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New York State 1—et`,e r Department of Motor Vehicles �OP MOSO4 5(19y SbRV TO REMOVE THIS VEHICLE FROM POLICY SUBMIT COPY TO INSURANCE COMPANY PLATE SURRENDER NAN4P PLATE REG TYPE YR MAKE REG EXPIRES K76272 PSD 2001 DODGE PERM VIN 3B6MF36511M264237 SURRENDER DATE 09/19/14 ITEMS SURRENDERED 1 PLATE SOUTHOLD TOWN DEPT OF PUBLIC WORKS PO BOX 178 PECONIC NY 11958 1679556F SEP 19 2014 MMO RVH628 20140919092259 1679556 F FS-6T(sin) COMMISSIONER OF MOTOR VEHICLES PART2 If the other side of this receipt indicates a registration suspension,this receipt is considered to be an official order suspending your registration certificates and plates in accordance with the terms specified.This action is taken under Section 318.1(a)of the Vehicle and Traffic Law. dys. ((iiLLrr11//\JJ�ir FS-6T(6/11) www.dmv.ny.gov i �e voxx sr 120 New York State Department of Motor Vehicles �OF MOM a is3 TO REMOVE THIS VEHICLE FROM POLICY SUBMIT COPY TO INSURANCE COMPANY PLATE SURRENDER tvh 4 .t 1J6CUlUtb ' JEV645936209US , EI150974665USI PLATE REG TYPE YR MAKE REG EXPIRES K28405 PSD 2001 DODGE PERM *zircr 3ECO vIN 3B6MF36531M575121 SURRENDER DATE 09/19/14 ITEMS SURRENDERED PLATES DESTROYED TOWN OF SOUTHOLD PO BOX 178 PECONIC NY 11958 1679557F SEP 19 2014 16795M H628 20140919092351 FS-6T(6/11) COMMISSIONER OF MOTOR VEHICLES PART 2 If the other side of this receipt indicates a registration suspension,this receipt is considered to be an official order suspending your registration certificates and plates in accordance with the terms specified.This action is taken under Section 318.1(a)of the Vehicle and Traffic Law. FS-6T(6/11) www.dmv.ny.gov ,�e OWEN J. Mc•SHANE- NEW Department of Director YORK p STATE Motor Vehicles DIVISION OF FIELD INVESTIGATION 6 EMPIRE STATE PLAZA •ROOM 431 •ALBANY, NY 12228 August 24, 2015 Southold Town Department of Public Works PO box 178 Peconic, NY 11958 Re: 2001 Dodge VIN: 3B6MF36511M264237 To Whom It May Concern, The Office of Field Investigation has notified us, that the above vehicle is listed as a DESTROYED vehicle. The vehicle was transferred to be destroyed. Therefore, the vehicle is considered a junk vehicle and can no longer be titled. • We are sorry for any inconvenience this may cause you. Sincerely, Elijah S. Auto Theft & Salvage o www.dmv.ny.gov MV-K.;----_-- I. Batch ��NEWYORK DeVEHICLE REGISTRAx ION/"t'ITLE File No. mum • , 1. art pment of .1/4,onyPQRTUNRY Motor Vehicles APPLICATION 0 Orig 0 Activity 0 Renewal 0 Lease Buyout ' ' This form is available at www.dmv.ny.gov 0 Dup 0 Activity W/RR 0 Renew WIRR 0 Sales Tax with Title .:_ Old Old 3 of Ins. Co Exp r' Class Name I I Code I I Date 11111 ft' .,..:',-.'i, Plate I I I I I I I I I 'IL,., Scofflaw Case New New ` Number(s) Plate I I I I I I I Class ; L `d''),�" Special ecial AT BV CF CO CP EX FL GI IF MO NE NF NR NU OD OP OV PA J(i, ��' Conditions PC PK RC RE SA SO SR SS SV TE TL TO TP TR TX XR X6 WO `=' i Sales Tax Status Value Jurisdiction Rate Out of Stale Audit (-_T,r7? Information ($) �4�� Is there a penholder' ❑Yes ❑No If"Yes", r'ct::` Did you issue plates to this Plate Reg Class Date Temp Issued Facility ID Number enter the information in Dealer Only box below f �r'41 vehicle? Number Alterations are not allowed In the lienholder sections. �1S 0 Yes 0 No INSTRUCTIONS 4 COMPLETE 0000 and 0. WHEN 3❑ AND 0 APPLY,COMPLETE THOSE SECTIONS. PRINT CLEARLY IN BLUE OR BLACK INK. 0 1 MARK THE BOX OF THE TYPE OF SERVICE YOU NEED.(For more information,refer to form MV-82 1,"Registering/Titling a Vehicle in New York State") 0 A FIRST REGISTRATION for this vehicle 0 CHANGE a title(refer to ❑5 ) 9 0 REGISTER a vehicle that I registered before Get a TITLE ONLY for a 1973 or newer vehicle If you mark one of the options below,write the PLATE NUMBER here 0 RENEW a Registration 0 CHANGE a Registration(refer to0) 0 REPLACE lost registration items 0 TRANSFER a Plate Number 0 Purchased my LEASED VEHICLE You can update the address on your registration and renew your registration online at www dmv nv goy 0 NAME OF PRIMARY REGISTRANT(Last,First,Middle) NYS driver license number of PRIMARY SEX DATE OF BIRTH M F Month Day Year Southold Town Depart of Public Works ❑❑ I I I I I I I NAME OF CO-REGISTRANT(Last,First,Middle) NYS driver license number of CO-REGISTRANT SEX DATE OF BIRTH M F Month Day Year ❑❑ 1111111 DAY TELEPHONE(Optional) NAME CHANGE? ADDRESS CHANGE? How didyouget Is this registration for a corporation IMNew ❑Leased New Area Code 7 6 5—18 0 0 �✓ FrNO or partnership'? ❑Yes il�No the vehicle'? ( 631765-1800 ❑YES(refer to❑5 ) [lfNO ❑YES (mark one) DUsed ❑Leased Used THE ADDRESS WHERE PRIMARY REGISTRANT GETS MAIL (Include Street Number and Name,Rural Delivery or box number This address will be on the aocument) Apt,No City or Town State Zip Code County of Residence PO Box 178 Peconic N I Y 11958 THE ADDRESS WHERE PRIMARY REGISTRANT RESIDES IF DIFFERENT FROM THE MAILING ADDRESS (DO NOT GIVE A P o BOX) Apt No, City or Town State Zip Code pDRIVER LICENSE NUMBER OF OWNER The owner of the vehicle must sign this section. NOTE: Do not complete this section if a completed Registration Authorization (form MV-95) is attached or if you apply to renew a vehicle registration and the owner of that vehicle has not NAME OF CURRENT OWNER(Last,First,Middle) changed.Proof of ownership and proof of owner's name and date of birth are DAY TEuired LEPHONE NUMBER OF DATE OF BIRTH OWNER.(Optional) Month Day Year Area Code 1111111 t ) THE ADDRESS WHERE OWNER GETS MAIL Rural Delverynclude theioret baxNu umber mbea) Name.d a Apt No City or Town State Zip Code County AUTHORIZATION:The registrant described in 0 is authorized to register the vehicle descnbed in 0 (Signature of owner or authorized person,and signature of co-owner if applicable) (Date) °I VEHICLE IDENTIFICATION NUMBER VEHICLE DESCRIPTION Body Type For Cars(mark one) I Year (Make II 3B6MF36511M264237Station Wagon c; 2001 I Dodge ❑2-Door❑4-Door 0 Convertible ❑Suburban ❑Other Body Type For Other Vehicles(mark one) Type of Power(Fuel) Color Unladen Weight �/ .Pick-up❑Van ❑Tow ❑Trailer ❑Other Red 5596 l!7 Gas 0 Diesel ❑Electric ❑Flex 0 CNG ❑Propane 0 None Truck ❑Motorcycle Truck For trailers&commercial vehicles For rentals,buses&taxis Does the ODOMETER display 5,6 or 7 For commercial vehicles Cylinders Maximum Gross Weight Seating Capacity Odometer Reading in Miles numbers?(wnte the number,do not Axles Distance include tenths) 5 s" Lien Filing Code Lienholder Name and id yi (Assigned Mailing Address toj T by DMV) ;r,r Mileage Brand Pdor Issuance TitleStatLien Lien Lien Release Owner � I 1111111 1 1 1 Number 1111 I I I _ Proof Submitted(Name and Ownership) Approved Stop/Response -'' By !,.'-;', "./Z.Date Old ' '- : ;', ,t'T Reg/Title State Fee Operator MV-82(1/15) PAGE 1 OF 2 © CHANGES-Write new information about a current registration or title cp ppga, 1:uf this form(for more information, refer to form MV-82 1, Pea tering/Titling a Vehicle in New York State") NAME CHANGE:Pnnt the former name exactly like the former name is printed on the current registration or title. CHANGES.Descnbe any vehicle changes and the reasons for the changes 0 ADDITIONAL VEHICLE INFORMATION QUESTIONS 1-3 MUST BE COMPLETED. 1. I certify that,to the best of of my knowledge,this vehicle 0 has been or has not been wrecked,destroyed or damaged to such an extent that the total estimate,or actual cost,of parts and labor to rebuild or reconstruct the vehicle to the condition it was in before an accident,and for legal operation on the road or highways,is more than 75%of the retail value of the vehicle at the time of loss.(Checking the"has been"box means the vehicle must have an anti-theft examination before being registered,and that the title issued will have the statement"Rebuilt Salvage"on it.) 2. Is this vehicle registered for your personal use? 0 Yes 0 No If you marked"Yes",go to the next question(question 3),If you marked"No';check any of these boxes that apply: ❑ This vehicle is a passenger vehicle that will be used for hire with a driver and will be operated in the following location(s): ❑ New York City(NYC) 0 A jurisdiction that is not NYC that regulates taxis 0 A jurisdiction that does not regulate taxis O This vehicle is a passenger vehicle that is rented without a driver. O This vehicle requires a permit for commercial operation.(Mark the box of the type of permit that was issued and write the permit number on the line.) ❑ NYS DOT Permit No. 0 Federal DOT Permit No O The government owns this vehicle. O This vehicle is used as(mark one) 0 an ambulance 0 an ambulette 0 a hearse or invalid coach If payment is received to carry passengers,mark this box.❑ O This vehicle is used exclusively as a hearse If payment is received to carry passengers,mark this box 0 0 This vehicle is a commercial tow truck with a gross vehicle weight rating of at least 8,600 pounds.• ❑ This vehicle is used only as a farm vehicle.(form MV-260F,Part 1,must be attached) ❑ This vehicle is used only as an agricultural truck O This vehicle is subject to the Department of Transportation inspection requirements for the carriers that transport passengers.(For more information,refer to form MV-82.1P,"Inspection Requirements for Carriers Transporting Passengers") 3 Has this vehicle been modified to change its registration class? 0 Yes 0 No If"Yes",explain 4 This vehicle is a pick-up truck with an unladen weight that is a maximum of 5,500 pounds.This vehicle is never used for commercial purposes and does not have advertising on any part of it. I want(mark one) 0 Passenger Plates 0 Commercial Plates 0 CERTIFICATION: The information I have given on this application is true to the best of my knowledge. I certify that the vehicle is fully equipped as required by the Vehicle and Traffic Law, and has passed the required New York State inspection within the past 12 months, or has qualified for a time extension (Form VS-1077)and will be inspected within 10 days I also certify that appropriate insurance coverage is in effect,and that the vehicle will be operated in accordance with the Vehicle and Traffic Law If I am applying for replacement registration items, I certify that the registration is not currently under suspension or revocation If I have plates in a series reserved for a special group, I certify that I am still eligi•le to receive them, and that I have only one set of these plates. If I am using a credit card for payment of any fees in connection with this/.plication, I nderstand that my signature below also authorizes use of my credit card. Print Name Here.k Scott A -Russell, Supervisor Sign Here (Print Name in F ofif registering f. .corporation,print your full name and title) r. ( ign Here) Print Additional , — Additional Signator Name Here If "''� Sign Here IP (Print Name in Full) (Sign Here-Additional signature required for a partnership or if registering this vehicle in more than one name) IMPORTANT: Making a false statement in any registration application or in any proof or statements in connection with it,or deceiving or substituting in connection with this application, is a misdemeanor under Section 392 of the Vehicle and Traffic Law,and may also result in the revocation or suspension of the registration pursuant to regulations established by the Commissioner The Department makes no representation that it will issue a certificate of title or transferable registration until the Commissioner is satisfied that the applicant is entitled to a certificate of title or transferable registration, and until all documentation required to establish ownership of the vehicle is submitted and deemed to be satisfactory Pending review of this application, neither the ' Commissioner of the Department of Motor Vehicles nor any of his or her employees,deputies or agents assumes any liability or responsibility for repairs performed,improvements made or work done to the vehicle referenced in this application. CREDIT CARD AUTHORIZATION IF CARDHOLDER IS NOT THE APPLICANT: My signature authorizes to use my credit card for payment of fees in connection with this application, Sign 10 and I understand that I must be present for this transaction Here (Cardholder-Sign Name in Full) W� �. �� � rovr�gtnt � n��r��� � . �ars.�� . t-S„^ To ) chit ted p!Y�k Cgglstered Npw Yor 5fia Dea ri',r 1Y Lr.-..tart OC trcin l Lien r444 Lien Filing Code(Assigned by DMv) Lienholder Name Mailing Address (Number and Street) (City) (State) (Zip Code) Lien Filing Code(Assigned by CMv) Lienholder Name Mailing Address (Number and Street) (City) (State) (Zip Code) NY DEALER CERTIFICATION: I certify that all information provided on this application • is true.I take responsibility for the integrity of the papers delivered to the Motor Vehicles office (Signature of Dealer or Authorized Representative) MV-82(1/15) PAGE 2 OF 2 New York State Department of Taxation and Finance DTF- 02 ,...4 Statement of Transaction — Sale or Gift of Motor Vehicle, V (1/11) Trailer, All-Terrain Vehicle (ATV), Vessel (Boat), or Snowmobile 8 Instructions This is a New York State sales tax return.The new owner's social security number,taxpayer identification number(TIN), or federal employer identification number(EIN)is required. Use this form to report the purchase of a vehicle or boat when sales tax was not collected at the time of purchase or when the vehicle or boat was received as a gift. If the donor/seller is not required to complete Section 6,the new owner must have a copy of the bill of sale signed by the seller. The seller or donor must complete Section 6 if: • the motor vehicle is a gift to a person other than a spouse, parent,child,stepparent,or stepchild • the motor vehicle is sold below fair market value to a person other than a spouse, parent,child,stepparent,or stepchild • the trailer,ATV, boat, or snowmobile is a gift • the trailer,ATV, boat, or snowmobile is sold below fair market value If for any reason you must obtain a registration or title before you can establish the amount of tax due based on the less than fair market value purchase price, you may obtain tax clearance by paying the tax due based on the fair market value as established by the Tax Department. If this results in an overpayment,you may apply to the Tax Department for a refund or credit of the amount overpaid. Submit the completed form to your local motor vehicle issuing office. Note: • If you are claiming an exemption other than a gift, use Form DTF-803 instead. • If you are claiming credit for taxes paid to another state, use Form DTF-804 instead. • If you are registering more than one motor vehicle for the same taxing jurisdiction, use Form DTF-805 instead. If you need information or forms,go to our Web site at www.tax.ny.gov. Forms are also available by calling(518)457-5431. Section 1 — Vehicle information Type of vehicle(mark one box) Motor vehicle n Trailer n AN n Snowmobile n Boat(length in feet). ft. Year Make Model Identification number 2001 Dodge 3B6MF36511M264237 Delivery location(complete only for an ATV or snowmobile) City County Storage/use location(complete only for an ATV or snowmobile) Do you have a residence in this county?(If Yes, City County see Tax rate note in Section 5) ❑ Yes ❑ No Section 2 — New owner information Last name,first name,middle initial or business name Social security number/TIN/EIN Number and street address City,state,and ZIP code County Business address(if commercial vehicle)(number and street) City,state,and ZIP code Section 3 — Previous owner information Last name,first name,middle initial or business name EIN(if applicable) Town of Southold 11-6001939 Number and street address City,state,and ZIP code County 53095 Main Road, PO Box 1179 Southold, New York 11971 Suffolk Section 4 — Transaction information DDte of jrransac ign Relationship of new owner to previous owner(mark one box) lb mm / dd /yyyy n None ❑ Spouse ❑ Parent ❑ Child ❑ Stepparent ❑ Stepchild ❑ Other(descnbe) This transaction Is a(mark one) Gift of a motor vehicle to a person other than spouse,parent,child,stepparent,or stepchild.(donor must complete Section 6) Purchase of a motor vehicle at below fair market value by a person other than spouse,parent,child,stepparent,or stepchild.(seller must complete Section 6) ❑ Gift of a trailer,ATV,boat,or snowmobile(donor must complete Section 6) I❑ Purchase of a trailer,ATV,boat,or snowmobile at below fair market value(seller must complete Section 6) r��r None of the above For office use only Date Initials Office Fair market value Audit Tax Rate Tax paid Term no 0 % Section 5 — Purchase information 1 Purchase price Value a. Amount of cash payment 1a $ 502.00 b. Balance of payments assumed lb $ .00 c. Value of property given,traded,or swapped,or services performed instead of cash payment1 c $ •00 d. Purchase price(total of lines la, lb,and 1c) id $ _ 502.00 2 Was this transaction the purchase of a motor vehicle from your spouse, parent, child,stepparent, or stepchild? Yes(enter 0 on line 4;no tax is due) rye �„i No(continue to line 3) 3 Tax rate* (enter as a decimal) 3 4 Sales tax due(multiply line ld by line 3) 4 $ 5 Is the amount on line 1 d lower than fair market value? n Yes.(seller/donor must complete Section 6) nNo(sign certification below) * Tax rate note:For a motor vehicle,trailer,or boat,use the tax rate of the new owner's place of residence.If the purchaser is a resident in two or more counties in the state,use the rate in effect in the place where the motor vehicle,trailer,or boat will be principally used or garaged.If the new owner is a business,use the tax rate of the place of business.If the business has locations in two or more counties in the state,use the rate in effect in the place where the motor vehicle,trailer,or boat will be principally used or garaged.For an ATV or snowmobile,use the higher rate of where the new owner took delivery,or where the vehicle is stored or used if new owner has a residence in storage/use locality. Purchaser certification — I certify that the above statements are true and complete; and I make these statements with the knowledge that willfully issuing a false or fraudulent statement with the intent to evade tax is a misdemeanor under Tax Law section 1817(b), and Penal Law section 210.45, punishable by a fine up to$10,000 for an individual and$20,000 for a corporation. Signature Date If this form is submitted by someone other than the new owner/lessee, please provide the following: Name/business name Social security number,TIN, or federal EIN Address Section 6 — Affidavit of sale or gift of a motor vehicle, trailer, ATV, vessel (boat), or snowmobile The seller or donor must complete if: • the motor vehicle is a gift to a person other than a spouse,parent,child,stepparent,or stepchild • the motor vehicle is sold below fair market value to a person other than a spouse, parent, child, stepparent,or stepchild • the trailer,ATV, boat,or snowmobile is a gift • the trailer,ATV, boat, or snowmobile is sold below fair market value 6 Cash payment received 6 $ 7 If, as a condition for the sale or gift of the vehicle or boat,the purchaser/recipient did any of the following in addition to, or in lieu of, a cash payment, please mark an X in the appropriate box and indicate the value of the service or goods you received. Value a Performed any service n Yes ❑No 7a $ b Assumed any debt n Yes ❑No 7b $ c Traded/swapped a vehicle or other property ri Yes n No 7c $ d Total selling price(total of lines 6, 7a, 7b and 7c) 7d $ 8 Complete only if a corporation or business is the seller/donor a Was or is the purchaser/recipient an employee, officer, or stockholder of the company/corporation? n Yes n No b Was the transaction part of any terms of employment,employment contract,or termination agreement? n Yes ❑ No 9 If you answered Yes to any part of line•7 or line 8, please provide an explanation: Seller/Donor certification — I have reviewed the information on Form DTF-802 and I certify that the statements are true and complete. I make these statements with the knowledge that willfully issuing a false or fraudulent statement with the intent to evade tax is a misdemeanor under Tax Law section 1817(b) . d Penal Law section 210.45 punishable by a fine up to$10,000 for an individual and$20,000 for a corporation. Signature / AO Name(printed or typed) Date �,. Scott A. Russell, Supervisor 7/16/15 Privacy notification—The Commissioner of Taxation and Finance may collect and maintain personal information Information concerning quarterly wages paid to employees is provided to certain state agencies for purposes of fraud pursuant to the New York State Tax Law,including but not limited to,sections 5-a,171,171-a,287,308.429.475, prevention,support enforcement,evaluation of the effectiveness of certain employment and training programs and other 505,697,1096,1142,and 1415 of that Law,and may require disclosure of social security numbers pursuant to purposes authonzed by law 42 USC 405(c)(2)(C)() Failure to provide the required information may subject you to civil or criminal penalties,or both,under the Tax Law This Information will be used to determine and administer tax liabilities and,when authorized by law,for certain tax offset This information is maintained by the Manager of Document Management,NYS Tax Department,W A Harriman Campus, and exchange of tax Information programs as well as for any other lawful purpose Albany NY 12227,telephone(518)457-5181 DTF-802(1/11) (back) 1".:".] ] D . . , / / \.. \ \ , \ \! , . ' TOWN OF SOUTHOLO PO BOX 173 _ PECDNIC , \ NY 11958 ` | ' ' „ -` \ ` '` ,001044. ' � i I I , ._._ ( , , . . ... . . , • . . • ,, , . . \ . .... . ... . ,-- ANY CHANGE OR'E:'''AZURE-WILL_‘1,01p.:THI.S.TITLE_-7.-AN_;Y F_ALSE SIAT_,,,,_EillEifi IS A 1 ECilill,SDEMEtki_q0R' STION -Trgrisfer by Owner [ -,;ObCiMETER DISCLOSURE STATEIVIEfri: ',.. -. ......._. ..,. . _ ... . _ ,.. .,. ..,......, .... - ODOidiETEF kEADING - ;.kote:This vehicie cannot be registered or titled in the nant_e of Inc new ownerunless"mileage is disclosed. - - _,, , __, ,VVV :::,..;:,: ,,,,,,, 1, " ','.. 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'.'4;.....(;',.. 4,,,, ' i--'`.,l':,:':::",•,":: ', .:-.'.:'''''t1-4"..i':;""?",...':.::',.gl.'iii:k:i''..:;-:':...-,j','Y.._, ",".-i.:-.::•;.,,K,'F.'•::;:17' ".:::::::::7','H.:',:::,;:::::1:5.':t 1,:.,::::::,,::i::.,:::,:,,,::7::'::.;:i.,:)....::,-- -,If:ii .::,-:,,,,;:: ..,,,j,,,,,,,y.....:,,,_:.:3:.i,..,.:,.:,:. ,..,„,.....,,;:,,,,,,,z,,,,,:::,,,yL, 7,7,7::,7:::,,,,,a±,--,21?1::::,!,„,,,:::,:''s :._ , _ ,Boat Dealer's - _ . MV-999 (1/11) ' j '6 1- . „ . .0-0 8-6 5 . ._ . Factlity# . _ , MV-82 Batch NEW VEHICLE REGISTRATION/TITLE File eNo SIAT(OfYORK Department of `Y' ,...Y Motor vehicles APPLICATION ❑Ong0 Activity0Renewal Lease Buyout This form is available at www.dmv.ny.gov 0 Dup 0 Activity W/RR 0 Renew W/RR 0 Sales Tax with Title t.Y Old 3 of Ins Co Exp r 4 Plate 1111111 Class I I Name I I Code I I Date I I I A ;;'P.' Scofflaw •. ,, Number(s)ase New New Plate I I I I I I I Class :,-,I, Special AT BV CF CO CP EX FL GI IF MO NE NF NR NU OD OP OV PA :ice,;- Conditions PC PK RC RE SA SO SR SS SV TE TL TO TP TR TX XR X6 WO " Sales Tax Status Value Jurisdiction Rate Out of Stale Audit Rif ,, Information ($) Is there a penholder' ❑Yes 0 No If"Yes-, ' .'../- Did you issue plates to this Plate Reg Class Date Temp Issued Facility ID Number enter the information in Dealer Only box below ___i,�ritl.y• vehicle' Number • M17 0 Yes 0 No Alterations are not allowed In the lienholder sections. INSTRUCTIONS 4 COMPLETE 00 00 and 0. WHEN 30 AND 50 APPLY,COMPLETE THOSE SECTIONS. PRINT CLEARLY IN BLUE OR BLACK INK. O MARK THE BOX OF THE TYPE OF SERVICE YOU NEED.(For more Information,refer to form MV-82 1,"Registenngffitling a Vehicle in New York State") raG❑A FIRST REGISTRATION for this vehicle 0 CHANGE a title(refer to ❑6 ) 0 REGISTER a vehicle that I registered before renewer vehicleLY for a 1973 If you mark one of the options below,write the PLATE NUMBER here ❑ RENEW a Registration 0 CHANGE a Registration(refer toll) 0 REPLACE lost registration items 0 TRANSFER a Plate Number 0 Purchased my LEASED VEHICLE You can update the address on your registration and renew your registration online at www dmv nv nov O NAME OF PRIMARY REGISTRANT(Last,First,Middle) NYS driver license number of PRIMARY SEX DATE OF BIRTH M F Month Day Year Southold Town Depart of Public Works ❑❑ I I I I I I I NAME OF CO-REGISTRANT(Last,First,Middle) NYS driver license number of CO-REGISTRANT SEX DATE OF BIRTH M F Month Day Year L ❑❑ 11 I I 1 I l DAY TELEPHONE(Optional) NAME CHANGE? ADDRESS CHANGE? Area Code Is this registration for a corporation How did you get eNew ❑Leased New 7 6 5—18 0 0 or partnership'? ❑Yes the vehicle'? ( 631 ) ❑YES(refer to 60) VNO ❑YES P1N0 ANO (mark one) ❑Used ❑Leased Used THE ADDRESS WHERE PRIMARY REGISTRANT GETS MAIL(Include Street Number and Name,Rural Delivery or box number This address will be on the document) Apt No City or Town State Zip Code County of Residence PO Box 178 Peconic N I Y 11958 THE ADDRESS WHERE PRIMARY REGISTRANT RESIDES IF DIFFERENT FROM THE MAILING ADDRESS (DO NOT GIVE A P 0 BOX) Apt No City or Town State Zip Code I 0 DRIVER LICENSE NUMBER OF OWNER The owner of the vehicle must sign this section. NOTE:Do not complete this section if a completed Registration Authorization (form MV-95) is I L attached or if you apply to renew a vehicle registration and the owner of that vehicle has not NAME OF CURRENT OWNER(Last,First,Middle) changed.Proof of ownership and proof of owner's name and date of birth are DAY TEuired. LEPHONE NUMBER OF DATE OF BIRTH OWNER (Optional) Month Day Year Area Code 1111111 ( I THE ADDRESS WHERE OWNER GETS MAIL Rua De�eryro b�numebe)d Name, Apt No City or Town State Zip Code County AUTHORIZATION:The registrant descnbed in 0 is authonzed to register the vehicle descnbed in 0 (Signature of owner or authorized person,and signature of co-owner if applicable) (Date) O VEHICLE IDENTIFICATION NUMBER VEHICLE DESCRIPTION Body Type For Cars(mark one) Year Make Station Wagon or 3B6MF36511M264237 2001 Dodge ❑2-Door❑4-Door ❑Convertible ❑Suburban ❑Other Body Type For Other Vehicles(mark one) Type of Power(Fuel) Color Unladen Weight �/ ligPricukc-kupp❑Van ❑Motorcycle ❑Tuck❑Trailer ❑Other Red 5596 lliGas 0 Diesel 0 Electric 0 Flex 0 CNG 0 Propane 0 None For traders 6 commercial vehicles For rentals,buses&taxis Does the ODOMETER display 5,6 or 7 For commercial vehicles Cylinders Maximum Gross Weight Seating Capacity Odometer Reading in Miles numbers'?(wnte the number,do not Axles Distance include tenths) I d:T' Lien Filing Code Lienholder Name and li'5t -- (Assigned Mailing Address ja3 �"p; by DMV) IssuanceLien Lien Release (fVJ�� Mileage Brand poor I I I Stated Title Llen Number I I 1 1111 OwnerI 1-,� Proof Submitted(Name and Ownership) Approved Stop/Response ,:� , By O d 2:03±1V U9t' Reg/Title State Date Fee Operator MV-82(1/15) PAGE 1 OF 2 5❑ CHANGES-Wnte new information about a current registration or title on page 1 of this form(for more information, refer to form MV-82 1, "P's5'tenng/Trtling a Vehicle in New York State") NAME CHANGE Print the former name exactly like the former name is printed on the current registration or title CHANGES Descnbe any vehicle changes and the reasons for the changes 0 ADDITIONAL VEHICLE INFORMATION QUESTIONS 1-3 MUST BE COMPLETED. 1. I certify that,to the best of of my knowledge,this vehicle 0 has been or la' has not been wrecked,destroyed or damaged to such an extent that the total estimate,or actual cost,of parts and labor to rebuild or reconstruct the vehicle to the condition it was in before an accident,and for legal operation on the road or highways,is more than 75%of the retail value of the vehicle at the time of loss(Checking the"has been" box means the vehicle must have an anti-theft examination before being registered,and that the title issued will have the statement"Rebuilt Salvage"on it.) 2. Is this vehicle registered for your personal use? 0 Yes 0 No If you marked"Yes",go to the next question(question 3).If you marked"No",check any of these boxes that apply: O This vehicle is a passenger vehicle that will be used for hire with a driver and will be operated in the following location(s) ❑ New York City(NYC) 0 A jurisdiction that is not NYC that regulates taxis 0 A jurisdiction that does not regulate taxis O This vehicle is a passenger vehicle that is rented without a driver O This vehicle requires a permit for commercial operation.(Mark the box of the type of permit that was issued and write the permit number on the line) ❑ NYS DOT Permit No 0 Federal DOT Permit No O The government owns this vehicle. O This vehicle is used as(mark one) 0 an ambulance 0 an ambulette 0 a hearse or invalid coach If payment is received to carry passengers,mark this box.❑ O This vehicle is used exclusively as a hearse If payment is received to cany passengers,mark this box 0 0 This vehicle is a commercial tow truck with a gross vehicle weight rating of at least 8,600 pounds O This vehicle is used only as a farm vehicle.(form MV-260F,Part 1,must be attached) ❑ This vehicle is used only as an agricultural truck O This vehicle is subject to the Department of Transportation inspection requirements for the carriers that transport passengers (For more information,refer to form MV-82.1 P,"Inspection Requirements for Carriers Transporting Passengers".) 3 Has this vehicle been modified to change its registration class? 0 Yes 0 No If"Yes",explain 4. This vehicle is a pick-up truck with an unladen weight that is a maximum of 5,500 pounds.This vehicle is never used for commercial purposes and does not have advertising on any part of it. I want(mark one): 0 Passenger Plates 0 Commercial Plates 0 CERTIFICATION: The information I have given on this application is true to the best of my knowledge. I certify that the vehicle is fully equipped as required by the Vehicle and Traffic Law, and has passed the required New York State inspection within the past 12 months, or has qualified for a time extension (Form VS-1077)and will be inspected within 10 days. I also certify that appropriate insurance coverage is in effect, and that the vehicle will be operated in accordance with the Vehicle and Traffic Law. If I am applying for replacement registration items, I certify that the registration is not currently under suspension or revocation. If I have plates in a series reserved for a special group, I certify that I am still eligi•le to receive them, and that I have only one set of these plates. If I am using a credit card for payment of any fees in connection with this J.plication, I nderstand that my signature below also authorizes use of my credit card. / Print Name Here* Scott A Russell, Supervisor Sign Here (Print Name in F if registenng f. .corporation,pnnt your full name and title) (Sign Here) Print Additional AP Additional Signaturp r Sign Here '" Name Here ! —" � �-� Si g IP (Print Name in Full) (Sign Here-Additional signature required for a partnership or it registering this vehicle in more than one name) IMPORTANT: Making a false statement in any registration application or in any proof or statements in connection with it,or deceiving or substituting in connection with this application,is a misdemeanor under Section 392 of the Vehicle and Traffic Law,and may also result in the revocation or suspension of the registration pursuant to regulations established by the Commissioner.The Department makes no representation that it will issue a certificate of title or transferable registration until the Commissioner is satisfied that the applicant is entitled to a certificate of title or transferable registration, and until all documentation required to establish ownership of the vehicle is submitted and deemed to be satisfactory. Pending review of this application, neither the ' Commissioner of the Department of Motor Vehicles nor any of his or her employees, deputies or agents assumes any liability or responsibility for repairs performed,improvements made or work done to the vehicle referenced in this application CREDIT CARD AUTHORIZATION IF CARDHOLDER IS NOT THE APPLICANT: My signature authorizes to use my credit card for payment of fees in connection with this application, Sign and I understand that I must be present for this transaction. Here (Cardholder-Sign Name in Fut) 7.7*,-*? ' ir a .oto lef : �reclNeanr tteaAeirtiii y -AL1a lianal:{L'i ate Lien Filing Code(Assigned by DMv) Lienholder Name Mailing Address (Number and Street) (City) (State) (Zip Code) Lien Filing Code(Assigned by DMV) Lienholder Name Mailing Address (Number and Street) (City) (State) (Zip Code) NY DEALER CERTIFICATION: I certify that all information provided on this application 0 is true. I take responsibility for the integrity of the papers delivered to the Motor Vehicles office. (Signature of Dealer or Authorized Representative) MV-82(1/15) PAGE 2 OF 2 ,i ,y, * * * RECEIPT * * * Date: 05/14/15 Recelpt#: 184773 . _ ,• ,, • Quantity Transactions. Reference Subtotal 1 Used Equipment-Part Town 2564&2753 $1,004.00 Total Paid: $1,004.00 Notes: - ,,). • A„. • Payment Type Amount Paid By CK#305&9101295244 $1,004.00 Wolbert, Steve .. 1 i i .:y; i ' • ,i Southold Town Clerk's Office ., 53095 Main Road, PO Box 1179 I Southold, NY 11971 I S,' 1 1 r i i ...S I i 4. I Name: Wolbert, Steve `., ,1 1590 West Mill Road POBox 280 'i Mattituck, NY 11952 1 Clerk ID: BONNIED Internal ID:2564&2753 MY/-82 Batch (-NEWYORKDepartment of VEHICLE REGISTRATION/TITLE File No oavonrunrrr Motor Vehicles APPLICATION 0 Orig 0 Activity 0 Renewal 0 Lease Buyout This form is available at www.dmv.ny.gov 0 Dup 0 Activity W/RR 0 Renew W/RR 0 Sales Tax with Title .Si Old 3 of Ins Co Exp I I I I I I I I NameI I I I �' , Plate Class Code Data ' Scofflaw Case New I I I I I I I New Q., Number(s) Plate Class Special AT By CF CO CP EX FL GI IF MO NE NF NR NU OD OP OV PA Conditions PC PK RC RE SA SO SR SS SV TE TL TO TP TR TX XR X6 WO Sales Tax Status Value Jurisdiction Rate Out of Stale Audit ;1/4.M. Information ($) %%i�..11[��.•••�' Is there a lienholder" El Yes ❑No If"Yes', '1 ( Did you issue plates to this Plate Reg Class Date Temp Issued Facility ID Number enter the information in Dealer Only box below +rte vehiclev Number Alterations are not allowed in the lienholder sections. Ulf 0 Yes 0 No INSTRUCTIONS 4 COMPLETE 00 00 and O. WHEN El AND El APPLY,COMPLETE THOSE SECTIONS. PRINT CLEARLY IN BLUE OR BLACK INK. O MARK THE BOX OF THE TYPE OF SERVICE YOU NEED.(For more information,refer to form MV-82 1,"Registering/Titling a Vehicle in New York State") ❑A FIRST REGISTRATION for this vehicle 0 CHANGE a title(refer to ❑5 ) 0 REGISTER a vehicle that I registered before �o eneweer veEhOINeLY for a 1973 If you mark one of the options below,write the PLATE NUMBER here ❑RENEW a Registration 0 CHANGE a Registration(refer tobl) 0 REPLACE lost registration items 0 TRANSFER a Plate Number 0 Purchased my LEASED VEHICLE You can update the address on your registration and renew your registration online at www dmv nv oov O NAME OF PRIMARY REGISTRANT(Last,First,Middle) NYS driver license number of PRIMARY SEX DATE OF BIRTH M F Month Day Year Southold Town Depart of Public Works ❑❑ I i I I I I 1 NAME OF CO-REGISTRANT(Last,First,Middle) NYS driver license number of CO-REGISTRANT SEX DATE OF BIRTH M F Month Day Year ❑❑ IIIIIII DAY TELEPHONE(Optional) NAME CHANGES ADDRESS CHANGESHow didyouget ,�./ Is this registration fora corporation L�JNew DLeased New Area Codethe vehicle" ( 631 ) 765-1800 ❑YES(refer to❑6 ) E�No El YES V'NO or partnership? 0 Yes II 'No (mark one) ❑Used ❑Leased Used THE ADDRESS WHERE PRIMARY REGISTRANT GETS MAIL(Include Street Number and Name,Rural Delivery or box number This address will be on the document) Apt No City or Town State Zip Code County of Residence PO Box 178 Peconic N I Y 11958 THE ADDRESS WHERE PRIMARY REGISTRANT RESIDES IF DIFFERENT FROM THE MAILING ADDRESS (DO NOT GIVE A P O.BOX) Apt No. City or Town State Zip Code pDRIVER LICENSE NUMBER OF OWNER The owner of the vehicle must sign this section. NOTE: Do not complete this section If a completed Registration Authorization (form MV-95) is attached or if you apply to renew a vehicle registration and the owner of that vehicle has not NAME OF CURRENT OWNER(Last,First,Middle) changed.Proof of ownership and proof of owner's name and date of birth are DAY TEuired LEPHONE NUMBER OF DATE OF BIRTH OWNER.(Optional) Month Day Year Area Code I I I I I I I ( ) THE ADDRESS WHERE OWNER GETS MAIL Rlural Delivery orboc numeber)d Name, Apt No City or Town State Zip Code County I AUTHORIZATION:The registrant described in ® is authonzed to register the vehicle described in 0 (Signature of owner or authorized person,and signature of co-owner if applicable) (Date) O VEHICLE IDENTIFICATION NUMBER VEHICLE DESCRIPTION Body Type For Cars(mark one) Year Make 3 B 6M F 3 6 5 31 M 5 7 5121 Station Wagon or 2 0 1 Dodge ❑2-Door❑4-Door ❑Convertible ❑Suburban _❑Other Body Type For Other Vehicles(mark one) Type of Power(Fuel) Color Unladen Weight 'Truck p❑Van ❑Motorcycle OTT ruck❑Trailer ❑Other Red 5596 llSGas ❑Diesel ❑Electric ❑Flex ❑CNG ❑Propane ❑None For trailers&commercial vehicles For rentals,buses&taxis Does the ODOMETER display 5,6 or 7 For commercial vehicles Cylinders Maximum Gross Weight Seating Capacity Odometer Reading in Miles numbers'?(write the number,do not Axles Distance include tenths) I I . Lien Filing Code Lienholder Name and ni l l�• (Assigned Mailing Address ( `, by DMV) , Mileage Brand Prior Issuance Title Lien Lien Lien Release OwnedI I I I I I I stateI I I Number I I I I I I I I Proof Submitted(Name and Ownership) Approved Stop/Response By Old lig-]~`) Reg/Title Stale Date Fee Operator MV-82(1/15) PAGE 1 OF 2 VICHANGES-Write new information about a current registration or title on page 1 of this form(for more information, refer to form MV-82 1, 'Rvgistenng/Titling a Vehicle in New York State") NAME CHANGE Print the former name exactly like the former name is printed on the current registration or title CHANGES Describe any vehicle changes and the reasons for the changes Q ADDITIONAL VEHICLE INFORMATION QUESTIONS 1-3 MUST BE COMPLETED. 1 I certify that,to the best of of my knowledge,this vehicle 0 has been or Ga has not been wrecked,destroyed or damaged to such an extent that the total estimate,or actual cost,of parts and labor to rebuild or reconstruct the vehicle to the condition it was in before an accident,and for legal operation on the road or highways,is more than 75%of the retail value of the vehicle at the time of loss(Checking the"has been"box means the vehicle must have an anti-theft examination before being registered,and that the title issued will have the statement"Rebuilt Salvage"on it.) 2 Is this vehicle registered for your personal use? 0 Yes 0 No If you marked"Yes';go to the next question(question 3).If you marked"No';check any of these boxes that apply: O This vehicle is a passenger vehicle that will be used for hire with a driver and will be operated in the following location(s). ❑ New York City(NYC) 0 A junsdiction that is not NYC that regulates taxis ❑ A jurisdiction that does not regulate taxis O This vehicle is a passenger vehicle that is rented without a driver. O This vehicle requires a permit for commercial operation.(Mark the box of the type of permit that was issued and wnte the permit number on the line) ❑ NYS DOT Permit No 0 Federal DOT Permit No O The government owns this vehicle O This vehicle is used as(mark one) 0 an ambulance 0 an ambulette 0 a hearse or invalid coach If payment is received to carry passengers,mark this box.❑ O This vehicle is used exclusively as a hearse If payment is received to carry passengers,mark this box 0 O This vehicle is a commercial tow truck with a gross vehicle weight rating of at least 8,600 pounds. O This vehicle is used only as a farm vehicle.(form MV-260F,Part 1,must be attached) 0 This vehicle is used only as an agricultural truck O This vehicle is subject to the Department of Transportation inspection requirements for the carriers that transport passengers (For more information,refer to form MV-82.1P,"Inspection Requirements for Carriers Transporting Passengers".) 3. Has this vehicle been modified to change its registration class? 0 Yes 0 No If"Yes",explain 4. This vehicle is a pick-up truck with an unladen weight that is a maximum of 5,500 pounds This vehicle is never used for commercial purposes and does not have advertising on any part of it. I want(mark one). 0 Passenger Plates 0 Commercial Plates O CERTIFICATION: The information I have given on this application is true to the best of my knowledge I certify that the vehicle is fully equipped as required by the Vehicle and Traffic Law, and has passed the required New York State inspection within the past 12 months, or has qualified for a time extension (Form VS-1077)and will be inspected within 10 days. I also certify that appropriate insurance coverage is in effect, and that the vehicle will be operated in accordance with the Vehicle and Traffic Law If I am applying for replacement registration items, I certify that the registration is not currently under suspension or revocation If I have plates in a series reserved for a special group, I certify that I am still e Ible to receive them, and that I have only one set of these plates If I am using a credit card for payment of any fees in connection with t applica ' , I understand that my signature below also authorizes use of my credit card. Print Name Here a Scott A. Russell, Supervisor Sign Here (Print Name in Full-if regis 'g for a corporation,pont your full name and title) (Sign Here) Print Additional Additional Signaturp Name Here # ( Sign Here ip (Print Name in Full) (Sign Here-Additional signature required for a partnership Dr if registenng this vehicle in more than one name) IMPORTANT: Making a false statement in any registration application or in any proof or statements in connection with it,or deceiving or substituting in connection with this application, is a misdemeanor under Section 392 of the Vehicle and Traffic Law,and may also result in the revocation or suspension of the registration pursuant to regulations established by the Commissioner.The Department makes no representation that it will issue a certificate of title or transferable registration until the Commissioner is satisfied that the applicant is entitled to a certificate of title or transferable registration, and until all documentation required to establish ownership of the vehicle is submitted and deemed to be satisfactory Pending review of this application, neither the Commissioner of the Department of Motor Vehicles nor any of his or her employees,deputies or agents assumes any liability or responsibility for repairs performed,improvements made or work done to the vehicle referenced in this application. CREDIT CARD AUTHORIZATION IF CARDHOLDER IS NOT THE APPLICANT: My signature authorizes to use my credit card for payment of fees in connection with this application, Sign and I understand that I must be present for this transaction. Here (Cardholder-Sign Name in Full) . - ,, :�� ; »��,:��- 1,�..:.,,t =.,.:� �-u�_ �krStat Deal":.,n�.� L-��t,n.n.�.- �;�; ,.-,:»:, •��:rx�� � ..�... ;�,:�;,,, '��."'�,�,�'v.= "T,•<Be'Co a letedby,,a*EtegisteredNew'�1(o: -' e?_ era=n y..y,��lst,anyr',additTonal,-'Lte�hol$ers�..::,�2-..:-'�'?"'� �;, . -r Lien Filing Code(Assigned by DMv) Lienholder Name Mailing Address (Number and Street) (City) (Stale) (Zip Code) Lien Filing Code(Assigned by DMv) Lienholder Name Mailing Address (Number and Street) (City) (State) (Zip Code) NY DEALER CERTIFICATION: I certify that all information provided on this application 0 is true. I take responsibility for the integnty of the papers delivered to the Motor Vehicles office (Signature of Dealer or Authorized Representative) MV-82(1/15) PAGE 2 OF 2 Southold Town Board - Letter Board Meeting of April 21, 2015 $. RESOLUTION 2015-358 Item# 5.13 5�y� °a ADOPTED DOC ID: 10736 THIS IS TO CERTIFY THAT THE FOLLOWING RESOLUTION NO. 2015-358 WAS ADOPTED AT THE REGULAR MEETING OF THE SOUTHOLD TOWN BOARD ON APRIL 21, 2015: RESOLVED that the Town Board of the Town of Southold hereby accepts the bid of Steven Wolbert for Asset# 25.64 2001 Dodge Ram and Asset# 2753 2001 Dodge Ram in the amount of $502.00 each. :.,„;,,eq2a2gviad, Elizabeth A. Neville Southold Town Clerk RESULT: ADOPTED [5 TO 0] MOVER: James Dinizio Jr, Councilman SECONDER:Jill Doherty, Councilwoman AYES: Ghosio, Dinizio Jr, Doherty, Evans, Russell ABSTAIN: William P. Ruland Generated April 22, 2015 Page 23 ',,,iii.,,,'• ' ��FFOC�40_ �' ELIZABETH A.NEVILLE,MMC , 40 4 L Town Hall,53095 Main Road TOWN CLERK o :- P.O.Box 1179 at �; Southold,New York 11971 REGISTRAR OF VITAL STATISTICS - .�'�� Fax(631)765-6145 MARRIAGE OFFICER i RECORDS MANAGEMENT OFFICER =_.�Q,l �',i i � Telephone(631) nny.gov iNg •' www.southoldtownny.gov FREEDOM OF INFORMATION OFFICER .. ,,, OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD May 4, 2015 _ _Steven Wolbert PO Box 280 Mattituck,NY 11952 Dear Mr Wolbert: Congratulations. At the regular Town Board meeting held on April 21, 2015, the Town Board accepted the bid of Steven Wolbert for used DPW trucks. A certified copy of the resolution is enclosed. The bid deposit will be applied toward the total balance due of$1,004.00. Thank you for your bid. Very truly yours, Lynda:M Rudder . -Deputy Town Clerk Ens. /',,,iii i ELIZABETH A. NEVILLE,MMC 1 ��;. �y Town Hall,53095 Main Road TOWN CLERK ® "" } .� P.O. Box 1179 t+ _ Southold,New York 11971 REGISTRAR OF VITAL STATISTICS 4-4*1). 1� Fax(631)765-6145 MARRIAGE OFFICER ; F est)* I Telephone(631)765-1800 : RECORDS MANAGEMENT OFFICER .�.� • i•�• www.southoldtownny.gov FREEDOM OF INFORMATION OFFICER OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD May 4, 2015 Steven Wolbert PO Box 280 Mattituck,NY 11952 Dear Mr Wolbert: Congratulations. At the regular Town Board meeting held on April 21, 2015, the Town Board accepted the bid of Steven Wolbert for used DPW trucks. A certified copy of the resolution is enclosed. The bid deposit will be applied toward the total balance due of$1,004.00. Thank you for your bid. Very truly yours, Lynda M Rudder Deputy Town Clerk Ens. Southold Town Board - Letter Board Meeting of April 21, 2015 t °9 RESOLUTION 2015-358 Item # 5.13 ADOPTED DOC ID: 10736 THIS IS TO CERTIFY THAT THE FOLLOWING RESOLUTION NO. 2015-358 WAS ADOPTED AT THE REGULAR MEETING OF THE SOUTHOLD TOWN BOARD ON APRIL 21, 2015: RESOLVED that the Town Board of the Town of Southold hereby accepts the bid of Steven Wolbert for Asset# 2564 2001 Dodge Ram and Asset# 2753 2001 Dodge Ram in the amount of $502.00 each. Elizabeth A. Neville Southold Town Clerk RESULT: ADOPTED [5 TO 0] MOVER: James Dinizio Jr, Councilman SECONDER:Jill Doherty, Councilwoman AYES: Ghosio, Dinizio Jr, Doherty, Evans, Russell ABSTAIN: William P. Ruland Generated April 22, 2015 Page 23 40004 ELIZABETH A.NEVILLE,MMC its* O4; Town Hall,53095 Main Road TOWN CLERK ; P.O.Box 1179 2 Z ; Southold,New York 11971 REGISTRAR OF VITAL STATISTICS p . �� Fax(631)765-6145 MARRIAGE OFFICER = � RECORDS MANAGEMENT OFFICER ®1 �a®a Telephone(631) nny.go0 �,.' www.southoldtownny.gov FREEDOM OF INFORMATION OFFICER - _,,,,,,, OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD BID OPENING 2015 bid for 2 DPW Trucks Bid Opening 4/9/15 2:00 P.M. 1 Bid Received Steven Wolbert $502.00 per vehicle PO Box 280 Mattituck,NY 11952 NON-COLLUSIVE BID CERTIFICATE The undersigned bidder certifies that this bid has been arrived at by the bidder independently and has been submitted without collusion with any other vendor of materials, supplies or equipment of the type described in the invitation for bids, and the contents of this bid have not been communicated by the bidder, nor, to its best knowledge and belief, by any of its employees or agents, to any person not an employee or agent of the bidder or its surety on any bond furnished —.LH-prior to me official opening of-fhe bid . Signed: i L tLL Print name SVeuen .A.) bk e_71- Corporate Ctl t-Corporate Title (if any) Company Name Mailing Address ago ��a*ttvd 11 Phone Number L23I - g ~ BID ON DPW Vehicles ,�,, 1 Asset# 2564: 1\1'e Vu- 0�1'`1vC]' 4100 (�OliIC V S $ 50a. 66 In words In numbers Asset# 2753: 41 ‘ lcm °" inuo O'a(lcti5 $ 50(9.6a In words In numbers #12172 STATE OF NEW YORK) SS: COUNTY OF SUFFOLK) Karen Kine of Mattituck, in said county, being duly sworn, says that she is Principal Clerk of THE SUFFOLK TIMES, a weekly newspaper, published at Mattituck, in the Town of Southold, County of Suffolk and State of New York, and that the Notice of which the annexed is a printed copy, has been regularly published in said Newspaper once each week for 1 week(s), successfully commencing on the 2nd day of April, 2015. Principal Clerk Sworn to before me this day of 1� 2015. • , LEGAL NOTICE NOTICE TO BIDDERS - • NOTICE IS HEREBY GIVEN that I , the Town Board of the Town of Southold is offering for sale the following USED , EQUIPMENT m"as is"-condition•- , ' All items can be viewed at the High- I CHRISTINA VOLINSKI way yard.All items are sold m"AS IS f NotA§V PUBLIC-STATE OF NEW YORK CONDITION" Asset No.2564, NO% 01 V06105050 , 2001 Dodge Ram 3500, iNo11titid In Suffolk County VIN#3BMF36511M264237, +E'dmFPi't3€M+holm February 28, 2016 Min Bid$500.00 Asset No.2753, , 2001 Dodge Ram 3500, VIN#3BMF36531M575121, Min Bid$500.00 The bid must be accompanied by a Non-Collusive Bid Certificate, which may be obtained at the Southold Town Clerk's Office,Town Hall,PO Box 1179, 53095 Mam'Road,Southold,N.Y.11971 (631)765-1800,and a bank draft or certi- fied check in the amount of$100.00. The sealed bid(s)will be received by the Southold Town Clerk,at the South- , old Town Hall,+53095 Main Road,PO Box 1179,Southold, New York 11971, ' until 2:00 P.M.,Thursday,April 9,2015 at which time they will be opened and read aloud in public. The Town Board of the Town of Southold reserves the right to reject any and all bids and waive any and all infor- � malities in any bid should it be deemed in the best interest of the Town of South- ' old to do so All bids must 6e signed and sealed in envelopes plainly marked,"Bid on Used , DPW Equipment",and submitted to the ,Office of the Town Clerk: Dated: March 24,2015 ELIZABETH A.NEVILLE SOUTHOLD TOWN CLERK 012172-1T 4/2 STATE OF NEW YORK) SS: COUNTY OF SUFFOLK) ELIZABETH A. NEVILLE, Town Clerk of the Town of Southold, New York being duly sworn, says that on the 31St day of March , 2015, she affixed a notice of which the annexed printed notice is a true copy, in a proper and substantial manner, in a most public place in the Town of Southold, Suffolk County, New York, to wit: Town Clerk's Bulletin Board, 53095 Main Road, Southold,New York. DPW Used Vehicles tort L lizabeth A. Neville outhold Town Clerk Sworn before me this 31St day of Marc , 2015. Notary Public LYNDA M. RUDDER Notary Public,State of New York No. 01RU6020932 Qualified in Suffolk County Commission Expires March 8,201_1 04/01/2015 8:18 AM FAX 6317656145 SOUTHOLD TOWN CLERK P.0001 $$$ Multiple Destinations $$$ Job No. 0361 Sheets 5 Unsent Sent [*0371 18775588282 MCGRAW HILL [*0381 18005243329 BURELLE'S INFO [*0391 18882329941 DATA CONSTRUCT [x0401 18007685594 DODGE REPORTS Error [ 0411 18009620544 CONSTRUCT INFO LEGAL NOTICE NOTICE TO BIDDERS NOTICE IS HEREBY GIVEN that the Town Board of the Town of Southold is offering for sale the following USED EQUIPMENT in "as is"condition: 2006 Ford CVC VIN#FA�71V19X1 02 2 Asset#832 102282 Asset#3381 2009 Ford CVC Minimum bid to be set at$500.00 each. Vehicles are no longer drivable and have been used for parts and will be sold in"as is"condition. Contact person is Lt.H.William Sawicki at 7652600. The vehicles are currently located behind Rich's Auto Body in Cutchogue. The bid must be accompanied by a Non-Collusive Bid Certificate,which'may be obtained at the Southold Town Clerk'sOffice,and a bank ldraft orox 1179, 53095 certifled check in the ain Road, Southold, N.Y. 11971 (631) 765-1800, amount of$100.00. The sealed bid(s) will be received by the Southold Town Clerk, at the Southold • Town Hall, 53095 Main Road, PO Box 1179, Southold, New York 11971, until 2:00 P.M., Thursday, April 9, 2015 at which time they will be opened and read aloud in public. The Town Board of the Town of Southold reserves the right to reject any and all bids and waive any and all informalities in any bid should it be deemed in the best interest of the Town of Southold to do so All bids must be signed and sealed in envelopes plainly marked, "Bid on Used PD Equipment",and submitted to the Office of the Town Clerk. Dated: March 24,2015 ELIZABETH A.NEVILLE • SOUTHOLD TOWN CLERK * * * PLEASE PUBLISH ON April 2,2015,AND FORWARD ONE(1)AFFIDAVIT OF PUBLICATION TO ELIZABETH A.NEVILLE,TOWN CLERK,TOWN HALL, 53095 MAIN ROAD,PO BOX 1179,SOUTHOLD,NY 11971. Copies to the following: . Suffolk Times Town Board Members Town Attorney i1_.i_..De..na•l'e LEGAL NOTICE NOTICE TO BIDDERS NOTICE IS HEREBY GIVEN that the Town Board of the Town of Southold is offering for sale the following USED EQUIPMENT in "as is"condition: All items can be viewed at the Highway yard. All items are sold in "AS IS CONDITION". Asset No. 2564, 2001 Dodge Ram 3500, VIN# 3BMF36511M264237, Min Bid $500.00 Asset No. 2753, 2001 Dodge Ram 3500, VIN# 3BMF36531M575121, Min Bid $500.00 The bid must be accompanied by a Non-Collusive Bid Certificate, which may be obtained at the Southold Town Clerk's Office, Town Hall, PO Box 1179, 53095 Main Road, Southold, N.Y. 11971 (631) 765-1800, and a bank draft or certified check in the amount of$100.00. The sealed bid(s) will be received by the Southold Town Clerk, at the Southold Town Hall, 53095 Main Road, PO Box 1179, Southold, New York 11971, until 2:00 P.M., Thursday, April 9, 2015 at which time they will be opened and read aloud in public. The Town Board of the Town of Southold reserves the right to reject any and all bids and waive any and all informalities in any bid should it be deemed in the best interest of the Town of Southold to do so All bids must be signed and sealed in envelopes plainly marked, "Bid on Used DPW Equipment", and submitted to the Office of the Town Clerk. Dated: March 24, 2015 ELIZABETH A. NEVILLE SOUTHOLD TOWN CLERK * PLEASE PUBLISH ON April 2,2015, AND FORWARD ONE (1) AFFIDAVIT OF PUBLICATION TO ELIZABETH A. NEVILLE, TOWN CLERK, TOWN HALL, 53095 MAIN ROAD, PO BOX 1179, SOUTHOLD, NY 11971. Copies to the following: Suffolk Times Town Board Members Town Attorney Comptroller PD Dodge Reports Burrelle's Information Data Construction Town Clerk's Bulletin Board NON-COLLUSIVE BID CERTIFICATE • The undersigned bidder certifies that this bid has been arrived at by the bidder independently and has been submitted without collusion with any other vendor of materials, supplies or equipment of the type described in the invitation for bids, and the contents of this bid have not been communicated by the bidder, nor, to its best knowledge and belief, by any of its employees or agents, to any person not an employee or agent of the bidder or its surety on any bond furnished herewith prior to the official opening of the bid . Signed: Print name Corporate Title (if any) Company Name Mailing Address Phone Number BID ON DPW Vehicles Asset# 2564: $ In words In numbers Asset#2753: $ In words In numbers Rudder, Lynda • From: Cerria Torres <ctorres@timesreview corn> Sent: Monday, March 30, 2015 1.06 PM To: Rudder, Lynda Subject: Re• for publication I have scheduled both these notices to publish in the Suffolk Times on 4/2/15. TIMES ' ,\REVIEW , MEDIA GROUP Cerria Orientale Torres Display Ad Coordinator 631.354.8011 (D) ctorres@timesreview.com legals c(r�timesreview.com www timesreview.com From: <Rudder>, Lynda Rudder<lynda.rudder@town.southold.ny.us> Date: Monday, March 30, 2015 12:38 PM To: "Standish,Jeff" <jeffs@town.southold.ny.us>, "Foote, Nancy" <nancy.foote@town.southold.ny.us>, "Blasko, Regina" <rblasko@town.southold.ny.us>, "Flatley, Martin" <mflatley@town.southold.ny.us>,Jim Dinizio <jim@jamesdinizio.com>, "Beltz, Phillip" <Phillip.Beltz@town.southold.ny.us>, "Cushman,John" <John.Cushman@town.southold.ny.us>, "Doherty,Jill" <jill.doherty@town.southold.ny.us>, "Finnegan, Martin" <martin.finnegan@town.southold.ny.us>, "Ghosio, Bob" <bob.Rhosio@town.southold.ny.us>, "Kiely, Stephen" <stephen.kiely@town.southold.ny.us>, "Krauza, Lynne" <lynne.krauza@town.southold.ny.us>, Louisa Evans <Ipevans06390@Rmail.com>, "Michaelis,Jessica" <jessicam@southoldtownny.gov>, "Reisenberg, Lloyd" <Lloyd.Reisenberg@town.southold.ny.us>, "Russell, Scott" <Scott.Russell@town.southold.ny.us>, "Standish, Lauren" <Lauren.Standish@town.southold.ny.us>, "Tomaszewski, Michelle" <michellet@town.southold.ny.us>,Times Review <tdoubrava@timesreview.com>,William Ruland <rulandfarm@yahoo.com> Subject: for publication Please publish in the 4/2/15 edition of the Suffolk Times and the town website Rudder, Lynda From: Rudder, Lynda Sent: Monday, March 30, 2015 12:38 PM To: Standish,Jeff; Foote, Nancy; Blasko, Regina; Flatley, Martin; (jim@jamesdinizio corn); Beltz, Phillip; Cushman,John; Doherty,Jill; Finnegan, Martin; Ghosio, Bob, Kiely, Stephen, Krauza, Lynne, Louisa Evans (Ipevans06390@gmail.com); Michaelis,Jessica; Reisenberg, Lloyd; Russell, Scott; Standish, Lauren;Tomaszewski, Michelle;Tracey Doubrava (tdoubrava@timesreview.com);William Ruland Subject: for publication Attachments: Used dpw car.doc, Used pd car.doc Please publish in the 4/2/15 edition of the Suffolk Times and the town website 2 Southold Town Board- Letter Board Meeting of March 24, 2015 U`s �F��QC�".,. `°N RESOLUTION 2015-286 Item# 5.25 93�` 7�a` ADOPTED DOC ID: 10664 THIS IS TO CERTIFY THAT THE FOLLOWING RESOLUTION NO. 2015-286 WAS ADOPTED AT THE REGULAR MEETING OF THE SOUTHOLD TOWN BOARD ON MARCH 24, 2015: RESOLVED that the Town Board of the Town of Southold hereby declares the following • equipment from the Public Works Department to be surplus equipment, and be it further RESOLVED that the Town Board authorizes and directs the Town Clerk's office to advertise for the sale at the minimum prices set forth below. All items can be viewed at the Highway yard. All items are sold in "AS IS CONDITION". Asset No. 2564, 2001 Dodge Ram 3500, VIN# 3BMF36511M264237, Minimum Bid $500.00 Asset No. 2753, 2001 Dodge Ram 3500, VIN# 3B6MF36531M575121, Minimum Bid$500.00 • R Elizabeth A. Neville Southold Town Clerk RESULT: ADOPTED [UNANIMOUS] MOVER: William P. Ruland, Councilman SECONDER:Louisa P. Evans, Justice AYES: Dinizio Jr, Ruland, Doherty, Evans, Russell ABSENT: Robert Ghosio Generated March 25, 2015 Page 42