Preview
(FILED: KINGS COUNTY CLERK 0371372017 04:35 PM INDEX NO. 521456/2016
NYSCEF DOC. NO. 31 RECEIVED NYSCEF: 03/13/2017
REQUEST FOR JUDICIAL INTERVENTION
UcS-840 (7/2012)
Supreme COURT, COUNTY OF. Kings
Index No: 521456/2016 Date Index Issued:__12/02/2016
fe Enter the complete case caption. Do not use et al or et ano. If more space is required,
CRaaOn attach a caption rider sheet.
2662 KINGSBRIDGE TERRACE, LLC.,
Plaintiff(s)/Petitioner(s)
LW
~against-
HOWARD LEVY and OCCIDENTAL FIRE &
CASUALTY COMPANY OF NORTH CAROLINA,
Defendant(s)/Respondent(s)
NATURE OF ACTION OR PROCEEDING: Check ONE box only and specify where indicated.
MATRIMONIAL. COMMERCIAL
Contested Business Entity (including corporations, partnerships, LLCs, etc.)
NOTE: For all Matrimonial actions where the parties have children under | © Contract
the age of 18, complete and attach the MATRIMONIAL Rul Addendum. —_| @) insurance (where insurer is a party, except arbitration)
For Uncontested Matrimonial actions, use Rul form UD-13. O ucc (including sales, negotiable instruments)
TORTS O other Commercial:
Asbestos (enecity)
O Breast Implant NOTE: For Commercial Division assignment requests [22 NYCRR §
O Environmental: 202.70(d)], complete and attach the COMMERCIAL DIV Rul Addendum.
(spect) REAL PROPERTY: _How many properties does the application include?
O Medical, Dental, or Podiatric Malpractice © Condemnation
© Motor Vehicle O Mortgage Foreclosure (specify: OResidential © Commercial
O Products Liability: Property Address:
(specify) ‘Street Address City State Zip
O other Negligence*Fallure to Procure NOTE: For Mortgage Foreclosure actions involving a one- to four-family,
(Speciy) ‘owner-occupied, residential property, or an owner-occupied
© Other Professional Malpractice: condominium, complete and attach the FORECLOSURE Rul Addendum.
(specty) O Tax Certiorari - Section: Block: Lot:
O other Tort: O Tax Foreclosure
(specity) O other Real Property:
OTHER MATTERS, (speci)
Certificate of Incorporation/Dissolution [see NOTE under Commercial] | SPECIAL PROCEEDINGS
QO mergency Medical Treatment O CPLR Article 75 (Arbitration) [see NOTE under Commercial]
Odtabeas Corpus O CPLR Article 78 (Body or Officer)
O Local Court Appeal O Election Law
O Mechanic's Lien © MHL Article 9.60 (Kendra's Law)
OvName Change © MHL Article 10 (Sex Offender Confinement-Initial)
O Pistol Permit Revocation Hearing © MHL Article 10 (Sex Offender Confinement-Review)
O Sale or Finance of Religious/Not-for-Profit Property O MHL Article 81 (Guardianship)
© Other: © Other Mental Hygiene:
(specify) (specify)
© Other Special Proceeding:
STATUS OF ACTION OR PROCEEDING: Answer YES or NO for EVERY question AND enter additional Information where indicated.
LYES | NO |
Has a summons and complaint or summons winotice been filed? © © _ tyes, date tiled: 12/02/2016
Has a summons and complaint or summons winotice been served? © O tyes, date serve: 12/02/2016
{s this action/proceeding being filed post-judgment? O @ _ tyes, judgment date:
1 of 2(FILED: KINGS COUNTY CLERK 0371372017 04:35 PM INDEX NO. 521456/2016
NYSCEF DOC. NO. 31 RECEIVED NYSCEF: 03/13/2017
| NATURE OF JUDICIAL INTERVENTION: ‘Check ONE box only AND enter additional information where indicated. ]
Infant's Compromise
O Note of Issue and/or Certificate of Readiness
© Notice of Medical, Dental, or Podiatric Malpractice —_—Datte Issue Joined:
© Notice of Motion Relief Sought;4udament- Summary Return Date: 04/07/2017
© Notice of Petition Relief Sought: Return Da
O order to Show Cause Relief Sought: Return Date:
© other Ex Parte Application Relief Sought:
© Poor Person Application
© Request for Preliminary Conference
CO Residential Mortgage Foreclosure Settlement Conference
© writ of Habeas Corpus
© Other (specify):
List any related actions. For Matrimonial actions, include any related criminal and/or Family Court cases.
if additional space is required, complete and attach the Rul Addendum. If none, leave blank.
Index/Case No. [Court [Judge (if assigned Relationship to Instant Case
RELATED CASES:
Case Title
For parties without an attorney, check "Un-Rep” box AND enter party address, phone number and e-mail address in space provided.
Hf additional space is required, complete and attach the RJl Addendum.
Attorneys and/or Unrepresented Litigants:
Provide attorney name, firm name, business address, phone number and e-mail
address of all attorneys that have appeared in the case. For unrepresented
litigants, provide address, phone number and e-mail address.
PARTIES:
Parties;
Un- |List parties in caption order and
Rep | indicate party role(s) (e.g. defendant;
3rd-party plaintiff),
12662 KINGSBRIDGE TERRACE, LLC JAguinick Scott E,
Last Name Last Name First Name
Insurance
Carrier(s):
[Greenblatt & Agulnick, P.C.
First Na Fle Name
Oo Pray
. 5 Northern Boulevard - Suite 302 Great Neck NewYork 11358.
Plaintiff Street Address city Stato
Role (If any): NO
Phono Fax e-mail
OCCIDENTAL FIRE & CASUALTY COMPAM Chernow Jonathan S
Last Name Last Name First Namo
Ihite Fleischner & Fino, LLP
oO Firm Namo
61 Broadway, 18th Floor New York New York 10006
Defendant Street Address City State zip
‘Socondary Role (if any):
+1 (212) 487-9700 +1 (212) 487-9777 jchernow@wff-law.com
Phone Fax ‘e-mall
Levy
Last Name Last Name First Name Oves
Howard
First Namo Firm Name
Primary Role:
1702 16th Avenue Brooklyn New York 11204,
Defendant Streot Address: City State Zip
‘Secondary Role (if any):
Phone Fax e-mail
Last Name Last Namo First Name
oO First Namo Firm Name
Primary Role:
Street Addross city State zip
‘Secondary Role (if any):
Phone
| AFFIRM UNDER THE PENALTY OF PERJURY THAT, TO MY KNOWLEDGE, OTHER THAN AS NOTED ABOVE, THERE ARE AND HAVE
BEEN NO RELATED ACTIONS OR PROCEEDINGS, NOR HAS A REQUEST FOR JUDICIAL INTERVENTION PREVIOUSLY BEEN FILED IN
THIS ACTION OR PROCEEDING.
Dated: 03/13/2017
SIGNATURE
Jonathan Chernow
ATTORNEY REGISTRATION NUMBER PRINT OR TYPE NAME (Lrmtrom |
2 of 2