Commonwealth of Massachusetts. Motor Vehicle Crash. Police Report < LOCATION >

Transcription

1 Police Use Only Date of Crash 03/4/06 Time of Crash 0:0:00 City/Town NEWTON 4HR AT INTERSECTION: Route# Direction Name of Roadway/Street At Commonwealth of Massachusetts Number Motor Vehicle Crash Vehicles Police Report < LOCATION > Number Injured Speed Limit Latitude Longitude State Police Local Police MBTA Police Other: NOT AT INTERSECTION: 5 NEEDHAM ST Route# Direction Address # Name of Roadway/Street Feet N S E W of or Mile Marker Exit Number Route# Direction Name of Intersecting Roadway/Street Also at Intersection with Feet N S E W of Route# Intersecting Roadway/Street Feet N S E W of Route# Direction Name of Intersecting Roadway/Street Landmark X Vehicle # Occupants Hit/Run Moped Case Number RMV Document Number License # S St DOB/Age Reg # J6869 Reg Type CON Reg State Sex M Lic. Class D Lic. Restrictions CDL Veh Year 000 Veh Make CHEVY Veh Config. Endorsment Operator BEN-EZRA AMI Owner EDELN DAVID Last First Middle Last First Middle Address 03 PAYSON RD Address 86 COMMONWEALTH AVE. City BROOKLINE State Zip 0467 City NEWTON State Zip 0460 Insurance Company SS HOMELAND INSURANCE Vehicle Action Prior to Crash 0 Damaged Area Code: (Circle Up to Three) Vehicle Travel Direction: N XS E W Responding to Emergency? Event Sequence Undercarriage Citation # (If Issued) Most Harmful Event Totaled 4 4 Violation : Ch Sec Violation : Ch Sec Driver Contributing Code 99 Violation 3: Ch Sec Violation 4: Ch Sec Underride/Override Towed Please fill out for operator and all occupants involved Seat Safety Airbag Airbag Eject Trap Injury Transp. Name (Last First Middle) Address Age/DOB Sex Pos. System Status Switch Code Code Status Code Medical Facility Operator See Above X Please Select One Vehicle # Occupants Non-Motorist A Type Action Location Condition Hit/Run Moped of the Following: X License # St DOB/Age 0/03/950 Reg # Reg Type Reg State Sex M Lic. Class Lic. Restrictions CDL Veh Year Veh Make Veh Config. Endorsment Operator SWERLING ROBERT D Owner Last First Middle Last First Middle Address 874 WASHINGTON ST Address City AUBURNDALE State Zip 0466 City State Zip Insurance Company Vehicle Action Prior to Crash Damaged Area Code: (Circle Up to Three) Vehicle Travel Direction: N S E W Responding to Emergency? Event Sequence 3 4 Citation # (If Issued) Most Harmful Event 3 0 Undercarriage 9 5 Totaled Violation : Ch Sec Violation : Ch Sec Driver Contributing Code 4 4 Violation 3: Ch Sec Violation 4: Ch Sec Underride/Override 5 Towed Please fill out for operator and all occupants involved Seat Safety Airbag Airbag Eject Trap Injury Transp. Name (Last First Middle) Address Age/DOB Sex Pos. System Status Switch Code Code Status Code Medical Facility Operator/Non-Motorist See Above

2 = Direction = Vehicle =Vehicle = Pedestrian ON THE ABOVE DATE AND TIME WHILE OPERATING NPD UNIT #56 I WAS DISPATCHED TO THE NATIONAL LUMBER PARKING LOT LOCATED AT 5 NEEDHAM STREET IN NEWTON FOR A REPORT OF A MOTOR VEHICLE CRASH INVOLVING A PEDESTRIAN. UPON MY ARRIVAL ON SCENE THE PEDESTRIAN WAS BEING EXAMINED BY THE MEDICS. THE FIRST PERSON I SPOKE TO WAS THE OPERATOR OF M/V # WHO WAS IDENTIFIED AS MR. AMI BEN-EZRA, 03 PAYSON ROAD IN BROOKLINE 0467, OLN #S I ASKED MR. BEN-EZRA TO TELL ME HIS VERSION OF THE EVENTS LEADING UP TO THE CRASH AND HE STATED THE FOLLOWING: HE WAS BACKING VERY SLOWLY OUT OF A PARKING SPACE WHEN SUDDENLY HE HEARD A N YELLING. HE HAD CHECKED HIS MIRRORS BEFORE BACKING UP AND HE DID NOT SEE ANYONE. HE BELIEVES THE PEDESTRIAN WALKED INTO THE REAR OF HIS VEHICLE WHILE TRYING TO SQUEEZE IN BETWEEN M/V# AND A VEHICLE THAT WAS PARKED DIRECTLY TO THE RIGHT OF M/V #. OAK LANE LEMOIE-ZARBA, SUSAN, VINEYARD HAVEN, 0568 Y Placard Material digit # Material Name Material 4 digit # Release code EDWARD J LAVALLE NEWTON POLICE DEPARTM 03/4/06

3 = Direction = Vehicle =Vehicle = Pedestrian I NEXT SPOKE TO THE PEDESTRIAN INVOLVED IN THE CRASH WHO WAS IDENTIFIED AS MR. ROBERT D. SWERLING, DOB-0/03/950, OF 874 WASHINGTON STREET IN AUBURNDALE I ASKED MR. SWERLING TO TELL ME HIS VERSION OF THE EVENTS LEADING UP TO THE CRASH AND HE STATED THE FOLLOWING: HE WAS WALKING THROUGH THE PARKING LOT WHEN M/V# BACKED INTO HIM. HE USED HIS HANDS TO STEADY HIMSELF AND THE TRUCK DE CONTACT WITH HIS LOWER LEFT LEG. I OBSERVED WHAT APPEARED TO BE A FRESH SCRAPE/ABBRASION ON MR. SWERLING'S LEFT KNEE AREA. I TOOK A PHOTO OF THE INJURY. MR. SWERLING STATED THAT THE PERSON OPERATING THE VEHICLE THAT WAS PARKED IN THE SPOT DIRECTLY TO THE RIGHT OF M/V # Y HAVE WITNESSED THE CRASH. I OBTAINED THE CONTACT INFORTION OF THAT PARTY FROM THE STAFF AT NATIONAL LUMBER. THE PARTY WAS IDENTIFIED AS MS. SUSAN LEMOIE-ZARBA, PH# , OF OAK LANE IN Placard Material digit # Material Name Material 4 digit # Release code EDWARD J LAVALLE NEWTON POLICE DEPARTM 03/4/06

4 = Direction = Vehicle =Vehicle = Pedestrian VINEYARD HAVEN AT APPROXITELY 300 HOURS I SPOKE TO MS. LEMOIE-ZARBA VIA TELEPHONE. SHE STATED THAT SHE WAS LOOKING DOWN AT HER PURSE AND DID NOT SEE THE CRASH OCCUR. SHE ONLY SAW THE TWO MEN TALKING TO EACH OTHER AFTER THE CRASH HAD ALREADY OCCURED. NPD OFFICERS A. GABRIEL AND T.KEEFE CANVASSED THE AREA FOR ANY OTHER WITNESSES AND ANY POSSIBLE VIDEO EVIDENCE OF THE CRASH WITH NEGATIVE RESULTS. I TOOK PHOTOS OF THE CRASH SCENE AND TURNED THE CAMERA MEMORY CARD OVER TO THE NPD I.T. BUREAU FOR CATALOGING. I ADVISED THE OPERATOR OF M/V # TO CONTACT HIS INSURANCE COMPANY AND TO COMPLETE A CRASH REPORT. I ADVISED Placard Material digit # Material Name Material 4 digit # Release code EDWARD J LAVALLE NEWTON POLICE DEPARTM 03/4/06

5 = Direction = Vehicle =Vehicle = Pedestrian BOTH PARTIES AS TO HOW THEY COULD OBTAIN A COPY OF MY REPORT ONCE IT IS COMPLETED Placard Material digit # Material Name Material 4 digit # Release code EDWARD J LAVALLE NEWTON POLICE DEPARTM 03/4/06