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Home My WebLink AboutTR-5571 .- '.'~... ... ~ '.~~~~~-~.-...!_-'~~-' . --!~. ~_._.~.~. '-' . ._"-'-' . - - '-'--'-~. -' ~ TERMS ilnd CONDITIONS The I'emIitœc David J. L!õ'C1aire 10505 Soundview Ave.. Southo1d ~u ~~u put' of !be coosideratioo for the /s<o'.~ óf the Permit does IIØdentoød aod prescribe to the fol- lowing: 1. TIw!be said BoaI:d of T~ aod the Town of SouthoId ue released áwa ISJf aod oil cIomoges, or claims fIX dama¡a, of suiø aåsiøg ditecdy or ÜIdireIdy u . result of ISJf 01*- adoo pedoamed punuaat to this peauit, aod the aid fl· JIf.... 'IriII, at his « I>et own ~-. defend ISJf aàd oil IUCb IUiCs"..&I-wI by third putiel, .... the Aid 1'0. 'lie-' .......... fo11 JiobIIity with reSpect tI>eteto, to the ~ '.-IncIn.. of the Boatd 01 TtaoUa of the Town of ~ , N/A 2. That this PeaaIt is ...w lex . pedocI of ID05. wtdcD is œGJl~11M to be !be ~........! time' tequitcd CD cninplele the wod< ia'9Ohed, butihoaJd ~........ w.....A, Ieqaest for ao exte!ISÏ.oo may be made to the BoaI:d u . later date. 3. TIw this Permit sbouId be reCained iadefioitely, or u loog u tbe Aid r......Ittee wishes CD m.j....in the sttuCt1ttC or project iavolved, to provide evidenœ to aoyooe cooœmed that oath- ,orizodoo WIS originally obtoioed. 4. That the wodcÍlm>lved will be subject to the in<pection aod approvaI of the Boud « lIS agents, aod noo-œmpIiaøce with, the provisioas of the origi....fI-og .ppliatioo, may be cause f« moatioa of this Permit by rao1otioo of tbe said Board. S. Thu tbeœ will be 110 unreosooable iaterfenoce with aavigatioo u . rauIt of !be 'WOdc heœin authorized. ' 6. TIw tbeœ sbaI1 be øo iaterfaeace with the right of the pub6c to pus .... lepus aloag !be beach between hi&h aod low water marks. 7. TIw iffuaue operoâ..... of !be Town of SoutbøId zeqaùe tbe .......... UlId/1X úcent/oas ia the Iocatioa of the wod< bereIa ...cJoo.~<I, or if, ia the opúdoo of the Boatd of Tmscees, the, wodc sho11 cause unmosoooble obsttuctloø to ftee aaYigIodoa, the Aid fI, ..dlle.: will be nqaIted, apoo clue aotiœ, to remove or alter this wotk 01: project beteIa stated wicboat RþCI 01. to !be Town of Southold. :. 8. TIw the said Board will be notified by tbe hnni~ ot the ~, Of the 'MId: 1IICh- orized. 9. That the Pennitœe will obcain oil other pemúII UlId ov-""ti dJat may be ¡equùed aap- p1emental [0 this pemdt wbIch may be subject to revoIœ upoa fdlure to obtain -. . . ~?>./U<'2 Albert J. Krupski, President James King, Vice-President Henry Smith Artie Foster Ken Poliwoda Town Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-1366 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Office Use Only _Coastal Erosion Permit Application /'Wetland Permit Application _ Major _Waiver! Amendment/Changes ....Received Application: ~J¡D/O ÍJ} --LReceived Fee:$ 5lJ' ~mpleted Application ÇfIO/O:JJ _Incomplete _ SEQRA Classification: Type I_Type II_Unlisted_ _ Coordination:(date sent) ...cAC Referral Sent: tølD'J.1 ----ð>ate of Inspection: ~/~JO ~ _Receipt ofCAC Repo : _Lead Agency Determination: Technical Review: _Public Hearing Held: Resolution: Minor ff:~-;-- - n I ! /' :',1 MAY 0 '2002 , ¡ - -_..~~.~- .-....., , -,. 1::.:.._. ._.~.~- Name of Applicant ÞA V I D :J it c.. LAI f1,. E ¡fl/§N<.IE Address /OStJ.S' .5:::vAliyv1EW NÝ /iC¡'1/-2.74S Phone Number:( $J{) rH ðLLJ Suffolk County Tax Map Number: 1000- ) ((,30 765-(.:,52.8 54 - 05- 31. 2. ,r~l' Property Location: IO~D) 5óVIIIIJ V/c-W /lv'E· "3wn-fúL/J / IJY. I J <¡ 71 - 2 7lf~ (provide LILCO Pole #, distance to cross streets, and location) AGENT: ;.I/A (If applicable) Address: 1"/14 Phone: ¡.J IIf · . Board of Trustees Application Land Area (in square feet): GENERAL DATA 4/.,1 4ç¡z. .l.S FT 5l!1. Area Zoning: R-L.O Previous use ofproperty:~Ac..AÑÍ \Z.E:S\'t>£t.Jí\ AL Intended use of property: f::ES \ DE 1\)', U\ L (S I NbLE ¡:::'A /VI I L Ý ) Prior permits/approvals for site improvements: Agency Date X No prior permits/approvals for site improvements, Has any permit/approval ever been revoked or suspended by a governmental agency? --X-No_ Yes If yes, provide explanation: Project Description (use attachments if necessary): K'é I/E6E. T"'r/DN ðF WEtLI'1A/A Bi.lF¡C"€X: ë.oNt As ~ S/-n:: ¡::z,/9t</ flt 375.56>. F-r. J. ¡.?EVE6Ií/lTIO/Ý oF /ì..4N-r/ WOO}:) 'I MA1'Ef2/~/..5 A:'> DlRE"CT£ð B1' Cf/R"vE"LL EJlravslð/1,/ SuFFO~ CðUNíÝ. SE£ srré l'1^1ð PL.4/VT'/Ntf¡ øws -¡e('f77{Cf/EtJ. · . Board of Trustees Application WETLANDrrRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: I?é VE61 7//7'/ CJN AN l> ¡f'£' .5 7ð~~ -rr ~ if FJ<E.5HW/17ER. ("JEff-FIND ßVrr£R -¿öAJé. J?E"R-éN/SI-/ I¥FEC.:rø LIIND A~ WITt-! ¡Jll-1ïl/E Veb/íFJt/ON. Area of wetlands on lot: ::1.9;::< 9 I. Z 8 square feet (I,vUUDINÓ, B()FFa~. 2.0NE: ') /9.-'I&.ld wlou-r" BUF",es? uN€ Percent coverage oftot: SS- % Closest distance between nearest existing structure and upland edge of wetlands: 75 feet Closest distance between ~earest proposed structure and upland edge of wetlands: N A feet . Does the project involve excavation or filling? x No Yes If yes, how much material will be excavated? III/A cubic yards How much material will be filled? IIJ /1/ cubic yards Depth of which material will be removed or deposited: ¡V/14 feet Proposed slope throughout the area of operations: ~O Be (/ N CHI{ tt/6C/J Manner in which material will be removed or deposited: VEf:,tT II 7Í O/Il to ß £ R.ANrt::7:J ¡,AI GKWPI^//:,S of 3-£/ PtA/{ 73 wrrH D/S7/1NC£.5 ðF /0 n:-, /2 Æ<=r BE-rw/:FIU p,eO¡PèJsE2) /'tA/\/7/N 6 C;,eoc/'~ . Statement of the effect, if any. on the wetlands and tidal waters of the town that may result by reason of such proposed operations (use attachments if appropriate): -rf/I:!; F/lOPasEl> Æi:vE6i711-rIO"¡ Pt.I9/ý tUlt-v /If" Arr£Cr IMJ11élJ/t1/G I/JE7Z.../'lND ENVI¡(CNW1é7'JT ~ /I'.s pl'l~tK-'1L WI'" {y1lÛé5 . . . Albert J. Krupski, President James King, Vice-President Henry Smith Artie Foster Ken Poliwoda Town Hall , 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-1366 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD BOARD OF TRUSTEES: TOWN OF SOUTHOLD ----------------------------------- In the Matter of the Application of --~~~-~~-~~~------------ COUNTY OF SUFFOLK) STATE OF NEW YORK) I, ÒtVJD t£&,¡/~ 5cvr¡'¡(Lh/ IfIV /f17/- ~ 7lfr being duly sworn, depose and say: AFFIDAVIT OF POSTING at /0[;0.5" &::u¡1/D VIEW f1Vgr/tÆ , residing That on theS/ day oflfA,f\{ ,2002. I personally posted the property known as by placing the Board of Trustees official poster where it can easily be seen, and that I have checked to be sure the poster has remained in place for eight days prior to the date of the public hElqring. Date of hearing noted thereon to be held ~~ ~~~ o t\ or (Jþ~..l:t ï:ot> ~ tC\. Dated: Œ:d£ Sworn to bef~*e me this 3/6l'--day OfrT1"1¡ 2002....- N~~C (ðì þ~~ NOTARyN~~E~~t:~~7 New YOfk , o. 01 806020932 Oualrfled in Suffolk C Term Expires ~1I1r('h R. ~~~ .....,..... - .. . Board of Trustees Application County of Suffolk Stat!õ' of New York ÊYtv/ò .::r L.-1f"C-LAIßé' BEING DULY SWORN DEPOSES AND AFFIRMS THAT HE/SHE IS THE APPLICANT FOR THE ABOVE DESCRIBED PERMIT(S) AND THAT ALL STATEMENTS CONTAINED HEREIN ARE TRUE TO THE BEST OF HIS/HER KNOWLEDGE AND BELIEF, AND THAT ALL WORK WILL BE DONE IN THE MANNER SET FORTH IN THIS APPLICATION AND AS MAY BE APPROVED BY THE SOUTHOLD TOWN BOARD OF TRUSTEES. THE APPLICANT AGREES TO HOLD THE TOWN OF SOUTHOLD AND THE TOWN TRUSTEES HARMLESS AND FREE FROM ANY AND ALL DAMAGES AND CLAIMS ARISING UNDER OR BY VIRTUE OF SAID PERMIT(S), IF GRANTED. IN COMPLETING THIS APPLICATION, I HEREBY AUTHORIZE THE TRUSTEES, THEIR AGENT(S) OR REPRESENT ATIVES(S), TO ENTER ONTO MY PROPERTY TO INSPECT THE PREMISES IN CONJUNCTION WITH REVIEW 0 PLICATION. SWORN TO BEFORE ME THIS 1 u.... DAY OF m~ ,200~ ~~ 2 e-t9Æf2¿U Notary blic (¡ UNDA J. COOPER Notary Public, Stale of New Yorn No. ~22563, Suffolk Cr,œ.tv . ,/ Torm E>:p'ras Decemo¡¡r ;; j. ¡.eJ>1.(;ú y October 15, 2002 Board of Trustees Town of South old Main Road Southold, NY 11971 (JL; f I 5 '21ì'JL RE: Request for Property Inspection This letter is being submitted as a fonnal request for a residential property inspection at the following address: 10505 Sound view Avenue Southold, NY 11971-2745 Plot Map NumberlOOO-54-5-37.2 The inspection is prescribed to insure compliance to the previously submitted and approved Re-vegetation Plan dated 06/20/02. Please notify me via mail when a convenient date can be set for the inspection. Thank-you. vld J. LeClaire Owner 631-765-6528 .r .- Albert J. Krupski, President James King, Vice-President Artie Foster Ken Poliwoda Peggy A. Dickerson . . Town Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-1366 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD YOU ARE REQUIRED TO CONTACT THE OFFICE OF THE BOARD OF TRUSTEES 72 HOURS PRIOR TO COMMENCEMENT OF THE WORK, TO MAKE AN APPOINTMENT FOR A PRE-GONSTRUCTION INSPECTION. FAILURE TO DO SO SHALL BE CONSIDERED A VIOLATION AND POSSIBLE REVOCATION OF THE PERMIT. INSPECTION SCHEDULE Pre-construction, hay bale line 1 st day of construction % constructed ~ Project complete, compliance inspection. . 10/1'\102- h~b~ ~ ~~t: ~~~ c'''W'-f~ ~ ~- 9.~ "/2..(,/02... f/o..",- +- h.) 1¿/3//ð¿ Albert J. Krupski, President James King, Vice~President Artie Foster Ken Poliwoda Peggy A. Dickerson . . Town Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-1366 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD June 28, 2002 Mr. David 1. LeClaire 10505 Soundview Ave. Southold, NY 11971 RE: 10505 Soundview Ave., South old SCTM#54-5-37.2 Dear Mr. LeClaire: The Board of Town Trustees took the following action during its regular meeting held on Wednesday, June 26, 2002 regarding the above matter: WHEREAS, DAVID J. LECLAIRE applied to the Southold Town Trustees for a pennit under the provisions of the Wetland Ordinance of the Town of South old, application dated May 10, 2002, and, WHEREAS, said application was referred to the Southold Town Conservation Advisory Council for their findings and recommendations, and, WHEREAS, a Public Hearing was held by the Town Trustees with respect to said application on June 26, 2002, at which time all interested persons were given an opportunity to be heard. and, WHEREAS, the Board members have personally viewed and are familiar with the premises in question and the surrounding area, and, WHEREAS, the Board has considered all the testimony and documentation submitted concerning this application. and, WHEREAS, the structure complies with the standards set forth in Chapter 97 ofthe Southold Town Code, WHEREAS, the Board has detennined that the project as proposed will not affect the health, safety and general welfare of the people of the town, 2 . . NOW THEREFORE BE IT, RESOLVED, that the Board of Trustees approve the application of DAVID J. LECLAIRE to re-vegetate the wetland buffer zone with plant/woody material, with the condition that all of the re-vegetation work is completed by December 31. 2002. BE IT FURTHER RESOLVED that this detennination should not be considered a detennination made for any other Department or Agency, which may also have an application pending for the same or similar project. Pennit to construct and complete project will expire D!õ'cember 31, 2002. Fees must be paid. if applicable, and pennit issued within six months of the date of this notification. Inspections are required and the Trustees are to be notified upon completion of said project. (See attached inspection schedule.) Fees: $5.00 Final Inspection Fee Very truly yours, (i~t t ·1 (J. /¿'-"--f"~'~" Albert J. Krup{ki, Jr. President. Board of Trustees AJK/lms Albert J. Krupski, President James King, Vice-President Artie Foster Ken Poliwods Peggy A. Dickerson . . Town Hall 53095 Route 25 P.O. Box 1179 Sout.hold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-1366 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD June 28, 2002 Mr. David J. LeClaire 10505 Soundview Ave. Southold, NY 1 1971 RE: 10505 Soundview Ave., Southold SCTM#54-5-37.2 Dear Mr. LeClaire: The following action was taken at the Southold Town Board of Trustees regular meeting held on Wednesday, June 26,2002: RESOLVED, that the Southold Town Board of Trustees APPROVE the request for a Transfer ofPermít #5196 from Manzi Homes, Inc. to David J. LeClaire. If you have any questions, please contact our office at (6311 765-1892. Sincerely, t2.:.L.J (1. /¿r.-..-",v&.. G.~ I , " Albert 1. Krupski. Jr. President, Board of Trustees AJK: bus Albert J. Krupski, President James King, Vice-President Henry Smith Artie Foster' Ken Poliwoda . . Town Hall 53095 Main Road P.O. Box 1179 Southold, New York 11971 Telephone (516) 765-1892 Fax (516) 765-1823 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD TO: flJJlJ-/d "'1' r';('Q({al a'o. Please be advised that your application, dated s-ItO/O;¡..J has been reviewed by this Board, at the regular meeting of fÓ /d.fð/OJ.J and the following action was taken: , ( ~ Application Approved (see below) (-) Application Denied (see below) (-) Application Tabled (see below) If your application is approved as noted above, a permit fee is now due. Make check or money order payable to the Southold Town Trustees. The fee is computed below according to the schedule of rates as set forth in the instruction sheet. The following fee must be paid within 90 days or re-application fees will be necessary. COMPUTATION OF PERMIT FEES: .;Jt f),DD 6(r)Ò1! l r1,¡)~{'"tCe,\J ~ ~/O .DD Õ1o..~ f-u- $.5/ ê. i~' TOTAL FEES DUE: _ ~ . L.-V þY 0,.,\ --ì IJD 'if ~ () JftSfí tla....·1 ~ 1&" /sJ..- (), SIGNED: y. 7 PRESIDENT, BOARD OF TRUSTEES BY: ~Q..u..u.nJt.{}L~l' cr; , BOARD OF TRUSTEES 4/98 Page 01.---1_ Pages Southold Town Police Department Route 25 Peconic, New York 11958 631-765-2600 .ent Report No. '5 O~- ~~"¡I SUPPLEMENTARY INCIDENT REPORT Narrative: (Print or Type Only) ,q" P~c...~ tE...~ ~ruAUO Alo ¡::u~ ~¡u. '1,..1. o 1 Name: last " c.. 2 First 3 Rank: '\';<:.. " tb 0 ~ 4 Date: I I g:'s-' 5Tíme ~ R E p o R T INCIDENT STATUS CODE A - Under Inv: B - Cleared by Inv: C - Cleared by Arrest D-Ale E ~ Inckfent Unfounded FOR OFFICE USE ONLY F - Ref. to Chiefs Office: G - Ref. to Chief of Operations H - Ref. to Traffic DiY. I ~ Ref. to Del DIY J - Ref. to Youth Div. K - Report to be Resubmitted Reason: L - Other . T A Status T 1 U . PDT$·2A Code Reviewing Officer 2 Dale:~_/~/_ 3 Forward Copy 10: 4 Signature Rank Time Hrs. . . Telephone (631) 765-1892 Town Hall. 53095 Main Road P.O. Box 1179 Southold. New Yark 11971 SOUTHOLD TOWN CONSERVATION ADVISORY COUNCIL At the meeting of the Southold Town ConserVation Advisory Council held Monday, June 24, 2002, the following recommendation was made: Moved by Melvyn Morris, seconded by Bill McDermott, it was RESOLVED to recommend to the Southold Town Board of Trustees APPROVAL of the Wetland Permit Application of DAVID J. LECLAIRE to re-vegetate the wetland buffer zone with planUwoody materials. Located: 10505 Soundview Ave., Southold. SCTM#54-5-37.2 Vote of Council: Ayes: Bob Ghosio, Melvyn Morris, Bill McDermott, Jason Petrucci. Abstained: Drew Dillingham Motion Carried . . Notice of Violation: Town of Southold Code Chap 97. Article II. See 97-20 Baelæround Approximately 2/3 of the land property in description 1000-54-05-37.2 is deemed wetlands out of the entire. 98 acre lot. I. David LeClaire, unknowingly and unintentionally altered the land inside the buffer zone as indicated in the land survey as recorded by the Town of Southold during the months of March and ApriL Unaware of the restrictions that were imposed prior to the issuance of the building pennit by the Town of South old and Board of Trustees, the following activities were conducted: · Fallen woody debris was removed and piled · Thorny vines were cut back and removed uom healthy trees, bushes, and shrubs · Dead tree branches were trimmed back uom healthy trees · Straw bail buffer line were spread out due to decomposition and insect breeding Also, 2-3 dead trees were cut down due to their proximity to the house structure and the risk of damage that could he caused by high winds. Intention In anticipation of the annual Town of South old Spring Clean-up. several piles (6 total) are currently situated along the front edge of my property awaiting pick-up and disposal. These piles of debris came primarily from the POrlÍOIIS oflalld outside the indicated buffer zone as plotted on the land suniey and my intentions were to take advantage of the Annual Spring Clean Up Program. Result Since cleaning up the wood debris and removing the thorny vines, the general appearance of the property has improved as well as the health ofthe many trees that were possibly once in jeopardy of dying from the vigorous spreading of thorny vines. Also, the wildlife activity seems to be prevailing with the removal of the thorny vines. Birds, herds of deer, squirrels. and ducks seem to enjoy the semi - cleared space where they can graze freely. The actions that were conducted on my behalf are not permanent and can be returned back to the otiginal state. Since I am now aware of the conditions that were originally stated on the Building Pennit. J will cease further debris clean-up and clearing within the indicated buffer zone of the land survey. Also. if necessary, I will comply with any/all recommendations or suggestions that you, Board of Trustees may issue. Thank-you. Sincerely, r- " Ie, , Ii J' i=- David J. LeClaire (owner) Cindy J. Silver (ownet) 10505 Soundview Avenue Southold, NY 11971 l.a 'S-(p ~;}..~ April 24. 2002 '.1 APRl5m. L_¡ TOvrLOf ~:'::.!. -...........'~. .. '~'- - --- . NOTICE . Police Dept. - Bay Constable Town of Southold Peconic, New York 11958 NOTICE OF VIOLATION Date: April 15 ~ 200:' To: David LeC181r~ (Owner or authorized agent of owner) Address: 10505 Soundvi~w Av.. Southold, ~.Y. tl97l (Address of owner or authorized agent of owner) Please take notice there exists a violation of the Code of the Town of Southold, Chapter 97 Article II, Section 97-20 a premises hereinafter described in that yuu are conducting activity in a non- di~turb¿~nce buffer zall~. You are therefore directed and ordered to comply with the following: C~ase all further activity \vithin non- ¿istur!Jance areõ1.. Apply for <J Trustee Permit for work already done. on or before the to day of ~t"y ,20~. The premises to which this Notice of Violation refers are situated at: 10505 Soundvielol Av.. ~otJth"ld. ';.Y. tun Town of Southold, Suffolk County, NY (Suffolk County Tax Map Designation: Dist. 1000 Section: 54 Block: 05 Lot: 37 . 2 ) Failure to comply with the applicable provisions of the law may constitute an offense punishable by fine or imprisonment or both. NOTICE: You have the right to apply for a hearing before the Board of Trustees of the Town of Southold, provided that you file a written request with the Clerk of the Trustees within 10 days after service of the Notice of Violation. Such request shall have annexed thereto a copy of the Notice of Violation upon which a Hearing is requested and shall set forth the reasons why such notice of viola- tion should be modified or rescinded. ~ 1,3. Bay Constable, Tow NY \ . . Local Cr iminal Court c.c. NUMBER I 02-3241 ARREST NUMBER(S) TOWN OF Southold DEFENDANTS IN CUSTODY VIOLATION INFORMATION FROM DATE & HOUR TO DATE & HOUR RK I. LK } 55 } Defendant(~ 2. uthold David LeClaire 3. B.C. Kent B. McCarthy VILLAGE OF DOCKET NO.(S) STATE OF NEW YO COUNTY OF SVFFO VILLAGE OF TOWN OF So Name (Complainant) of No. Southold Town Police Department, POB 911. Peconic. N.Y. 11958 being duly sworn, says that on or about April 15. 2002 at about at 10505 Soundview Av. ~~f Southold Townof Southold County of Suffolk, State of New York, the defendant(¡) David LeClaire 10505 Soundview Av.. Southold. N.Y. 11971 DOB 7/15/65 wrongfully, intentionally, knowingly, Iœ~~b<nccti~ committed the offense(~ of: Conduct activitv in a non-disturbance buffer zone. No Trustee Permit pursuant to 97-20. A violation of Section 97-33A of the Southold Town Code. Count #1 in that: the defendant. at 10505 Soundview Av.. Hamlet of Southold, Town of Southold. County of Suffolk. State of New York. on or about April 15, 2002, having no right to do so. did conduct activity in a non-disturbance buffer zone without first obtaining a permit from the Southold Town Trustees. Therefore violating Section 97-33A of the Southold Town Code. This complaint is based on (personal knowledge) J&cØxfaaaalion<aad:ào¡icf){JtllQ,:JDII[_illlXç~ltodd~om:~,gf Direct involvement of deponent. dated ] [the attached laboratory repot! of the J.. dated SWORN TO BEFORE ME THIS 15 DAY OF ,-¿,/ JÍ / - ¿/, ~('/. ll¿í1/F"/Z~ } ~ ß--f./7¡/ -'^--.... /. c.--- SIGNATURE OF OFFICIAL ADMINISTERING OATH Sergeant- Southold Town Police April 1'9' 200~ P.J . /!... If.:.....::t ~- COMPLAINANT 1'4 TITLE VILLAGE OF TOWN OF Southold SSCS-3000b 'STRIKE OUTWQRDS NOT APPLlCASLE: 53·240..5Ig1cs 1'.3''''n'' INc~m~T~~p~~~ I ~~~~-I5". I '~~:~p ~C¡;3'¡'1 I' In"d,n, NO. 9 Report TIme 0ccVrr@d 10. D"V 11 Dale 112. Time Occurred 1] Day 14 Dau~ . 115. Time q~IS-""""';' fl'/IJ H'"i 115"1 OJ.. q:I~~ 'Î.'/IJ ... 1/5"1°1.. 1:1.:1-> I. Agency SOUT"t-ML" 'OWI'-' 7. Report Day f'10r-l 8 Date <( I I S' I Oa. >- Z ~ o o ;!; 161nc,dentType . T.......... ~1:>1L I.1,OLf\T',(jN lB. Weapon(~) 17 8u~lne~~ Name 20. (itV. Stine. Zip (0 ( 0 r 0 v So,,'¡"'~Lt> tV'! 1/ ~ 11 NAME Of OFFENSE r-Jo 'ï'~~.,...tL A:.A..I"'\I ';""'"' 21 location (ode "'-...'0-"" 19 Inc,den! Address (Street N~ Stre-et Name. S!dg No. Apt NO) ¡o'i;oS- <.,ou....1:",,'II:.W A" 22. OFf. NO. LAW SECTION - SUB Cl CAT q1 CTS lJ. NO. of Victims I OEG ATT , 'õ'"t... .3.3 A LL - c.. v , 3 24. No. of Su~ ~ Z o ~ '" ~ ... o ~ >- « o o ~ '" « 25.Person TyØI!:CO '" Complainant or.. Other PI.. Person In~entiewed Pft= PeBon Reporting WI '" WitnesS NI_ Not Interviewed VI '" Victim TYPE/NO NAME (LAST, FIRST, MIDDLE. TITLE) Date 01 STREET NO.. STRfET NAME. BLDG. NO., APT. NO., CITv, STATE. 8irth I 26 Victim al~ complainant 0 Y 0 1\1 ~p Te4ephon@No. :.h4'1 ~ ,'P¡? I 7(, ..-. J2'17-- F. ~-, Fa.. 'i"U:. ~-r,E... '7/LU !:> Ti:E--3 ,~~~ S,.. .f,..¡}T~) J I 11'j'7l G. Oï-I L...CL...:H_ ~ ~v :1:1 j /,~-II.." lOS-OS- 'OIJ",hV:Fl.U Au <"",..~t> 710'5"· "5.ól\S H ~ F u ~ 32 Handicap 133 Flesidence Status 0 Temp Res. - Foreign Nat. o ", 8 Resloent 0 TOurist 0 Student n Other o No Commuter 0 Mditary 0 Home'lëu 0 Unk 27. Dllte01 øirth I I 28. Äg@ 29. Se~ I IR~ OF 3D.Race D White 0 81ðCk 0 Other o Indian 0 ASian 0 Unk. 31. EthniC o HispanrC 0 Unk. o Non-Hispanic 34.TypetNo 35. Nam@ (La~t. First. Middle) 37. Apparent Conditron o Impaired Drugs 0 Mental Dis 0 Unk. o I""pa.red Alco 0 InJ I HI 0 App Norm 36. AliaslNicknam@lMaid@nNam@(Last,First,M.ddle) z o ~ '" ~ ... >-0 V::;: 1,1,1"" 41. ...~ ~'" ::>« ~« ð z ¡¡; '" ~ 1.12 Age 49 Vvelg/'lt 150 Hair 51 EVe~ 39.PhoneNo. o Home OWC'rk 44. Race 145. Ethnic 146 Skin o white 0 81ack 0 Other 0 Hispanic 0 Unit. 0 Light 0 Dar~ 0 Unk. o Indian 0 As.an 0 Unk. 0 Non-Hispanic 0 Medium 0 Other 52 Gla~~M 53 Build I '54. EmploverlSchOol IS5. lIddre5S DYes 0 Contacts 0 S""aU 0 Large o No 0 Med.um 41. Occupation 38. Addres~ (Street No., Street Name, Bldg. No., Apt No. CltV. State.l.p) 40 SocIal Security No 43. S@~ OM 0 F Ou Date of Srrt/'l 1 AB.He.ght, 56 ScarstMarkstTattoos(Deswbe) S7.M,sC ~~; ~~~.r Property Status Property T,,,,' Model S@rlaINo. 3~~~~:f O~:ðk~u~ }@scrrption Value .. >- '" ~ ... o '" ... 162 f~p. Yr. 168 Style 163 Plate Type 64. Value 69 VIN 59. Vehicle Statvs 60. License Plate No F l 61 Stare Part.alO ~ ... V :;: ... > 66 Make 67 Medel 6S. Veh. Yr. I" Towed By: To. 172 Veh,cle Notes 10.Color(s) n. R"-iI>l..I'-~"E.-O ~ 'r' T¡+e.. ..."'..",,1'....- 0".--, \ [I~_ t'...:"'..L ¡:¡""prL'r"r" ¡I'L"O'> So"",,!)v,£..w F->-. AL.....'....¡yy "'~ ,N.(- Co.....",;,_>"I'...I\ '''-'' .. .L"~ "r~.' ...... .J.."';u., "'.. J,¡.,L......-..~P..I :tI"-1 T<> ,-<J 0..1 'r1> ".~...... c .<!.. -¡-o Rv So"''T'HOL,.". C> ..L,."" _ )." <.-:-' c,.L ......L... '" 11,:''-",,,,,",,0,,-, ~ > ¡:: « '" '" « z "'.-.-.:D 7,~""£L -r....."~.. ~ > ¡:: « '" >- '" z ~ o « 75 NysprN MesSdge No. 76 Compl¡"nant Signatur@ 74 Inquiries (Check all that "pply) o OMV 0 Want!Warrant 0 ScoHla..... o Crim. HIstory D Stolen Prooerty 0 Other 77. Reportlflg Officer S.gnature {Indude R¡,nk) " /~ 178 rD NO ß.e. ,..(. + Ï",. M. (''þ....r¿ 1'1- 1.- B1. Status ~t DOpen D'-loÍed{rfClOsed.Chec~_~'beIO""") o VIet. Refused to Coop. D Arrest 0 Pros Declined o eBI 0 Ju~. ·/ljo Custody 0 ArresT ·Ju~ 0 Offender Delld 79. Super~.sor·5 S.gnature (Include Ran~J I so IDNo , ð LI83 NOtlfleCIfTOT Ounfo..ndeCI o Warrant Ad~.sea OEotrild Dec"" .:JUnlCno....n B2. Statu~Date 4{ IS" 005-3205 /2.'971 *FALSE STATEMENTS ARE PUNISHABLE AS A CRIME. PURSUANT TO THE NEW YORK STATE PENAL LAW ^. . c. 2:)1 E I. J. K. , M N [J [J ŒJ [J [] GJ [J GJ GJ GJ CJ o EI B i ""'<ovo< ,..., ... ) "'age 0' I Pages - -_.....-.~_.~~~...... .....-...--.-.... .. -........... .". . _...:..:..-..,..... / . . ELIZABETH A. NEvn..LE TOWN CLERK ~-""':::2:~'::...-"',,>- .t.~ --c~ v'~ '!.UFFOq' ~~. '1}~\,).<::;:'';< y~ ~"- ~Y¡S .:",,-~ ... ""'~ 'ð ~!J ~ . ~$' ~O./ + ~~c:s ~~ "?o-.-.t.. "1'ß .~ Town Hall, 53095 Main Road P.O. Box 1179 Southold. New York 11971 Fax (516) 765-1823 Telephone (516) 765-1800 REGISTRAR OF VITAL STATISTICS MARRIAGE OFFICER RECORDS MANAGEMENT OFFICER FREEDOM OF INFORMATION OFFICER OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD APPLICATION FOR PUBLIC ACCESS TO RECORDS INSTRUCTIONS: Please complete Section I of this form and give to Town Clerk's Office (agency Freedom of Information Officer). One copy will be retLJrned to you in response to your request, or as an interim response. ------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------- SECTION I. TO: ( Department /""' I ~ r Officer. if known, that has the information you are requesting.) R£CORD YOU WISH TO INSPECT: (Describe the record sought. If possible, 5upply date, file title, tax map number, and any other pertinent information.) r,~ \; (\~lt~ _I) '""' I/.· ..,....¡-- (, ,hÔe .1 ~ , .J 'íì - 1/1:.( ~ Ç(~ i~/,n(~----4-, /111 (( n ' ~ / [11 fí /I/1<¥.{' " I rlì s+ , 1 1// ~ *- ~ j f --> i/ Printed Name: / nilV¡ I , S¡gnature of Applicant: Address: Mailing Address (if different from above): I Telephone Number: 631-+-b(""- "LIl' \.j Date: t( 1/ " /1,..J' , ==--===========--===========--======--=======--=========== [ ] APPROVED [ ] APPROVED WITH DELAY* ~4~t2 ?:þ~~/¿ ~-;Zbeth A. Neville Freedom of Information Officer ItEcelVED [ ] DENIED* NOV 1 5 2000 :!Inurhnl'" J 0'fjR ëi.rk ate * If delayed or denied see reverse side for explanation. 1 ~ ~~ i~ "> ~ 1 1 / 1 1 / 1 1 &/ .w c2' - 1 ~~ ./~ ./ 1 1 I I - 1--- 1 / 1 1 / 1 1 / I~ .~ ~, -'l -0- .¡.. b -'l .¡.. b ~ ö1 --i è5 r m - ~ - - ~ANo - YC6/ìA - _ nON - _ LINE - - .É//O/ao --0 Q~ mC) (\--0 7\~ m 10 20' 10--0 7J7J -() <"11 mC) 1:.0' ~m -<'10 10 ~--o m~ 0'C) 10--0 m() Ztf\ (\m mQ , ' ~~ ,- ê\~ I () \ U\ Xi /-...... J-<IJ r:~ / í U\ o / ñ1 -IoK \;J L::J '-.. L ...... / '\ 0 \ 5' ......- /'1IN 1 , / -'l VI VI , ~ 30'-6- , ,UI /; , , jJ - - .. nl 71_Ll: S VI VI \J1 () q