Preview
FILED: NASSAU COUNTY CLERK 06/13/2024 12:40 PM INDEX NO. 610388/2024
NYSCEF DOC. NO. 1 RECEIVED NYSCEF: 06/13/2024
SUPREMECOURTOF THE STATE OFNEWYORK, COUNTYOFNASSAU
X
WORKERS'
COMPENSATION BOARDOFTHESTATEOF NEW YORK, :
Plaintiff,
-against- :
:
ALFA CONTRACTING
INC :
AFFIRMATION
Defendant(s) :
OF
NON-PAYMENT
:
:
:
:
X
Workers'
The undersigned, an attorney in the office of the Compensation Board of the State of New
York, Plaintiff herein, hereby affirms that the following is true under the penalty of perjury, upon
information and belief
Workers'
This affirmation is based upon a review of the file which is maintained by the Compensation
Board in its regular course of business.
I amfamiliar with the status of payment in this matter. The award/penalty/assessment/demand for
deposit of security made against the defendant(s) in the amount of $22,000.00 is in default, as more
than thirty days have elapsed since the demand upon the defendant(s) herein for payment. No payment
has been received nor has the aforesaid security been deposited in compliance with said demandto
date, except the sum of $0.00, leaving due and payble the sum of $22,000.00.
Dated: 13th day of May , 2024 .
S/
Michele A. Mealy, Esq.
Judgment Unit
C-45.45E 1/2009
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FILED: NASSAU COUNTY CLERK 06/13/2024 12:40 PM INDEX NO. 610388/2024
NYSCEF DOC. NO. 1 RECEIVED NYSCEF: 06/13/2024
SUPREMECOURTOF THE STATE OFNEWYORK, COUNTYOFNASSAU
X
WORKERS'
COMPENSATION BOARDOFTHESTATEOF NEW YORK, :
Plaintiff,
-against- :
:
ALFA CONTRACTING
INC :
AFFIRMATION
Defendant(s) :
OF
REGULARITY
:
:
:
:
X
Workers'
The undersigned, an attorney in the office of the Compensation Board of the State of New
York, Plaintiff herein, hereby affirms that the following is true under the penalty of perjury, upon
information and belief
Workers'
This affirmation is based upon a review of the file which is maintained by the Compensation
Board in its regular course of business.
The Workers' Compensation Board of the State of New York, in accordance with the provisions of the
Workers'
Compensation Law, has made an assessment/award in the sum of $22,000.00, against the
defendant(s). Attached hereto and made a part hereof are certified copies of the Notice of Decision and
Award, and/or a certified copy of the demandfor deposit of security, and/or a certified copy of the chair's
order imposing, and the demandfor payment of, assessments imposed by the chair pursuant to
Workers'
subdivision five of section fifty-two and/or one hundred thirty one of the Compensation Law, as
Workers'
required for filing of judgment per Compensation Law, Section 26 and/or 219. Appeals before
the Board have been exhausted.
No payment of award has been made except $0.00, leaving $22,000.00 due and payable.
WHEREFORE,
it is respectfully requested that judgment be entered against the Defendant(s) herein in
the sum stated as remaining due and payable.
Dated: 13th day of May , 2024 .
S/
Michele A. Mealy, Esq.
Judgment Unit
C-45.1E 6/2007
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FILED: NASSAU COUNTY CLERK 06/13/2024 12:40 PM INDEX NO. 610388/2024
NYSCEF DOC. NO. 1 RECEIVED NYSCEF: 06/13/2024
STATE OFNEW YORK
WORKERS'COMPENSATION BOARD
NEw Workers' AGENCY
THIS EMPLOYS ANDSERVES
s? rE CompenSation JUDGMENT UNIT PEOPLE
WITHDISABILITIES WITHOUT
Board 328 STATE STREET DISCRIMINATION.
SCHENECTADY,NY 12305-2318
866-298-7830
ALFA CONTRACTING
INC WCBEMPLOYER
#: 3010521
115 BETHPAGE
RD UlER #: 09-02151
HICKSVILLENY 11801-1522
FEIN/SS #: *****7958
It is hereby certified that this is a true
and correct copy of the original as filed
Workers'
with the Compensation Board
S/
* Michele A. Mealy, Esq.
DATE: 05/13/2024
FINAL NOTICE Judgment Unit
Non-Compliance
Item Description Dates Accident Date Balance Due
2023W0020445 Failure to Carry Workers' 02/23/2023-05/07/2024
Comp Ins $22,000.00
TotalBalance Due $22,000.00
*
If payment is not received immediately, judgment will be filed and the employer is subject to seizure
of assets, both business and personal, without further notice from the Board.
PAYMENTINSTRUCTIONS
To make online payments e-mail Biljin_g@mb.ang_oy. OR
prompt credit of your payment, complete the following with the
In order to insure
Date, Numberand Amount of your check and return it, along with your payment to:
NYSWORKERS'
COMPENSATION BOARD
PCBOX5530
BINGHAMTON,NY 13902-5530
___________________________Pfe_ase. e_cac_h_a_F_d_f_e!gp__b_9_E_9m_p_9_G_i.qn_wi!h__y_qg_pa_ymeny_________________________
MAKECHECKSPAYABLETO"COMMISSIONER
OFTAXATIONANDFINANCE".
PLEASEINCLUDE YOURWCBEMPLOYER
NUMBERONYOUR CHECK.
Employer ALFA CONTRACTING
INC WCBEmployer # 3010521
Customer ID # 1919665
Check
Check Date Check #
Amount
C-45.37 10/2023 Page 1 of 2
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FILED: NASSAU COUNTY CLERK 06/13/2024 12:40 PM INDEX NO. 610388/2024
NYSCEF DOC. NO. 1 RECEIVED NYSCEF: 06/13/2024
Non-Compliance
Item Description Dates Accident Date Balance Due
MAKECHECKSPAYABLETO "COMMISSIONEROF TAXATIONAND FINANCE"
______________________________________________________________________
Mail payment along with this form to:
NYSWORKERS'COMPENSATION BOARD
POBOX5530
BINGHAMTON,NY 13902-5530
C-45.37 10/2023 Page 2 of 2
6 of 7
FILED: NASSAU COUNTY CLERK 06/13/2024 12:40 PM INDEX NO. 610388/2024
NYSCEF DOC. NO. 1 RECEIVED NYSCEF: 06/13/2024
SUPREMECOURTOF THE STATE OFNEWYORK, COUNTYOFNASSAU
X
WORKERS'
COMPENSATION BOARDOFTHESTATEOF NEW YORK, : JUDGMENT
Plaintiff,
-against- : EMP# : 3010521
: JUD# : 2361500
ALFA CONTRACTING
INC :
Defendant(s) : INDEX# :
FILING DT:
:
:
:
X
Workers'
By order of the Chair of the Compensation Board of the State of New York, demandfor the
payment of the sum of $22,000.00, representing Awards and Penalties having been made against the
above captioned Defendant(s), after due notice, having defaulted in payment thereof, except the sum of
$0.00 leaving $22,000.00 due and payable.
NOW, upon the certified copies of notices attached hereto, and upon motion of the General Counsel of
Workers'
the Compensation Board of the State of New York, attorney for Plaintiff, pursuant to Section
26 of the Workers' Compensation Law of the State of New York providing for entry of judgment by the
Workers'
County Clerk in event of such default, it is ADJUDGED,that the Plaintiff, Compensation Board
of the State of New York, 328 State Street, Schenectady, NY 12305 does recover from the
above-captioned Defendant(s), whose last known address(es) are; 115 BETHPAGE RD, HICKSVILLE,
NY 11801-1522, respectively; the sum of $22,000.00, and the Plaintiff have execution therefore.
Judgment signed this: day of , .
Clerk
Michele A. Mealy, Esq.
Attorney for Plaintiff
Workers'
Compensation Board
328 State St.
Schenectady, NY 12305
C-45 6/2007
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Preview
FILED: NASSAU COUNTY CLERK 06/13/2024 12:40 PM INDEX NO. 610388/2024 NYSCEF DOC. NO. 1 RECEIVED NYSCEF: 06/13/2024 SUPREMECOURTOF THE STATE OFNEWYORK, COUNTYOFNASSAU X WORKERS' COMPENSATION BOARDOFTHESTATEOF NEW YORK, : Plaintiff, -against- : : ALFA CONTRACTING INC : AFFIRMATION Defendant(s) : OF NON-PAYMENT : : : : X Workers' The undersigned, an attorney in the office of the Compensation Board of the State of New York, Plaintiff herein, hereby affirms that the following is true under the penalty of perjury, upon information and belief Workers' This affirmation is based upon a review of the file which is maintained by the Compensation Board in its regular course of business. I amfamiliar with the status of payment in this matter. The award/penalty/assessment/demand for deposit of security made against the defendant(s) in the amount of $22,000.00 is in default, as more than thirty days have elapsed since the demand upon the defendant(s) herein for payment. No payment has been received nor has the aforesaid security been deposited in compliance with said demandto date, except the sum of $0.00, leaving due and payble the sum of $22,000.00. Dated: 13th day of May , 2024 . S/ Michele A. Mealy, Esq. Judgment Unit C-45.45E 1/2009 1 of 7 FILED: NASSAU COUNTY CLERK 06/13/2024 12:40 PM INDEX NO. 610388/2024 NYSCEF DOC. NO. 1 RECEIVED NYSCEF: 06/13/2024 2 of 7 FILED: NASSAU COUNTY CLERK 06/13/2024 12:40 PM INDEX NO. 610388/2024 NYSCEF DOC. NO. 1 RECEIVED NYSCEF: 06/13/2024 SUPREMECOURTOF THE STATE OFNEWYORK, COUNTYOFNASSAU X WORKERS' COMPENSATION BOARDOFTHESTATEOF NEW YORK, : Plaintiff, -against- : : ALFA CONTRACTING INC : AFFIRMATION Defendant(s) : OF REGULARITY : : : : X Workers' The undersigned, an attorney in the office of the Compensation Board of the State of New York, Plaintiff herein, hereby affirms that the following is true under the penalty of perjury, upon information and belief Workers' This affirmation is based upon a review of the file which is maintained by the Compensation Board in its regular course of business. The Workers' Compensation Board of the State of New York, in accordance with the provisions of the Workers' Compensation Law, has made an assessment/award in the sum of $22,000.00, against the defendant(s). Attached hereto and made a part hereof are certified copies of the Notice of Decision and Award, and/or a certified copy of the demandfor deposit of security, and/or a certified copy of the chair's order imposing, and the demandfor payment of, assessments imposed by the chair pursuant to Workers' subdivision five of section fifty-two and/or one hundred thirty one of the Compensation Law, as Workers' required for filing of judgment per Compensation Law, Section 26 and/or 219. Appeals before the Board have been exhausted. No payment of award has been made except $0.00, leaving $22,000.00 due and payable. WHEREFORE, it is respectfully requested that judgment be entered against the Defendant(s) herein in the sum stated as remaining due and payable. Dated: 13th day of May , 2024 . S/ Michele A. Mealy, Esq. Judgment Unit C-45.1E 6/2007 3 of 7 FILED: NASSAU COUNTY CLERK 06/13/2024 12:40 PM INDEX NO. 610388/2024 NYSCEF DOC. NO. 1 RECEIVED NYSCEF: 06/13/2024 4 of 7 FILED: NASSAU COUNTY CLERK 06/13/2024 12:40 PM INDEX NO. 610388/2024 NYSCEF DOC. NO. 1 RECEIVED NYSCEF: 06/13/2024 STATE OFNEW YORK WORKERS'COMPENSATION BOARD NEw Workers' AGENCY THIS EMPLOYS ANDSERVES s? rE CompenSation JUDGMENT UNIT PEOPLE WITHDISABILITIES WITHOUT Board 328 STATE STREET DISCRIMINATION. SCHENECTADY,NY 12305-2318 866-298-7830 ALFA CONTRACTING INC WCBEMPLOYER #: 3010521 115 BETHPAGE RD UlER #: 09-02151 HICKSVILLENY 11801-1522 FEIN/SS #: *****7958 It is hereby certified that this is a true and correct copy of the original as filed Workers' with the Compensation Board S/ * Michele A. Mealy, Esq. DATE: 05/13/2024 FINAL NOTICE Judgment Unit Non-Compliance Item Description Dates Accident Date Balance Due 2023W0020445 Failure to Carry Workers' 02/23/2023-05/07/2024 Comp Ins $22,000.00 TotalBalance Due $22,000.00 * If payment is not received immediately, judgment will be filed and the employer is subject to seizure of assets, both business and personal, without further notice from the Board. PAYMENTINSTRUCTIONS To make online payments e-mail Biljin_g@mb.ang_oy. OR prompt credit of your payment, complete the following with the In order to insure Date, Numberand Amount of your check and return it, along with your payment to: NYSWORKERS' COMPENSATION BOARD PCBOX5530 BINGHAMTON,NY 13902-5530 ___________________________Pfe_ase. e_cac_h_a_F_d_f_e!gp__b_9_E_9m_p_9_G_i.qn_wi!h__y_qg_pa_ymeny_________________________ MAKECHECKSPAYABLETO"COMMISSIONER OFTAXATIONANDFINANCE". PLEASEINCLUDE YOURWCBEMPLOYER NUMBERONYOUR CHECK. Employer ALFA CONTRACTING INC WCBEmployer # 3010521 Customer ID # 1919665 Check Check Date Check # Amount C-45.37 10/2023 Page 1 of 2 5 of 7 FILED: NASSAU COUNTY CLERK 06/13/2024 12:40 PM INDEX NO. 610388/2024 NYSCEF DOC. NO. 1 RECEIVED NYSCEF: 06/13/2024 Non-Compliance Item Description Dates Accident Date Balance Due MAKECHECKSPAYABLETO "COMMISSIONEROF TAXATIONAND FINANCE" ______________________________________________________________________ Mail payment along with this form to: NYSWORKERS'COMPENSATION BOARD POBOX5530 BINGHAMTON,NY 13902-5530 C-45.37 10/2023 Page 2 of 2 6 of 7 FILED: NASSAU COUNTY CLERK 06/13/2024 12:40 PM INDEX NO. 610388/2024 NYSCEF DOC. NO. 1 RECEIVED NYSCEF: 06/13/2024 SUPREMECOURTOF THE STATE OFNEWYORK, COUNTYOFNASSAU X WORKERS' COMPENSATION BOARDOFTHESTATEOF NEW YORK, : JUDGMENT Plaintiff, -against- : EMP# : 3010521 : JUD# : 2361500 ALFA CONTRACTING INC : Defendant(s) : INDEX# : FILING DT: : : : X Workers' By order of the Chair of the Compensation Board of the State of New York, demandfor the payment of the sum of $22,000.00, representing Awards and Penalties having been made against the above captioned Defendant(s), after due notice, having defaulted in payment thereof, except the sum of $0.00 leaving $22,000.00 due and payable. NOW, upon the certified copies of notices attached hereto, and upon motion of the General Counsel of Workers' the Compensation Board of the State of New York, attorney for Plaintiff, pursuant to Section 26 of the Workers' Compensation Law of the State of New York providing for entry of judgment by the Workers' County Clerk in event of such default, it is ADJUDGED,that the Plaintiff, Compensation Board of the State of New York, 328 State Street, Schenectady, NY 12305 does recover from the above-captioned Defendant(s), whose last known address(es) are; 115 BETHPAGE RD, HICKSVILLE, NY 11801-1522, respectively; the sum of $22,000.00, and the Plaintiff have execution therefore. Judgment signed this: day of , . Clerk Michele A. Mealy, Esq. Attorney for Plaintiff Workers' Compensation Board 328 State St. Schenectady, NY 12305 C-45 6/2007 7 of 7