Preview
FILED: ORANGE COUNTY CLERK 05/12/2022 12:15 PM INDEX NO. EF005836-2021
NYSCEF DOC. NO. 22 RECEIVED NYSCEF: 05/12/2022
REQ UEST FOR JUDICIAL INTERVENTION o*Û°022)
Supreme COURT, COUNTY OF Orange
Index No: EF005836-2021 Date Index issued: 08/19/2021 For Court Use Only
CAPTION Enter thecompletecase caption.Do not use et al or et ano. If more
space attach
is needed, a captionridersheet. IAS EntryDate
Kathleen PetroviCs
Judge Assigned
Plaintiff(s)/Petitioner(s)
-against-
Garnet Health Medical Center, MB Real Estate,John Doe Company RJ1FiledDate
Defendant(s)/Respondent(s)
NATURE OF ACTION OR PROCEEDING: Check only one box and specify
where indicated.
COMMERCIAL MATRIMONIAL
O BusinessEntity (includes corporations, partnerships, LLCs,LLPs,etc.)¡ Contested
¡ Contract NOTE: if there are children under the age of 18, complete and attach the
Insurance (where insurance company is a party, except arbitration) MATRAMONIALRJIAddendum (UCS-840M).
¡
¡ UCC(includes sales and negotiable instruments) For UncontestedMatrimonial actions, use the UncontestedDivorce Rji (UD-13).
O Other Commercial (specify): REAL PROPERTY Specify how many properties the application includes:
¡ Condemnation
NOTE: For CommercialDivision assignment requests pursuant to 22 NYCRR202.70(d),
complete and attach the COMMERCIALDIVISION RJ1ADDENDUM (UCS-84OC)- ¡ Residential
Mortgage Foreclosure(specify):
¡ O Commercial
TORTS Property Address:
O Asbestos NOTE: For Mortgage Foreclosureactions involving a one to four-family, owner-
O ChildVictims Act occupiedresidential property or owner-occupiedcondominium, complete and
atta e FORECOSURE RJIADDENDUM (UCM4M.
¡ Environmental (specify):
O Medical, Dental or Podiatric Malpractice ¡ Partition
¡ Motor Vehicle NOTE: Complete and attach the PART1TIONRJIADDENDUM (UCS-840P).
¡ Products Liability (specify): ¡ Tax Certiarari (specify):
Section: Block: Lot:
¡ Other Negligence(specify): ¡ Tax Foreclosure
¡ Other ProfessionalMalpractice(specify): ¡ Other Real Property (specify):
Other Tort (specify): Personal Injury OTHER MATTERS
SPECIAL PROCEEDINGS ¡ Certificate of Incorporation/Dissolution
[see NOTE in COMMERCIALsection]
¡ Assisted ReproductionO
Child-ParentSecurity Act (specify): O Surrogacy Agreement¡ Emergency MedicalTreatment
¡ CPLRArticle 75 - Arbitration
[see NOTE in COMMERCIALsection] ¡ HabeasCorpus
¡ CPLRArticle 78 - Proceedingagainst a Body or Officer ¡ Local Court Appeal
¡ Election Law ¡ Mechanic'sLien
¡ Extreme Risk ProtectionOrder ¡ Name Change/SexDesignationChange
¡ MHLArticle 9.60 - Kendra'sLaw ¡ Pistol Permit Revocation Hearing
¡ MHLArticle 10 - Sex Offender Confinement (specify):
¡ Initial¡ Review ¡ Saleor Financeof Religious/Not-for-ProfitProperty
¡ MHLArticle 81 (Guardianship) O Other (specify):
¡ Other Mental Hygiene(specify):
¡ Other Special Proceeding(specify):
STATUS OF ACTION OR PROCEEDING Answer YES or NO for every
questionand enteradditional
informationwhere indicated.
LYES_NOj
Hasa summonsand complaint or summonswith notice been filed? If yes, date filed: 08/19/2021
Hasa summonsand complaint or summonswith notice been served? If yes, date served: 09/07/2021
Is this action/proceeding being filed post-judgment? O If yes, judgment date:
NATURE OF JUDICIAL INTERVENTION Check one box only and enter
additional
informationwhere indicated.
Infant's Compromise
O Extreme Risk Protection Order Application
Note of ISSue/Certificateof Readiness
Noticeof Medical, Dental or Podiatric Malpractice
Date Issuejoined:
Noticeof Motion Relief Requested:
Amend Caption/Pleadings Retum Date: 06/10/2022
O Noticeof Petition Relief Requested: Retum Date:
Order to ShowCause Relief Requested: Retum Date:
O Other Ex ParteApplication Relief Requested:
O Partition Settlement Conference
O PoorPersonApplication
Requestfor Preliminary Conference
O ResidentialMortgage ForeclosureSettlement Conference
O Writ of HabeasCorpus
Other (specify):
Filedin Orange County 05/12/2022 12:15:50 PM $95.00 Bk: 1 of
5146 2 Pg: 699 Index: # EF005836-2021 Clerk:DK
FILED: ORANGE COUNTY CLERK 05/12/2022 12:15 PM INDEX NO. EF005836-2021
NYSCEF DOC. NO. 22 RECEIVED NYSCEF: 05/12/2022
RELATED CASES List any related
actions.
For Matrimonialcases,list any related
criminalor FamilyCourtcases.If none,
leave blank.
If additional complete
space is required, and attachtheRJI Addendum (UCS-840A).
Case Title Index/Case Number Court Judge (ifassigned) Relationship to instantcase
For parties
withoutan a torney,
check "Un-Rep" box and enter number
PARTIES the theparty'saddress,phona and emailin thespace
provided.If additional
s lace
is required,
complete and attach
the RJI Addendum (UCS-84CA).
Un- Parties Attorneys and Unrepresented Litigants issue joined insurance Carriers
Rep List parties in same order as listed in the
For represented parties, provide attorney's name, firm name, address, phone
For each defendant,
Foreach defendant,
caption and indicate roles (e.g., plaintiff,
and email. For unrepresented parties, provide party's address, phone and
indicate if issue has
indicate insurance
defendant, 3rdparty plaintiff, etcJ ernail. beenjoined. carrier, if applicable.
Name: Petrovics,Kathleen EVAN FOULKE, FOULKE LAW FIRM, 55 Main Street,2nd
Floor , Goshen, NY 10924, 845-294-4308, D YES O NO
Role(s):Plaintiff/Petitioner foulke@foulkelaw.com
Name: Garnet Health Medical SEAMUS WEIR, CATANIA, MAHON & RIDER, PLLC, 641
Center BROADWAY , NEWBURGH, NY 12550, O YES O NO
Role(s):Defendant/Respondent sweir@cmmrlegal.com
Name: MB Real Estate Robert Myers, Wilson ElserMoskowitz Edelman & Dicker,
O 150 E. 42nd Street,New York, NY 10017, 212-490-3000, O YES O NO
Role(s):Defendant/Respondent robert.myers@wilsonelser.com
Name: John Doe Company
O YES D NO
Role(s):Defendant/Respondent
Name:
O
O YES O NO
Role(s):
Name:
O
O YES O NO
Role(s):
Name:
O
O YES O NO
Role(s):
Name:
O
O YES O NO
Role(s):
Name:
O
O YES O NO
Role(s):
Name:
O
O YES O NO
Role(s):
I AFFIRM UNDER THE PENALTY OF PERJURY THAT, UPON INFORMATION AND BELIEF, THERE ARE NO OTHER RELATED ACTIONS OR
PROCEEDINGS, EXCEPT AS NOTED ABOVE, NOR HAS A REQUEST FOR JUDICIAL INTERVENTION BEEN PREVIOUSLY FILED INTHIS
ACTION OR PROCEEDING.
Dated: 05/12/2022 EVAN M FOULKE
Signature
2427037 EVAN M FOULKE
Attorney Registration Number PrintName
This form was generated by NYSCEF
2 of 2
Preview
FILED: ORANGE COUNTY CLERK 05/12/2022 12:15 PM INDEX NO. EF005836-2021 NYSCEF DOC. NO. 22 RECEIVED NYSCEF: 05/12/2022 REQ UEST FOR JUDICIAL INTERVENTION o*Û°022) Supreme COURT, COUNTY OF Orange Index No: EF005836-2021 Date Index issued: 08/19/2021 For Court Use Only CAPTION Enter thecompletecase caption.Do not use et al or et ano. If more space attach is needed, a captionridersheet. IAS EntryDate Kathleen PetroviCs Judge Assigned Plaintiff(s)/Petitioner(s) -against- Garnet Health Medical Center, MB Real Estate,John Doe Company RJ1FiledDate Defendant(s)/Respondent(s) NATURE OF ACTION OR PROCEEDING: Check only one box and specify where indicated. COMMERCIAL MATRIMONIAL O BusinessEntity (includes corporations, partnerships, LLCs,LLPs,etc.)¡ Contested ¡ Contract NOTE: if there are children under the age of 18, complete and attach the Insurance (where insurance company is a party, except arbitration) MATRAMONIALRJIAddendum (UCS-840M). ¡ ¡ UCC(includes sales and negotiable instruments) For UncontestedMatrimonial actions, use the UncontestedDivorce Rji (UD-13). O Other Commercial (specify): REAL PROPERTY Specify how many properties the application includes: ¡ Condemnation NOTE: For CommercialDivision assignment requests pursuant to 22 NYCRR202.70(d), complete and attach the COMMERCIALDIVISION RJ1ADDENDUM (UCS-84OC)- ¡ Residential Mortgage Foreclosure(specify): ¡ O Commercial TORTS Property Address: O Asbestos NOTE: For Mortgage Foreclosureactions involving a one to four-family, owner- O ChildVictims Act occupiedresidential property or owner-occupiedcondominium, complete and atta e FORECOSURE RJIADDENDUM (UCM4M. ¡ Environmental (specify): O Medical, Dental or Podiatric Malpractice ¡ Partition ¡ Motor Vehicle NOTE: Complete and attach the PART1TIONRJIADDENDUM (UCS-840P). ¡ Products Liability (specify): ¡ Tax Certiarari (specify): Section: Block: Lot: ¡ Other Negligence(specify): ¡ Tax Foreclosure ¡ Other ProfessionalMalpractice(specify): ¡ Other Real Property (specify): Other Tort (specify): Personal Injury OTHER MATTERS SPECIAL PROCEEDINGS ¡ Certificate of Incorporation/Dissolution [see NOTE in COMMERCIALsection] ¡ Assisted ReproductionO Child-ParentSecurity Act (specify): O Surrogacy Agreement¡ Emergency MedicalTreatment ¡ CPLRArticle 75 - Arbitration [see NOTE in COMMERCIALsection] ¡ HabeasCorpus ¡ CPLRArticle 78 - Proceedingagainst a Body or Officer ¡ Local Court Appeal ¡ Election Law ¡ Mechanic'sLien ¡ Extreme Risk ProtectionOrder ¡ Name Change/SexDesignationChange ¡ MHLArticle 9.60 - Kendra'sLaw ¡ Pistol Permit Revocation Hearing ¡ MHLArticle 10 - Sex Offender Confinement (specify): ¡ Initial¡ Review ¡ Saleor Financeof Religious/Not-for-ProfitProperty ¡ MHLArticle 81 (Guardianship) O Other (specify): ¡ Other Mental Hygiene(specify): ¡ Other Special Proceeding(specify): STATUS OF ACTION OR PROCEEDING Answer YES or NO for every questionand enteradditional informationwhere indicated. LYES_NOj Hasa summonsand complaint or summonswith notice been filed? If yes, date filed: 08/19/2021 Hasa summonsand complaint or summonswith notice been served? If yes, date served: 09/07/2021 Is this action/proceeding being filed post-judgment? O If yes, judgment date: NATURE OF JUDICIAL INTERVENTION Check one box only and enter additional informationwhere indicated. Infant's Compromise O Extreme Risk Protection Order Application Note of ISSue/Certificateof Readiness Noticeof Medical, Dental or Podiatric Malpractice Date Issuejoined: Noticeof Motion Relief Requested: Amend Caption/Pleadings Retum Date: 06/10/2022 O Noticeof Petition Relief Requested: Retum Date: Order to ShowCause Relief Requested: Retum Date: O Other Ex ParteApplication Relief Requested: O Partition Settlement Conference O PoorPersonApplication Requestfor Preliminary Conference O ResidentialMortgage ForeclosureSettlement Conference O Writ of HabeasCorpus Other (specify): Filedin Orange County 05/12/2022 12:15:50 PM $95.00 Bk: 1 of 5146 2 Pg: 699 Index: # EF005836-2021 Clerk:DK FILED: ORANGE COUNTY CLERK 05/12/2022 12:15 PM INDEX NO. EF005836-2021 NYSCEF DOC. NO. 22 RECEIVED NYSCEF: 05/12/2022 RELATED CASES List any related actions. For Matrimonialcases,list any related criminalor FamilyCourtcases.If none, leave blank. If additional complete space is required, and attachtheRJI Addendum (UCS-840A). Case Title Index/Case Number Court Judge (ifassigned) Relationship to instantcase For parties withoutan a torney, check "Un-Rep" box and enter number PARTIES the theparty'saddress,phona and emailin thespace provided.If additional s lace is required, complete and attach the RJI Addendum (UCS-84CA). Un- Parties Attorneys and Unrepresented Litigants issue joined insurance Carriers Rep List parties in same order as listed in the For represented parties, provide attorney's name, firm name, address, phone For each defendant, Foreach defendant, caption and indicate roles (e.g., plaintiff, and email. For unrepresented parties, provide party's address, phone and indicate if issue has indicate insurance defendant, 3rdparty plaintiff, etcJ ernail. beenjoined. carrier, if applicable. Name: Petrovics,Kathleen EVAN FOULKE, FOULKE LAW FIRM, 55 Main Street,2nd Floor , Goshen, NY 10924, 845-294-4308, D YES O NO Role(s):Plaintiff/Petitioner foulke@foulkelaw.com Name: Garnet Health Medical SEAMUS WEIR, CATANIA, MAHON & RIDER, PLLC, 641 Center BROADWAY , NEWBURGH, NY 12550, O YES O NO Role(s):Defendant/Respondent sweir@cmmrlegal.com Name: MB Real Estate Robert Myers, Wilson ElserMoskowitz Edelman & Dicker, O 150 E. 42nd Street,New York, NY 10017, 212-490-3000, O YES O NO Role(s):Defendant/Respondent robert.myers@wilsonelser.com Name: John Doe Company O YES D NO Role(s):Defendant/Respondent Name: O O YES O NO Role(s): Name: O O YES O NO Role(s): Name: O O YES O NO Role(s): Name: O O YES O NO Role(s): Name: O O YES O NO Role(s): Name: O O YES O NO Role(s): I AFFIRM UNDER THE PENALTY OF PERJURY THAT, UPON INFORMATION AND BELIEF, THERE ARE NO OTHER RELATED ACTIONS OR PROCEEDINGS, EXCEPT AS NOTED ABOVE, NOR HAS A REQUEST FOR JUDICIAL INTERVENTION BEEN PREVIOUSLY FILED INTHIS ACTION OR PROCEEDING. Dated: 05/12/2022 EVAN M FOULKE Signature 2427037 EVAN M FOULKE Attorney Registration Number PrintName This form was generated by NYSCEF 2 of 2