On February 11, 2021 a
Proof of Service
was filed
involving a dispute between
Inez G. Perlin,
and
East Northport Fire Department Rescue,
East Northport Fire District,
Thomas Bourne,
for Torts - Motor Vehicle
in the District Court of Suffolk County.
Preview
FILED: SUFFOLK COUNTY CLERK 02/22/2021 02:41 PM INDEX NO. 602421/2021
NYSCEF DOC. NO. 5 RECEIVED NYSCEF: 02/22/2021
*
THE STATE OF NEW YORK
Index No.: 602421/2021
SUPREME COURT, SUFFOLK COUNTY FRed On: 2N121021
INEZ G. PERLIN,
-against- AFFIDAVIT OF SERVICE
THORIAS BOURNE, ET AL.
STATE OF NEW YORK, COUNTY OF NASSAU: PatrickButtler,being duly sworn, poses and says thatdeponent isnot
partyto thisaction,isover 18 years of age and resides in theState of New York.
That on 2/15/2021 at 6·.SS PM at 620 6TH STREET, EAST NORTHPORT, NY 11731, your deponent served the NOTICE OF
ELECTRONIC FILING, E-FILED SUMMONS AND E-FILED VERIFIED COMPLAINT bearing Index# 602421/2021 and tileddate
2/11/2021 upon THOMAS BOURNE. During service ofthe documents, your deponent has adhered to current CDC and NYS
Department of HealthGuideBnes.
[ ] INDIVIDUAL
By personallydeliveringa truecopy thereofto said known
recipient, by deponent to be saidperson named therein.
[ ] AGENCY / BUSINESS
By thereat
delivering a truecopy of eachto JOHN DOE-REFUSED NAME, CORESIDENT. Your deponent knew the person so served
to be an agentauthorizedto accepton behalfor the to be served.
entity
[ X ] SUITABLE AGE PERSON
ofannahla and wit·
By deliveringa true
copy of eachto a person age to
discretion, JOHN DOE-REFUSED NAME, CORESIDENT, who
verilled
thatthe intendedrecipient resides
actually location.
at this
[ ] AFFlXING TO DOOR
a true
By allixing copy of eachto thedoor ofthe address at 6206TH STREET, EAST NORTHPORT, NY 11731,thatbeing theintended
recipientsdwellingplace or usualplace ofabode sincewith due diggence, theintended recipientcouldnot be found nor a person of
sullable age and discregon who would receive same.Your deponent attempted to make personal deBvery of the aforemenBoned
documents on 2/12/2021 at14:08:00,2/13/2021 at 14:19:00.
[ ] MAILING COPY
That on 2/18/2021,your deponent malled a truecopy of same by FirstClassMail propedy enclosed and sealed in a postpaid
wrapper
addressed to therecipientat:620 6TH STREET, EAST NORTHPORT, NY 11731 in anenvelope bearing the legend "Personal and
Confidential".
Said envelope was deposited in an oAcial
depositoryunder exclusivecare and custody of the
U.S. PostalService.
[ X)DESCRIPTION
Skin· Age· Height· Weight·
Gender Male; While; Hair:Brown; 48 - 52; Sit 7in -Slt
11in; 185 - 195;
[ ]WiTNESS FEE
[ X ] MILITARYSERVICE
i3spamat asked the personspoken to whether the recipientor intendedrecipient,where applicable,was presentlyon active dutyor
dependent on someone who was on acEve dutyin themililmyserviceof theUnited Statesand was infonned thathe/she was not.
Sworn to before me on 2/1
JOE SIBDE
P ck Buttler
N Public,Steleof New York
No.o18E8330370
Qualifiedin NASSAU County
Commiselon Empiree 09ft4f2033
foo KoehlerAvenue 8uneA
761 KoehlerAvenue,
RONNONNOMANY 11779 Ronkonhoma, NY 11779
Phone: (831) 73T-4110 Ph: 631-981-4400
File No. 20058T (NC8780683F)AZ 1057646
1 of 1
Document Filed Date
February 22, 2021
Case Filing Date
February 11, 2021
Category
Torts - Motor Vehicle
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Preview
FILED: SUFFOLK COUNTY CLERK 02/22/2021 02:41 PM INDEX NO. 602421/2021 NYSCEF DOC. NO. 5 RECEIVED NYSCEF: 02/22/2021 * THE STATE OF NEW YORK Index No.: 602421/2021 SUPREME COURT, SUFFOLK COUNTY FRed On: 2N121021 INEZ G. PERLIN, -against- AFFIDAVIT OF SERVICE THORIAS BOURNE, ET AL. STATE OF NEW YORK, COUNTY OF NASSAU: PatrickButtler,being duly sworn, poses and says thatdeponent isnot partyto thisaction,isover 18 years of age and resides in theState of New York. That on 2/15/2021 at 6·.SS PM at 620 6TH STREET, EAST NORTHPORT, NY 11731, your deponent served the NOTICE OF ELECTRONIC FILING, E-FILED SUMMONS AND E-FILED VERIFIED COMPLAINT bearing Index# 602421/2021 and tileddate 2/11/2021 upon THOMAS BOURNE. During service ofthe documents, your deponent has adhered to current CDC and NYS Department of HealthGuideBnes. [ ] INDIVIDUAL By personallydeliveringa truecopy thereofto said known recipient, by deponent to be saidperson named therein. [ ] AGENCY / BUSINESS By thereat delivering a truecopy of eachto JOHN DOE-REFUSED NAME, CORESIDENT. Your deponent knew the person so served to be an agentauthorizedto accepton behalfor the to be served. entity [ X ] SUITABLE AGE PERSON ofannahla and wit· By deliveringa true copy of eachto a person age to discretion, JOHN DOE-REFUSED NAME, CORESIDENT, who verilled thatthe intendedrecipient resides actually location. at this [ ] AFFlXING TO DOOR a true By allixing copy of eachto thedoor ofthe address at 6206TH STREET, EAST NORTHPORT, NY 11731,thatbeing theintended recipientsdwellingplace or usualplace ofabode sincewith due diggence, theintended recipientcouldnot be found nor a person of sullable age and discregon who would receive same.Your deponent attempted to make personal deBvery of the aforemenBoned documents on 2/12/2021 at14:08:00,2/13/2021 at 14:19:00. [ ] MAILING COPY That on 2/18/2021,your deponent malled a truecopy of same by FirstClassMail propedy enclosed and sealed in a postpaid wrapper addressed to therecipientat:620 6TH STREET, EAST NORTHPORT, NY 11731 in anenvelope bearing the legend "Personal and Confidential". Said envelope was deposited in an oAcial depositoryunder exclusivecare and custody of the U.S. PostalService. [ X)DESCRIPTION Skin· Age· Height· Weight· Gender Male; While; Hair:Brown; 48 - 52; Sit 7in -Slt 11in; 185 - 195; [ ]WiTNESS FEE [ X ] MILITARYSERVICE i3spamat asked the personspoken to whether the recipientor intendedrecipient,where applicable,was presentlyon active dutyor dependent on someone who was on acEve dutyin themililmyserviceof theUnited Statesand was infonned thathe/she was not. Sworn to before me on 2/1 JOE SIBDE P ck Buttler N Public,Steleof New York No.o18E8330370 Qualifiedin NASSAU County Commiselon Empiree 09ft4f2033 foo KoehlerAvenue 8uneA 761 KoehlerAvenue, RONNONNOMANY 11779 Ronkonhoma, NY 11779 Phone: (831) 73T-4110 Ph: 631-981-4400 File No. 20058T (NC8780683F)AZ 1057646 1 of 1