tattoos(Describe) 57 Misc 1 CW •56.Victlmo4 .'Property Property Quantity/ Make or '= tx Value No.,: :',Status T pe Measure DrugT Model,• _ Serial No. De?r+tPU 2 w - 59 Vehicle 60.License Plate No Full❑ 61 State 62 Exp Yr. 63 Plate Type 64 Value ❑- O Status Partial❑ 5❑Cr T W a 'V 65 Veh Yr 66 Make 67 Model 68 Style 69 vin ❑ x W 70 COIOr(s) 71 lowed By 72 Vehicle Notes 7 To 73. f�/�i<<� .ate cZ,�.o-� .�. U � c� � oa- aa� ,�� d.� a•, � ��_ Le_ A El Q ❑ Lti� ct 1�P - !U Fcl�( !Z n2 Qno G1�'! iE] W 74 Inquiries(Check all that apply) y 75 NYSPIN Message No 76 Complainant Signature B > ❑ DMV ❑ Want/Warrant ❑Scofflaw ❑ I Crim History ❑Stolen Pro y ❑Other 'use.co-er Q sheet 77 Porti icer Signature(I Jude Ra 78 i0 No� 7i�� —so s Si nat rcl�d�Rank) 80 ID No / C Id 84 Cr 81 Status ❑Open +r�,G�uied(if Closed check boe below) ❑Unfounded 82 Status Date 93 NOlifiedrTOT of C] ❑Vict Refused to Coop r�lArrest ❑Pros Declined ❑warrant Ad�isec_ /)�/I 1067 �/ Q ❑CBI Cl JUr NO Lusiody ,J reit ru —Offendzr Dead ❑c•trad Dechn _ Dern (/ (� i V - -ir �7nn 17ro7 -PAI CF CTATcysch<<pO:OI iNISHARI= AS A CpiMF PI IRS' _ .' TO THE NEW YORK STATE PEND- _a'.'V i I Agency 2 Dwis.on/PreanCt New York State 3 Opti 4 Orig 5 CaseNo 6 I^Cidem No S p , �t !d o� vx n 2 INCIDENT REPORT NY SIS`i ❑ s-pp SSG 5 �' 7 Report Day B Date 9 Report Time Occurred t0 Day I Date 11 nme Occurred 13 Day is Date 15 time 41 F 16 Incid n[TCpe 17 Business Name t8 we,, A w l tlt Ciller .Qc SG T V 21 Location Code V 19 Incident Address(Street NO.Str t Name Bldg No Apt No 20 Cay Stale.Zip(❑C Q ❑ ) Z �q 9 j . C����c v B _ _ I v v. Is,t.L- 22.OFF NO LAW SECTION SUB CL CAT DEG ATT NAME OF OFFENSE CTS 23 No of victims C 1 2 24-No.of Suspects / 3 I 25.Person Type:CO=Complainant OT=Other Pf=Person InteMewed PR=Person Reporting W1=Wititite-A M=14ot kiterviewed VI=Vktim 26,Vrcttmalso complainant []YON E H TYPE/NO NAME(LAST,FIRST,MIDDLE,TIRE) Date of STREET NO,STREET NAME,BLDG-NO-APT.NO.,CITY, STATE, ZIP Telephone NO. Z Birth O N Cr Lul 7/.� 1 OLV"CS [ y ( F a p G V H O %A N Q I f 27 Date of Birth Tge 1 29 Sec 30 Race 31 Ethnic 32 Handicap 33 Residence Status ❑Temp Res -Foreign Nat Q M ❑ F ❑ white❑ Black❑Other ❑ Hispanic 0 Unk ❑ Yes ❑ Resident ❑Tourist❑Student❑Other I S ❑ U ❑ Indian❑Asian❑ Unk ❑Non+iispanic ❑No ❑Commuter❑Military ❑Fbmeless❑Unk 34 Type/No 35 Name(Last,First,Middle) 36 Alias7NicknametMaden Name(Last,First.Middle) 37 Apparent Condition K Z ❑ Impaired Drugs ❑ Mental Dis ❑Unk 0 ❑Impaired Alco ❑Inj/III Q App Norm Vf Cr a 38.Address(Street No,Street Name,Bldg No.Apt No.City,State,Zip) 39 Phone No ❑Home 40 Social Security No L ❑Work t...w W In 41 Date of Birth 42 Age 43 Sec 44.Race 45 Ethnic 46 Skin 47 Occupation M Q_W ❑ M ❑ F ❑ White❑ Black❑Other ❑ Hisparnc❑ Unk ❑Light (]Dark ❑Unk in �Cce: ❑U ❑Indian❑Asian ❑ Unk ❑NGxs-Hispanic []Medium❑Other to Q 0 48 Height 49 Weight 50 Hair 51 Eyes 52 Glasses 53 Build 54 EmployerfSchool 55 Address N Z Q Yes❑ Contacts []Small ❑Large %n Q No ❑Medium to 56 Scars/Marks 7Tattoos(Describe) 57 Mix ❑ 1 58.ViRlm or` Property ;PcoPerty, -Qijantityl Make or Serial No. Description value a No c Statin T Measure Dr T Model - a r_ - a K W 59 Vehicle 60 License Plate No Full C] 61 State 61 Exp Yr 63 Plate Type 64 Value 0 Status Partial C15 O Cr W 65 Veh Yr 66 Make 6) Model 68 Style 69 VIN ❑ V 6 W 70 Color(s) 71 Towed By 72 Vehicle Notes 7❑ fo 73. FB xvteSS �- sr I tom( U: L.�Y 10 W F Q OC 12E Q Z t3 W 74 Inquiries(Check all that apply) 75 NYSPIN Message No 76 Complainant SignatureU ❑ DMV ❑ WantNVarrant ❑Scofflaw yK r F ❑Crim History ❑Stolen Property ❑Other sheet � 77 potting Officer Signa e(include Xank) 78(-D N�/ 79 Supttvrsor s S4r/('1nclv-e Rank) 80 ±No ,, B4 sVC/81 Statu ❑Open ✓osd(if Closed check bor below) ❑Unfounded 82 a:us Date 83 NOtif�ed/ of ❑ViCL R�Used to Coop Q Arrest ❑Pro% Declined ❑Warrant Ad+iseC �� I Pa M Q luv No Custody QArrest Ia,, ❑Offender Dead ❑Eorad D^V,n ]On-0- 9 ^I A 2 Division/Precinct ., , %c WW Ybrk State 3 ORI 4 Ong s Case No 6 1 fit to INCIrDENT REPORT NY,& El Supp 7.qeRort Day 8 Date 9 Report Time ,Occuried�y.� 0 Day 11 Dale 12 Time Occurred 13 Day 14 Date 15 Time TO: r ! ? '•'DiVFrOiil=: ( IJ 16 In6tTypeL __1117 Business Name 18 Weapon(s) V� 19 Incident Aress(Street Net Name 8d�70:Apt NO) 20_ y State Z..ip(f❑C [3T ❑V) 21 Lion e 8 Z c5Y1 �"lL W\.U� V�.Q- 22.OFF.NO. LAW SECTION SUB CL CAT DEG "5'ATT`"-' NAtcEOFOFFENSE CTSi 23 No of Victims _ 1 C 2 24.No.of Suspects D ''-zaa::�c•v,��-nrsa::,�r.-:.fir•:.�E'.i. .�3r"�-=t,�s£�o�=-.2az..� •�-i�h;.� *.r r��•it<"" v� ms>Z_.- a;.z..-•.-_. _ i t,� Person CO=_Com attarRU7=0 Pl _ ' "' 7ypc pl �oGt person7rl' ervteWed:PR= -(Cepo�tt � = , sN0�4RlCYfeYYIQ VI.=�/fCtIR1yt`,`,u 26 Victim also complainant ❑Y Q N N- PEMO NAME(LAST,FIRST;MIODLE,-TITLE)=- 'Dateof:""3ySTREETiNO'd�iTREtiKAME;6LDG_NO.,APT.NO.,=CITY,+,STATE„ZIP °�'�•`•:'S',`*':�"�'-"- -7,��:" E Z•' - = - w..... ,Birth, Ct o w G rem C, b-L SJ3.1- �r, `��(... c�"��' PE• F D, G � R=S�OEt:rr Q H sA- Q 27.Date of Birth 28 Age 29 Sex 30 Race 31 Ethnic 32 Handicap 33 Residence Status []Temp Res -Foreign Nat v 11M C] F C]White❑ Black❑Other C] Hispanic Q Unk ❑ Yes E] Resident ❑Tourist C]Student❑Other 1 > ❑U ❑Indian ❑Asian❑Unk. ❑Non-Hispanic ❑No E]Commuter❑Military E]Homeless❑Unk 34 Type7No 35 Name(Last,First,Middle) 36 Alias/Mckname/Maiden Name(Last.First,Middle) 37 Apparent Condition K Z ❑ Impaired Drugs ❑ Mental Dis ❑Unk H - - • - _ ❑Impaired Alco ❑In//III❑App Norm C 'W 38.Address(Street No,Street Name,Bldg No,Apt Apt No.City,State,Zip) 39 Phone No. 40.Social Security No AL Q Home L. �C ❑ Work W �4A 41 Date of Birth 42 Age 43 Sex 44.Race 45_Ethnic 46 Skin 47.Occupation M NM+ r ❑ M ❑ F Q White❑ Black❑Other ❑ Hispanic❑ Unk ❑ light ❑Dark ❑Unk. :3= ❑U ❑Indian❑Asian❑ Unk. ❑Non-Hispanic ❑Medium❑Other TA t1 r of Q 48 Height 49 Weight 50 Hair 51 Eyes 52 Glasses 53 Build 54 Employer/School 55 Address N Z ❑ Yes❑ Contacts ❑Small ❑Large in -' _ ❑NO ❑Medium _N _ tom❑ 56.Scars/Marks/Tattoos(Describe) 57.Mist: �tcdmort HopeftYk -Moperty^• titi F` c •q .IlAakeoiscat k i, 1 __ _d- ' �” r. - r„ws,, 3S'._r.__r-�. r ` =•r� _ 4; 'f,7 7:;Qua �'.- �' S; .y $ `art=`.' ”" �'" .t...;' -Descn tion. �?9,�' •#"/.� i^1:� ^❑ i„ �^Statui 'T Pei:- :Meaiur `yJ�+::-Did:T' �FIr�S�MOde(�� __�� :,n- ,a.. ..�a•,�--,.3..i,•. ��+r..�n" ;. s,-. -E i TAB', U 1AbLE V s 59.Vehicle 60 License Plate No Full❑ 61.State 62 Exp Yr 63 Plate Type 64 Value 'oral Q W Status.._ G �. TA .:. Partial❑ ♦Y= W' 65 Veh.Yr 66 Make 67 Model 68.Style 69 VIN _6 - a ?" 70.Colors) 71 Towed By 72 Vehicle Notes a To. 73. sarrr_otil jlLILlja\/ �g 14_4- w rN 0 L^_--I\ 1„_1 c.rQ__ t ( l� h rLJ �- 12 Z 13 _- i n••i -W s 74.Inquires(Check all that apply) 75 NYSPIN Message No 76 Complainant Signature ` ❑ DMV ❑Want/Warrant ❑Scofflaw Q- ❑Crim History ❑Stolen Property ❑ Other 77 rting Officer Sig tura(Include Rank) 78 ID No 79 ...per s S ature(}nclude 4 80 iD No 81 Status C]Open Closed(if Closed,check box below) ❑Unfounded 82 atus Date 83 Notified/TOT of Q ❑Vict Refused to Coop ❑Arrest ❑Pros Declined ❑warrant Advised a 0g CBi ❑luv Flo Custody ❑ C] ❑Arrest luv Offender Dead Ex[rad Dech ] ov,n n Ukno 71 CASE NUMBER INCIDENT REPORT REPORTED C�Z_O Southold Town Police Department y 0 TE HRs ACTIVITY NUMSER Rote 25 OCCURRED Peconic,New York 11958 CASE DESC_RPTION-- - _ .516-765-2600, FROM, _-- HRS - >�� l•eJ�� � •- - -- - -- -- ---- TO HRS_ CLASS CODE CASE TYPE ❑CRIMINAL CASE L ��Q NON CRIMINAL DESK OFFICER — HOW F(COFFICER ENED ALL FOR SERVICE INITIATED PATROL OFFICER i❑ COUNTER REPORT PAGE OF I 1�an��0 G - L INCIDENT LOCATION C -7-1 oY�1 �� 4 �- � f Db lJ� A NBR STREETNAME TYPE DIR APL SECTOR T ❑ BLOCK ❑ COMMERCIAL BLDG. ❑ PUBLIC BLDG. ❑ SCHOOL ❑ COUNTRY CLU_BJGROLMW 0 ❑ NTERSECTION 13 INDUSTRIAL BLDG. ❑ PUBLIC PARK ❑ BANK ❑ OTHER N PRIVATE HOME ❑ MULTI DWELLING ❑ PARKING LOT ❑ CHURCH PERSON EMU= C-COMPLAINANT F-FINDER M-MISSING PERSON R-REPORTING PERSON V-VICTIM D-DRIVER [-INJURED/AIDED O-OWNER S-SUSPECT W-WITNESS E-EMPLOYEE J-JUVENILE P-POLICE OFFICER U-UNKNOWN Z-OTHER PERSON LAST NAME FIRST MI ADDRESS t w c4{L, mrd('6 1 ZI C ,— C-*-- oG CODE HOME PHONE BUSINESb PHONE OCCUPATION RACE SEX DOB AGEHGT WGTFS HAIR COMPLEXION T• �-{S RACE CODES P A-ASLAN/ORIENTAL B-BLACK H-HISPANIC I-AMERICANINDIAN O-OTHER W-wHfTE E PERSON LAST NAME FIRST MI ADDRESS R S O CODE HOME PHONE BUSINESS PHONE OCCUPATION `S RACE SEX DOB AGE HGT WGT EYES HAIR COMPI.EXION -PERSOti --LAST NAME------ -----f' --— --- - CODE HOME PHONE BUSINESS PHONE OCCUPATION __TRACE I SEX DOB AGE -[--HGT WOT EYES HAIR COMPLEXION Narrative:(Pi a TYPO ODM 1 OF -50 t--rr't L�-Ss - W� TU 3�1 s rnE -r9 cs kA . PDTS-1 A LAP .CASSE NUMBER INCIDENT REPORT REPORTED ACTIVITY NUMBER .Southold Town Police Department DATE HRS Route 25' occuaaED - P9=1c,New York 11958 CASE DESCaIP 516-765.2600 - _ _-- —FROM- - - �� Has CLASS CODE CASE s '"�---- HRS ©n� ❑CRIMINAL CASE r - E --- - - -- - - - -- - NONCRIMINAL DESK OFFICER F�W�iECENED - CALL FOR SERVICE PATROL OFFICER ❑ OFFICER INITIATED PAGE OF 13COUNTER REPORT A NBR STREET NAME TYPE J 61_R APT. SECTOR T ❑ BLOCK O COUJkRCIAL BLDG. ❑ PUBLIC BLDG. ❑ SCHOOL ❑ COUNTRY CLUBf_GROUNDS 1RSECTION O INDUSTRIAL BLDG. ❑ PUBLIC PARK ❑ BANK ❑ OTHER NPRIVATE HOME ❑ MULTI DWELLING ❑ PARKING LOT ❑ CHURCH PERSON INVOLVEMENT CODES C-COMPLAINANT F-FINDER M-MISSING PERSON R-REPORTING PERSON V-VICTIM D-DRIVER I-INJURED/ADED O-OWNER S-SUSPECT W-WITNESS E-EMPLOYEE J-JUVENILE P-POLICE OFFICER U-UNKNOHN Z-OTHER PE ON OLAST .AME n I FIF ST MI ` DE HOME P E _ ) INESS PHONE OCCUPATION RACE I SEXS / B HGT *-IT EYES HAIR COMPLEXION 14 1 —L b RACE CODES P A-ASWVORIENTAL B-BLACK H-HISPANIC I-AMERICAN NDUW O-OTHER W-WHITE E PERSON LAST NAME _FIRST MI ADDRESS R S 0 CODE HOME PHONE BUSINESS PHONE OCCUPATION j S RACE SEX DOB AGE GT WGT EYES HAIR COMPLEXION • $ F i -PERSON— FIRST— ----Mi- -- ---ADDRESS CODE HOME PHONE BUSINESS PHONE OCCUPATION RACE SEX _ DOB AGE MGT WGT EYES HAIR COMPLEXION ,F -1 Nary tiv •(PrIM or Type nly) 4L 1 JLC A6 W a � -1 - - a,y e PDTS-1 A 10 ,CASE NUMBER INCIDENT REPORT REPORTED DATE ACTNRYNUMBER Smffx d Town Police Department Route 25 - OCCURRED Peomtic,New York 11958 CASE DESCRIPTION. - -__ -_-- -- 516-765-.2600.."....__.:._ _- FROM _.- _ _ _ _ .._ -.-•.-- .HRS Ale. ��R�Y/`_ . Y.{�ZcTfl _ -- .....�..T.. _- - "I r©OZm f�, HRS CLASS CODE CASE ❑CRIMINAL CASE TO _r �fiON CRIMINAL DESK OFFICER HOW RECEIVED s .ALL FOR SERVICE ❑ OFFICER(VITIATED PATROL OFFICER PAGE OF ❑ COUNTER REPORTLz / - CIS O INCIDENT LOCATION ,�� ��,Z G•�: /T/f�-I I $Q� A NSR STREET NAME TYPE DIR APT. SECTOR T ❑ BLOCK ❑ COMMERCIAL BLDG. ❑ PUBLIC BLDG. ❑ SCHOOL ❑ COUNTRY CLUBIGROUNDS 1 ❑ INTERSECTION ❑ INDUSTRIAL BLDG. ❑ PUBLIC PARK ❑ BANK ETHER N 13 PRIVATE HOME ❑ MULTI DWELLING 13 PARKING LOT ❑ CHURCH PERSON INVOLVEMENT CODES C-COMPLAINANT F-FINDER M-MUSSING PERSON R-REPORTING PERSON V-VICTIM D-DRIVER I-INJURED I AIDED 0-OWNER S-SUSPECT W-WITNESS E-EMPLOYEE J-JUVENILE P-POLICE OFFICER U-UNKNOWN Z-OTHER PERSON LAST NAME FIRST MI ADDRESS l G✓ r / /i Z.ion/ �- C�� yr CODE HOdE PHONE r BUSINESS PHONE OCCUPATION SEX DOB AGE HGT I WGT EYES HAIR COMPLEXION RACE CODES P A-ASIAWORIENTAL B-BLACK H-HISPANIC I-AMERICAN INDIAN 0-OTHER W-WHfTE E PERSON -- LAST NAME -FIRST MI ADDRESS - R S O CODE HOME PHONE BUSINESS PHONE OCCUPATION N S RACE I SEX DOB AGE HGT WGT EYES HAIR COMPLEXION -PERSON --LASTNAME pT -MI-- - - -- - ADDRESS CODE HOME PHONE BUSINESS PHONE OCCUPATION RACE I SEX DOB AGE 5 WGT EYES HAIR COMPLEXKIN Narrative:tPrInt or Type Only) �✓io .Aj IRNA YA 11 IRM" -X0130-7----- � o POTS-1A T CASE NUMBER L INCIDENT REPORT REPORTEDDDA02 �_ c1 Southold Town Police Department ACTNITY NUMBER HRs Route 25 OCCURRED Peconic,New York 11958 CASE DE RIPTION 516-765-2600 FROM HRS i�7 69 s L CLASS CODE 6 eP�y� CASE IyPE ❑CRIMINAL CASE TO HRS (Y Wf9 CRIMINAL DESK OFFICER HOW RECEIVED ❑ CALL FOR SERVICE PATROL OFFICER ❑ OFFICER INITIATED ❑ COUNTER REPORT PAGE OF L INCIDENT LOCATION l/�71r '► N O Csoz- A NBR STREET NAME TYPE DIR APT. SECTOR T ❑ BLOCK ❑ COMMERCIAL BLDG. ❑ PUBLIC BLDG. D SCHOOL D COUNTRY CLUB/GROUNDS O IO ❑ INTERSECTION ❑ INDUSTRIAL BLDG. O PUBLIC PARK 11 BANK ❑ OTHER N ❑ PRIVATE HOME ❑ MULTI DWELLING O PARKING LOT D CHURCH PERSON INVOLVEMENT CODES C-COMPLAINANT F-FINDER M-MISSING PERSON R-REPORTING PERSON V-VICTIM D-DRIVER I-INJURED/AIDED O-OWNER S-SUSPECT W-WITNESS E-EMPLOYEE J-JUVENILE P-POLICE OFFICER U-UNKNOWN Z-OTHER PERSON LAST NAME � /IRST MI ADDRESS AfAy CODE HOM PHONE BUST ESS PHONE OCCUPATION Y- s 3/ RACE I SEX. DOB AGE HGT WGT EYES HAIR COMPLEXION_ V 13 2J RACE CODES P A-ASIAN/ORIENTAL B-BLACK H-HISPANIC I-AMERICAN INDIAN O-OTHER W-WHITE E PERSON LAST NAME FIRST MI ADDRESS R S 0 CODE HOME PHONE BUSINESS PHONE OCCUPATION N _ S RACE I SEX DOB AGE I HGT WGT EYES HAIR COMPLEXION PERSON LAST NAME FIRST MI ADDRESS CODE HOME PHONE BUSINESS PHONE OCCUPATION RACE SEX DOB AGE HGT WGT EYES HAIR COMPLEXION Narrative:(Print w Type Only) / fUr /L/ fYo�-,r1 .S�// zV r/E ./� _ L (/Ztfz�9t/�� J . cJ (�.CG�J L f�-- ,l., ,��/%/T L-r �,1' /�-�i�t/r.!'i�L'0 `�Y'/4�✓�9'�s���� COUNTY OF SUFFOLK ROBERT J.GAFFNEY SUFFOLK COUNTY ERECUTrVE DEPARTMENT OF SOCIAL SERVICES JOHN B_WINGATE COMMISSIONER Southold Town Building Dept July 5, 2000 Att:Ed Forrester Please be advised that Suffolk Co. Child Protective Services,Team 72,is currently involved in an investigation concerning the residence of Maggie and Henry Wyche at#249 Zion St. in Cutchogue. We are aware that Southold PD has been involved in at least 13 aided calls since Jan.2000,as well as having responded to calls made in the past. We are requesting that you forward a copy of the specific risk factors noted during the home visit made by Southold Town last week:Le build up of kerosene and soot, garbage in front yard,rodents/vermin, and any other safety concems noted. There are concerns that the housing conditions pose both health and safety risks to anyone living in there, especially young children. It is strongly recommended that this family be rehoused in light of the current living conditions, and therefore,we would appreciate any information you could forward to our agency. Thank you for your attention to this matter. If you have any questions concerning this matter,please do not hesitate to call me at# 852-3681. Sincerely, Shannon Dowd CPS Team 472 4--h-di'A 1�?-J" - Rachelle Schwartzb Supervisor Team#72 Box 19100 (516)854-9935 i ATTACHMENT F ------------ 7"-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY n e REMARKS: r uo #- c1 C n DATE �`Z-� a� INSPECTO �,.-� COUNTY OF SUFFOLK ROBERT J.GAFFNEY SUFFOLK COUNTY EXECUTIVE DEPARTMENT OF HEALTH SERVICES 6/27/00 CLARE B.BRADLEY,M.D.,M.P.H. COMMISSIONER Town of Southold 23095 Main Road-Building Division Southold, NY 11971 Dear Sirs: A canplaint was received by this office on 6/26/00 regarding 249 Zion St., Cutchogue. A large amount of rubbish, debris and trash was noted on the property. This lot appears to be in violation of the NYS Fire Prevention and Building Code, Subchapter F, sections 1242.8, 1242.10, and 1245.1(h), which refer to garbage, refuse and junk, and their disposal. Your assistance in this matter is appreciated. Should you have any questions, or if I can be of assistance, please contact me at 852-2069 or 852-2071. Sincerely, General Sanitation � tZ1-� Z 8 5 Keith R. 4Jsen, R.S. Acting Sr. P.H. Sanitarian KRJ/bg 2� S• ( C�1 Sc, r . c. r y BUREAU OF ENVIRONMENTAL PROTECTION ■ ROOM 5238,COUNTY CENTER,RIVERHEAD,NY 11901-3397 ■ FAX (631)852-3694 NOTICE VML1►D U WJ0lP `1CG 09 UN.5APS &[j0D OUS DSD D�L�lD� L �� D� MAD►� O[3 ®'��;�������� ��i����'�OL`� Z 900 DkPLrp LF0Do UW, L, AWFU)L TO REM-OVEHI 0TW WITHOUT WRITTEN PERM05= OF THE BUILDING INSPECTOR PECK TER THE BUMDONGEXCEPT 0 THE PURPOSE OF MAKING THE REQUIRED REPAIRS OR DEM OMMO THERE F® TOWN OF SOUTHOLD"S CODE 90-8 UNSAFE BUILDING52-60 USING CODE � UIQ iajNspEcToR EC 45-508 FIRE PREVENTION ��;,' ���G��✓ � " 12/81 07/U.7/uu ntl) 1.7.L0 CAo tJl060A0u6J LJJ �••� COUNTY OF SUFFOLK ROBERT J.GAFFNEY SUFFOLK COUNTY ERECUTIVE DEPARTMPINT OF SOCIAL SERVICES TORN B-WINGATE, CONIIMISSIONER Southold Town Building Dept July 5, 2000 Au: Ed Forrester Please be advised that Suffolk Co. Child Protective Services,Team 72,is currently involved in an investigation concerning the residence of Maggie and Henry'Wyche at#249 Zion St.in Cutchogue. We are aware that Southold PD has been involved in at least 13 aided calls since Jan.2000,as well as having responded to calls made in the past. We are requesting that you forward a copy of the specific risk factors noted during the home visit made by Southold Town last week:i.e build up of kerosene and soot, garbage in front yard,rodents/vemiin,and any other safety concerns noted. There are concerns that the housing conditions pose both health and safety risks to anyone living in there,especially young children. It is strongly recommended that this family be rehoused in light of the current living conditions, and therefore,we would appreciate any information you could forward to our agency. Thank you for your attention to this matter. If you have any questions concerning this matter,please do not hesitate to call me at#852-3681. Sincerely, Shannon Dowd CPS Team#72 Rachelle Schwartzber Supervisor Team#72 Dox 18100 Hauppauge,N.Y. 11788.8900 (516)954-9935 C 3 RECRDEO rt � Number of pages TORRENS 00 AUG 29 PM 12: 38 Serial# E U lid s D LEP�.�ROMAINE Certificate# SUFFOLK COUNTY Prior Ctf.# Deed/Mortgage Instrument Deed/Mortgage Tax Stamp Recording/Filing Stamps 4 FEES Page/Filing Fee K Mortgage Amt. Handling 1. Basic Tax TP-584 2.Additional Tax Notation _ Sub Total EA-52 17(County) Sub Total Spec./Assit. EA-5217(State) Or Spec./Add. RP.T.S.A. S`- �yCs�� �1�j�, TOT.MTG.TAX Comm.of Ed. 5 00 ,§' Dual Town Dual County Id Held for Apportionment Affidavit °9,1 �q�rJ�+ Transfer Tax �hn NoeQe 11 Certified Copy Mansion Tax The property covered by this mortgage is or Reg. will be improved by a one or two family Sub Total dwelling only. Other YES or NO GRAND TOTAL If NO,see appropriate tax clause on page# of this instrument. 5 Real Property Tax Service Agency Verification 6 Community Preservation Fund K9d Dist. Section B lock Lot Consideration Amount $ Ttan)dj vr ��� 0 �� / CPF Tax Due $ Improved Init'als Vacant Land :f Satisfactions/Discharges/Releases List Property Owners Mailing Address TD RECORD&RETURN TO: TD TD (�7'L 5-3 09 -j-4t,?,L-)E6'Z �) 8 Title Company Information //Q 7/ Co. Name t V ® Title# 9 Suffolk CountX Recording Endorsement Page This page forms part of the attached ��At' - made by: (SPE TYPE OF STR The premises herein is situated in q J,0g&&jjp1 SUFFOLK COUNTY,NEW YORK. TO In the Township of In the VILLAGE or HAMLET of - BOXES 5 THRRU 9 MUST BE TYPED OR PRINTED IN BLACK INK ONLY PRIOR TO RECORDING OR FILING. IOVERI y l i l EDWARD FORRESTER o� OG Southold Town Hall Director of Code Enforcement =� y1 53095 Main Road ti Z P.O. Box 1179 p Southold, New York 11971 Fax(516) 765-1823 t . Telephone(516) 765-1802 BUILDING DEPARTMENT TOWN OF SOUTHOLD NOTICE Pursuant to Chapter 90 Southold Town Code DATE: August 28, 2000 TO: Alma R. Williams 533 Third Street Greenport N.Y. 11944 A. The last Assessment rolls of the Town of Southold shows you are the owner of the following described premises; Located on Church Lane Cutchogue NY., bounded on the north by Town of Southold property, on the east by a Private Road, on the south by the Baxter property, on the west by the Mason property. The above described premises are the same described in a deed recorded in the Suffolk County Clerk's Office in Liber 11900 Page 924. Also referred to as Suffolk County Tax Map Designation : District 100,0,/Section 96, Block 1 Lot 11Gt; =�- a <�`�`� B. The single family dwelling located on the property is structurally unsafe and dangerous and as such constitutes a hazard to safety by reason of; In particular: The roof of the structure is deteriorated causing the coiling to collapse in the kitchen area, the flooring in the kitchen is unsound, the porch and front steps are unsound, the circuit breaker panel has fallen away from the wall supporting it, exposed wiring on the surface of the walls, open switch boxes with loose outlets and switches hanging from same, extension cords powering appliances located outside the structure, a wall mounted gas heater with a bed placed against it. C. You are hereby ordered to ; make the building safe and secure or demolish and remove the debris D. The above work shall commence within ten (10 ) days from the date of this notice and shall be completed within thirty ( 30 ) days thereafter. E. In the event you fail to comply with the above, a hearing will be held before the Southold Town Board concerning same at 9:00 A.M on Tuesday September 26, 2000 at Southold Town Hall, 53095 Main Road, Southold 11971. F. In the event that the Southold Town Board after the hearing herein shall determine that the building or structure is unsafe or dangerous to the public, the Town Board may order the building or structure to be repaired and secured or demolished and removed. G. In the event that the building or structure shall be determined by the Town to be unsafe or dangerous and in the event of the neglect or refusal of the owner to repair or remove same within the time provided, the Town may remove such building or structure by whatever means it deems appropriate and assess all costs and expenses incurred by the Town in connection with the proceedings to remove and secure, including the cost of actually removing said building or structure, against the land on which said building or-structure is-located. i STATE OF NEW YORK ss.. County of Suffolk I, EDWARD P. ROMAINE,Clerk of the County of Suffolk and Clerk of the Supreme Court of the State of New York in and for said County(said Court being a Court of Record)DO HEREBY CERTIFY that I have compared� �he annexed copy of���— �Cl��-(��, � C.Gra ,Y agi .v+a hJ /�0& Aq, and that it is a just aid true copy of such original and _ of the whole thereof. IN TESTIMONY WHEREOF,I have hereunto set my hand and affixed the seal of said County and Court this _? day of pt,ei . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 'Clerk. I Form No. 104 72-109 12J89cs I s Y UNIFORM FORM CERTIFICATE OF ACKNOWLEDGMENT State of New York ) - ss: Countyof/�)- 9 ) On the day of in the ye�. ' a U°L before me, the undersigned personally appeared 1.41 .✓ personally known to me or proved to me on the basis of satisfactory evidence to be the individual(s) whose name(s) is/are 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 his/her/their signature(s) on the instrument, the individual(s), or the person upon behalf of which the individual(s) acted, executed the instrument. Notary Pub1- ,, THOMAS®.CAULFIFLD 'Notary Public,Stote of Now Ybik No.01CA4691026-Suffolk County Commission Expires 0dober 31,2001 i ..^:i ,+M:. ,),,� a+ �,;1):, '::k _. z, lq :..3•.!. ,1`:el ,gyp r-:.J3 `ht'fn r,1-f�::.-.k :�✓Y �{VY :�; 5�;�-T `4l -MhD--: -''�S awRt ;.�.�?+ 1.. �ib k/ :-+, i ,,rl �F,yr•lv+, �.;�Vtx�k�F Y,^'1 y(`fii '•'v,'�a• aE„+•9? ''.. ``r �r ,'r.4f�d'b� 'Y. •�e': �'Ss�+#. r,,�.l�r'If�,: F 'a` v��1�,..nb'. ac, rn$nr Y'�,+>•{f 61,J+�'►(V w 3 '-��. .1,t- f:;�"� /..�:�i�� �..'^ �;:: '}"FA rl,�. i •...'�f� i'+`,'`I y r.;^ti s •dlr, a� �'7•?'/+ ''t:. '€"ut.4>tw,,,e rWai�`. '/,<�vt.F;;,c�,r�..'74,r rty. .x1�� s'� 'r�i�, �,�e .. � � �;,, 1,.,.wt .e e 7 �' � � t2� za r5 3. a t y �• � "`�'�'d�Ft <hx1 rt 4�,., .n u ;1, .?x / kt�. 3 +C,.:�♦ 9�c -, z p .i i .n .:/ { Sy,�.4,�.x"Y t..:Sl�'t r+'F•:i�. 'hi Ic-F,C�.yF�.�TF .,A'R� yY'�!.�Y'/� f �j.S' - L '<t 1 V'� k.r�.�1,1�l,�+ :h i, .•i!i,a•. 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"r.1:^.F�� &��r�y�k::�3" r\4":yd�ya �..r' " �R f:d;.=fa �r�r�.0 S-ti.,r R �.�' '• •�;�1 4V,t ., ., rM'C .fit ._ci# Y��, 'iA A Ir•.<.:.;' ! r' t4:k tela"mw'RR7("b Y; v..3 � r.;'#}t7 .ra•i.;.'r.•-e uty/r1� Y;."r-`•.'. •.4. t: :� .•ei •.:.�. �.k�.7-..t�,..e: .�a AFFIDAVIT OF PERSONAL SERVICE -----------------------------------------------------------------------X STATE OF NEW YORK) COUNTY OF SUFFOLK) ss.: I, the undersigned, being sworn, say: I am not a party to the action, am over 18 years of age and reside at 1114 Sipp Avenue, Medford, New York; On August 28, 2000, 1 served the within NOTICE Pursuant to Chapter 90 Southold Town Code by delivering a true copy to Alma R. Williams at 533 Third Street, Greenport, New York. I knew said person served to be the person mentioned and described in said papers. ccs--P� Edward Forrester Sworn to before me this 25th day of September, 2000 u,,�� w &L Notaky Public LYNDA M.BOHN NOTARY PUBLIC,State of Ne ya* No.01 806020932 Qualified in Suffolk Cou Term Expires March 8,20AA