On February 27, 2019 a
Exhibit,Appendix
was filed
involving a dispute between
Jose Andaluz Also Known As Jose Gabriel Andaluz Espejo,
Jose Andaluz
Also Known As Jose Gabriel Andaluz Espejo,
and
Safe N Lock Self Storage, Llc,,
Snl Construction, Llc,
Snl Development Group, Llc,,
Snl Eri Fort Hamilton, Llc,,
Snl Eri Holdings Llc,,
Snl Ix Llc,
Snl Orix Fort Hamilton, Llc,
for Torts - Other (labor law)
in the District Court of Kings County.
Preview
FILED: KINGS COUNTY CLERK 04/15/2024 03:51 PM INDEX NO. 504378/2019
NYSCEF DOC. NO. 198 RECEIVED NYSCEF: 04/15/2024
EXHIBIT 22
FILED: KINGS COUNTY CLERK 04/15/2024 03:51 PM INDEX NO. 504378/2019
NYSCEF DOC. NO. 198 RECEIVED NYSCEF: 04/15/2024
1702-- 3491 Ft. Hamilton Parkway
3491 Ft. Hamilton Parkway Brooklyn, NY 11218
Date Fri 01/18/2019 Job # 1702 Prepared By Aaron Stevens
01/18/19
01/18/19 || 07:19AM
07:19AM 01/18/19
01/18/19 || 07:02AM
07:02AM 01/19/19
01/19/19 || 01:30PM
01:30PM 01/18/19
01/18/19 || 07:35AM
07:35AM
Weather
6:00 AM 12:00 PM 4:00 PM
30° 36° 37°
Overcast Overcast Overcast
Wind: 3 MPH | Precipitation: .01'' | Humidity: 91% Wind: 1 MPH | Precipitation: .02'' | Humidity: 86% Wind: 6 MPH | Precipitation: .02'' | Humidity: 83%
Work Logs
Name Description Quantity Hours Hours To Date
Shotgun Masonry and Welding of pile extensions on West side and rakers in NE 13 8 4528
Concrete corner. Lagging at East Elevation 2nd lift and at pile
extensions west and north sides. Shotgun employee
Gabriel Andaluz injured at 12:56PM
Aaron Stevens | 01/19/19 | 06:03PM
Total 13 104 5079.5
Time Cards No entry
Work Log Photos
Shotgun Masonry and Concrete: | QTY: 13 | HRS: 8.0 | HTD: 4528.00
1 of 7 | 1702-- 3491 Ft. Hamilton Parkway
FILED: KINGS COUNTY CLERK 04/15/2024 03:51 PM INDEX NO. 504378/2019
NYSCEF DOC. NO. 198 RECEIVED NYSCEF: 04/15/2024
01/18/19
01/18/19 || 07:20AM
07:20AM 01/18/19
01/18/19 || 07:41AM
07:41AM 01/19/19
01/19/19 || 01:30PM
01:30PM 01/19/19
01/19/19 || 01:30PM
01:30PM
01/19/19
01/19/19 || 01:30PM
01:30PM 01/19/19
01/19/19 || 01:30PM
01:30PM 01/18/19
01/18/19 || 10:03AM
10:03AM 01/18/19
01/18/19 || 10:34AM
10:34AM
01/18/19
01/18/19 || 10:17AM
10:17AM 01/18/19
01/18/19 || 10:57AM
10:57AM 01/19/19
01/19/19 || 01:30PM
01:30PM
Notes, Issues, Concerns
1. DOB Arrived at site at 2:19 PM pursuant to injury reported by Aaron Stevens to DOB CSE Unit at 1:04 PM
which generated complaint #3683338. Full SWO and two (2) violations issued, #35377064R & 35377065Z.
Aaron Stevens | 01/19/19 | 01:57PM
01/19/19
01/19/19 || 12:07PM
12:07PM 01/19/19
01/19/19 || 12:07PM
12:07PM 01/19/19
01/19/19 || 12:07PM
12:07PM
Site Safety Observations
1. SHOTGUN EMPLOYEE INJURED
EMPLOYEE NAME: Gabriel Andaluz, carpenter/laborer
2 of 7 | 1702-- 3491 Ft. Hamilton Parkway
FILED: KINGS COUNTY CLERK 04/15/2024 03:51 PM INDEX NO. 504378/2019
NYSCEF DOC. NO. 198 RECEIVED NYSCEF: 04/15/2024
TIME: 12:56 PM
NATURE OF INJURY: Deep laceration to back outside top of left calf
INJURY CAUSED BY: Stihl TS 700 motorized cut-off saw spinning around while place on ground while power
still on and cutting outside top of left calf
WORK BEING PERFORMED WHILE INJURED: Worker was cutting pieces of lagging to length for installation
REPORTED CIRCUMSTANCES OF INJURY BY SHOTGUN FOREMAN LUIS CABRERA: Worker was getting
another piece of lumber to cut and put saw down while still on. Saw spun around and blade struck worker in
left calf
NOTES:
- Worker has 30-hour OSHA training
- Worker Received Safety Orientation on site was issued sticker #029 on October 10, 2018
- Stihl TS 700 should have been used for cutting wood per manufacturer's specifications
Aaron Stevens | 01/19/19 | 03:10PM
Attachments: Gabriel Anda... | Gabriel Anda... | STIHL-TS-700...
2. See attached 3491 Ft Hamilton Pkwy - OSHA Form 300_Log of Work Related Injuries &
Illnesses_001_190118 & 3491 Ft Hamilton Pkwy - OSHA Form 301_Injury Incident Report_001_190118
Aaron Stevens | 01/19/19 | 03:12PM
Attachments: 3491 Ft Hami... | 3491 Ft Hami...
3. See attached Accident Report Timeline of events from time of injury and pictures of events
Aaron Stevens | 01/19/19 | 05:51PM
01/19/19
01/19/19 || 11:30AM
11:30AM 01/19/19
01/19/19 || 11:30AM
11:30AM 01/18/19
01/18/19 || 01:24PM
01:24PM 01/19/19
01/19/19 || 11:30AM
11:30AM
01/18/19
01/18/19 || 01:24PM
01:24PM 01/18/19
01/18/19 || 01:25PM
01:25PM 01/19/19
01/19/19 || 11:30AM
11:30AM 01/19/19
01/19/19 || 11:30AM
11:30AM
01/19/19
01/19/19 || 11:30AM
11:30AM 01/18/19
01/18/19 || 01:47PM
01:47PM 01/19/19
01/19/19 || 11:30AM
11:30AM 01/18/19
01/18/19 || 01:31PM
01:31PM
3 of 7 | 1702-- 3491 Ft. Hamilton Parkway
FILED: KINGS COUNTY CLERK 04/15/2024 03:51 PM INDEX NO. 504378/2019
NYSCEF DOC. NO. 198 RECEIVED NYSCEF: 04/15/2024
01/19/19
01/19/19 || 11:30AM
11:30AM 01/19/19
01/19/19 || 11:30AM
11:30AM 01/19/19
01/19/19 || 11:30AM
11:30AM 01/18/19
01/18/19 || 01:47PM
01:47PM
01/19/19
01/19/19 || 11:30AM
11:30AM 01/19/19
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11:30AM 01/19/19
01/19/19 || 11:30AM
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01/19/19
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11:30AM 01/19/19
01/19/19 || 11:30AM
11:30AM
01/19/19
01/19/19 || 11:30AM
11:30AM 01/18/19
01/18/19 || 01:55PM
01:55PM 01/19/19
01/19/19 || 11:30AM
11:30AM 01/18/19
01/18/19 || 01:55PM
01:55PM
01/19/19
01/19/19 || 11:30AM
11:30AM
Attachments: 3491 Ft Hami...
4. See attached DOB Daily Log
Aaron Stevens | 01/21/19 | 04:16PM
4 of 7 | 1702-- 3491 Ft. Hamilton Parkway
FILED: KINGS COUNTY CLERK 04/15/2024 03:51 PM INDEX NO. 504378/2019
NYSCEF DOC. NO. 198 RECEIVED NYSCEF: 04/15/2024
01/21/19
01/21/19 || 04:15PM
04:15PM
Quality Control Observations No entry
Survey
Questions N/A No Yes Description
NYC Office of Emergency
Management, Citywide Interagency
Coordinator, Phil Molina in response
to injury report.
DOB Inspector Janine Karakatsanis,
Was an inspector on site and if so what was Badge #2980, in response to injury
1. report. Injury report called in to DOB by
being inspected and its location?
Aaron Stevens of SNL Construction.
Injury report converted to DOB
Complaint #3683338.
OSHA Compliance Officers Rui Zhen
(Gordon) Mei, and Damian Kuna.
Aaron Stevens | 01/19/19 | 01:24PM
Work generally stopped at 1:00PM
after accident, back-filling and other
safety wrap up completed at areas
where work was in-progress. Full SWO
2. Any schedule delays occur? Issued at approximately 4:15, along
with (2) violations, as a result of the
injury sustained by Shotgun Employee
Gabriel Andaluz.
Aaron Stevens | 01/19/19 | 01:23PM
3. Did weather cause any delays?
NYC OEM and DOB, and OSHA
inspectors per above. EMS,
Paramedics, NYPD, FDNY all came to
site. Irving Lopez of Flash
4. Any visitors on site? Reprographics to drop off Coordinated
Drawing Sets. Andy Perol of AEL to
pick up cylinders. United Fuel to
deliver fuel for generator and SOE
equipment.
Aaron Stevens | 01/19/19 | 01:20PM
Full SWO issued at 4:15PM but
5. Any areas that can't be worked on? worked generally stopped at 1:00PM
due to the injury
Aaron Stevens | 01/19/19 | 06:05PM
6. Any equipment rented on site? Generator, (2) Toilets, Trailer & toilet,
5 of 7 | 1702-- 3491 Ft. Hamilton Parkway
FILED: KINGS COUNTY CLERK 04/15/2024 03:51 PM INDEX NO. 504378/2019
NYSCEF DOC. NO. 198 RECEIVED NYSCEF: 04/15/2024
oxygen and acetylene canisters &
hand truck from Awisco, Large
Excavator and small excavator from
Herc for Shotgun, (1) Herc welding
machine, (1) Sunbelt dual welding
machine, cages from Awisco
Aaron Stevens | 01/18/19 | 11:29AM
Survey Photos
1.
01/19/19
01/19/19 || 12:07PM
12:07PM 01/19/19
01/19/19 || 11:30AM
11:30AM 01/19/19
01/19/19 || 11:30AM
11:30AM 01/19/19
01/19/19 || 11:30AM
11:30AM
4.
01/19/19
01/19/19 || 11:28AM
11:28AM 01/19/19
01/19/19 || 11:28AM
11:28AM 01/18/19
01/18/19 || 01:54PM
01:54PM 01/19/19
01/19/19 || 11:28AM
11:28AM
01/19/19
01/19/19 || 11:28AM
11:28AM 01/18/19
01/18/19 || 01:56PM
01:56PM 01/19/19
01/19/19 || 11:28AM
11:28AM 01/18/19
01/18/19 || 01:54PM
01:54PM
01/19/19
01/19/19 || 11:28AM
11:28AM 01/18/19
01/18/19 || 01:54PM
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11:28AM 01/19/19
01/19/19 || 11:28AM
11:28AM
6 of 7 | 1702-- 3491 Ft. Hamilton Parkway
FILED: KINGS COUNTY CLERK 04/15/2024 03:51 PM INDEX NO. 504378/2019
NYSCEF DOC. NO. 198 RECEIVED NYSCEF: 04/15/2024
01/19/19
01/19/19 || 11:28AM
11:28AM 01/19/19
01/19/19 || 11:28AM
11:28AM 01/18/19
01/18/19 || 01:56PM
01:56PM
Attachments
01/18/19
01/18/19 || 08:53AM
08:53AM 01/18/19
01/18/19 || 10:13AM
10:13AM
I, Aaron Stevens, have reviewed and completed this report.
Aaron Stevens | 01/19/19 | 06:06PM
7 of 7 | 1702-- 3491 Ft. Hamilton Parkway
Document Filed Date
April 15, 2024
Case Filing Date
February 27, 2019
Category
Torts - Other (labor law)
For full print and download access, please subscribe at https://www.trellis.law/.
Preview
FILED: KINGS COUNTY CLERK 04/15/2024 03:51 PM INDEX NO. 504378/2019 NYSCEF DOC. NO. 198 RECEIVED NYSCEF: 04/15/2024 EXHIBIT 22 FILED: KINGS COUNTY CLERK 04/15/2024 03:51 PM INDEX NO. 504378/2019 NYSCEF DOC. NO. 198 RECEIVED NYSCEF: 04/15/2024 1702-- 3491 Ft. Hamilton Parkway 3491 Ft. Hamilton Parkway Brooklyn, NY 11218 Date Fri 01/18/2019 Job # 1702 Prepared By Aaron Stevens 01/18/19 01/18/19 || 07:19AM 07:19AM 01/18/19 01/18/19 || 07:02AM 07:02AM 01/19/19 01/19/19 || 01:30PM 01:30PM 01/18/19 01/18/19 || 07:35AM 07:35AM Weather 6:00 AM 12:00 PM 4:00 PM 30° 36° 37° Overcast Overcast Overcast Wind: 3 MPH | Precipitation: .01'' | Humidity: 91% Wind: 1 MPH | Precipitation: .02'' | Humidity: 86% Wind: 6 MPH | Precipitation: .02'' | Humidity: 83% Work Logs Name Description Quantity Hours Hours To Date Shotgun Masonry and Welding of pile extensions on West side and rakers in NE 13 8 4528 Concrete corner. Lagging at East Elevation 2nd lift and at pile extensions west and north sides. Shotgun employee Gabriel Andaluz injured at 12:56PM Aaron Stevens | 01/19/19 | 06:03PM Total 13 104 5079.5 Time Cards No entry Work Log Photos Shotgun Masonry and Concrete: | QTY: 13 | HRS: 8.0 | HTD: 4528.00 1 of 7 | 1702-- 3491 Ft. Hamilton Parkway FILED: KINGS COUNTY CLERK 04/15/2024 03:51 PM INDEX NO. 504378/2019 NYSCEF DOC. NO. 198 RECEIVED NYSCEF: 04/15/2024 01/18/19 01/18/19 || 07:20AM 07:20AM 01/18/19 01/18/19 || 07:41AM 07:41AM 01/19/19 01/19/19 || 01:30PM 01:30PM 01/19/19 01/19/19 || 01:30PM 01:30PM 01/19/19 01/19/19 || 01:30PM 01:30PM 01/19/19 01/19/19 || 01:30PM 01:30PM 01/18/19 01/18/19 || 10:03AM 10:03AM 01/18/19 01/18/19 || 10:34AM 10:34AM 01/18/19 01/18/19 || 10:17AM 10:17AM 01/18/19 01/18/19 || 10:57AM 10:57AM 01/19/19 01/19/19 || 01:30PM 01:30PM Notes, Issues, Concerns 1. DOB Arrived at site at 2:19 PM pursuant to injury reported by Aaron Stevens to DOB CSE Unit at 1:04 PM which generated complaint #3683338. Full SWO and two (2) violations issued, #35377064R & 35377065Z. Aaron Stevens | 01/19/19 | 01:57PM 01/19/19 01/19/19 || 12:07PM 12:07PM 01/19/19 01/19/19 || 12:07PM 12:07PM 01/19/19 01/19/19 || 12:07PM 12:07PM Site Safety Observations 1. SHOTGUN EMPLOYEE INJURED EMPLOYEE NAME: Gabriel Andaluz, carpenter/laborer 2 of 7 | 1702-- 3491 Ft. Hamilton Parkway FILED: KINGS COUNTY CLERK 04/15/2024 03:51 PM INDEX NO. 504378/2019 NYSCEF DOC. NO. 198 RECEIVED NYSCEF: 04/15/2024 TIME: 12:56 PM NATURE OF INJURY: Deep laceration to back outside top of left calf INJURY CAUSED BY: Stihl TS 700 motorized cut-off saw spinning around while place on ground while power still on and cutting outside top of left calf WORK BEING PERFORMED WHILE INJURED: Worker was cutting pieces of lagging to length for installation REPORTED CIRCUMSTANCES OF INJURY BY SHOTGUN FOREMAN LUIS CABRERA: Worker was getting another piece of lumber to cut and put saw down while still on. Saw spun around and blade struck worker in left calf NOTES: - Worker has 30-hour OSHA training - Worker Received Safety Orientation on site was issued sticker #029 on October 10, 2018 - Stihl TS 700 should have been used for cutting wood per manufacturer's specifications Aaron Stevens | 01/19/19 | 03:10PM Attachments: Gabriel Anda... | Gabriel Anda... | STIHL-TS-700... 2. See attached 3491 Ft Hamilton Pkwy - OSHA Form 300_Log of Work Related Injuries & Illnesses_001_190118 & 3491 Ft Hamilton Pkwy - OSHA Form 301_Injury Incident Report_001_190118 Aaron Stevens | 01/19/19 | 03:12PM Attachments: 3491 Ft Hami... | 3491 Ft Hami... 3. See attached Accident Report Timeline of events from time of injury and pictures of events Aaron Stevens | 01/19/19 | 05:51PM 01/19/19 01/19/19 || 11:30AM 11:30AM 01/19/19 01/19/19 || 11:30AM 11:30AM 01/18/19 01/18/19 || 01:24PM 01:24PM 01/19/19 01/19/19 || 11:30AM 11:30AM 01/18/19 01/18/19 || 01:24PM 01:24PM 01/18/19 01/18/19 || 01:25PM 01:25PM 01/19/19 01/19/19 || 11:30AM 11:30AM 01/19/19 01/19/19 || 11:30AM 11:30AM 01/19/19 01/19/19 || 11:30AM 11:30AM 01/18/19 01/18/19 || 01:47PM 01:47PM 01/19/19 01/19/19 || 11:30AM 11:30AM 01/18/19 01/18/19 || 01:31PM 01:31PM 3 of 7 | 1702-- 3491 Ft. Hamilton Parkway FILED: KINGS COUNTY CLERK 04/15/2024 03:51 PM INDEX NO. 504378/2019 NYSCEF DOC. NO. 198 RECEIVED NYSCEF: 04/15/2024 01/19/19 01/19/19 || 11:30AM 11:30AM 01/19/19 01/19/19 || 11:30AM 11:30AM 01/19/19 01/19/19 || 11:30AM 11:30AM 01/18/19 01/18/19 || 01:47PM 01:47PM 01/19/19 01/19/19 || 11:30AM 11:30AM 01/19/19 01/19/19 || 11:30AM 11:30AM 01/19/19 01/19/19 || 11:30AM 11:30AM 01/19/19 01/19/19 || 11:30AM 11:30AM 01/19/19 01/19/19 || 11:30AM 11:30AM 01/19/19 01/19/19 || 11:30AM 11:30AM 01/19/19 01/19/19 || 11:30AM 11:30AM 01/19/19 01/19/19 || 11:30AM 11:30AM 01/19/19 01/19/19 || 11:30AM 11:30AM 01/18/19 01/18/19 || 01:55PM 01:55PM 01/19/19 01/19/19 || 11:30AM 11:30AM 01/18/19 01/18/19 || 01:55PM 01:55PM 01/19/19 01/19/19 || 11:30AM 11:30AM Attachments: 3491 Ft Hami... 4. See attached DOB Daily Log Aaron Stevens | 01/21/19 | 04:16PM 4 of 7 | 1702-- 3491 Ft. Hamilton Parkway FILED: KINGS COUNTY CLERK 04/15/2024 03:51 PM INDEX NO. 504378/2019 NYSCEF DOC. NO. 198 RECEIVED NYSCEF: 04/15/2024 01/21/19 01/21/19 || 04:15PM 04:15PM Quality Control Observations No entry Survey Questions N/A No Yes Description NYC Office of Emergency Management, Citywide Interagency Coordinator, Phil Molina in response to injury report. DOB Inspector Janine Karakatsanis, Was an inspector on site and if so what was Badge #2980, in response to injury 1. report. Injury report called in to DOB by being inspected and its location? Aaron Stevens of SNL Construction. Injury report converted to DOB Complaint #3683338. OSHA Compliance Officers Rui Zhen (Gordon) Mei, and Damian Kuna. Aaron Stevens | 01/19/19 | 01:24PM Work generally stopped at 1:00PM after accident, back-filling and other safety wrap up completed at areas where work was in-progress. Full SWO 2. Any schedule delays occur? Issued at approximately 4:15, along with (2) violations, as a result of the injury sustained by Shotgun Employee Gabriel Andaluz. Aaron Stevens | 01/19/19 | 01:23PM 3. Did weather cause any delays? NYC OEM and DOB, and OSHA inspectors per above. EMS, Paramedics, NYPD, FDNY all came to site. Irving Lopez of Flash 4. Any visitors on site? Reprographics to drop off Coordinated Drawing Sets. Andy Perol of AEL to pick up cylinders. United Fuel to deliver fuel for generator and SOE equipment. Aaron Stevens | 01/19/19 | 01:20PM Full SWO issued at 4:15PM but 5. Any areas that can't be worked on? worked generally stopped at 1:00PM due to the injury Aaron Stevens | 01/19/19 | 06:05PM 6. Any equipment rented on site? Generator, (2) Toilets, Trailer & toilet, 5 of 7 | 1702-- 3491 Ft. Hamilton Parkway FILED: KINGS COUNTY CLERK 04/15/2024 03:51 PM INDEX NO. 504378/2019 NYSCEF DOC. NO. 198 RECEIVED NYSCEF: 04/15/2024 oxygen and acetylene canisters & hand truck from Awisco, Large Excavator and small excavator from Herc for Shotgun, (1) Herc welding machine, (1) Sunbelt dual welding machine, cages from Awisco Aaron Stevens | 01/18/19 | 11:29AM Survey Photos 1. 01/19/19 01/19/19 || 12:07PM 12:07PM 01/19/19 01/19/19 || 11:30AM 11:30AM 01/19/19 01/19/19 || 11:30AM 11:30AM 01/19/19 01/19/19 || 11:30AM 11:30AM 4. 01/19/19 01/19/19 || 11:28AM 11:28AM 01/19/19 01/19/19 || 11:28AM 11:28AM 01/18/19 01/18/19 || 01:54PM 01:54PM 01/19/19 01/19/19 || 11:28AM 11:28AM 01/19/19 01/19/19 || 11:28AM 11:28AM 01/18/19 01/18/19 || 01:56PM 01:56PM 01/19/19 01/19/19 || 11:28AM 11:28AM 01/18/19 01/18/19 || 01:54PM 01:54PM 01/19/19 01/19/19 || 11:28AM 11:28AM 01/18/19 01/18/19 || 01:54PM 01:54PM 01/19/19 01/19/19 || 11:28AM 11:28AM 01/19/19 01/19/19 || 11:28AM 11:28AM 6 of 7 | 1702-- 3491 Ft. Hamilton Parkway FILED: KINGS COUNTY CLERK 04/15/2024 03:51 PM INDEX NO. 504378/2019 NYSCEF DOC. NO. 198 RECEIVED NYSCEF: 04/15/2024 01/19/19 01/19/19 || 11:28AM 11:28AM 01/19/19 01/19/19 || 11:28AM 11:28AM 01/18/19 01/18/19 || 01:56PM 01:56PM Attachments 01/18/19 01/18/19 || 08:53AM 08:53AM 01/18/19 01/18/19 || 10:13AM 10:13AM I, Aaron Stevens, have reviewed and completed this report. Aaron Stevens | 01/19/19 | 06:06PM 7 of 7 | 1702-- 3491 Ft. Hamilton Parkway