FILED: KINGS COUNTY CLERK 07/17/2018 03:09 PM
`NYSCEF DOC. NO. 13
`REQUEST
`
`INTERVENTION
`
`FOR JUDICIAL
`UCS-840 (7/2012)
`
`Supreme
`
`COURT,
`
`COUNTY
`
`OF
`
`Kings
`
`Index
`
`No:
`
`504751/2018
`
`Date
`
`index
`
`Issued:
`
`03/08/2018
`
`INDEX NO. 504751/2018
`
`RECEIVED NYSCEF: 07/17/2018
`Use Only:
`For Court
`Clerk
`IAS I-ntry Uate
`
`. -
`
`CÃPTION
`
`Enter1he cornplete case caption Do not use et al or et ano.
`attach a caption rider sheel
`
`If more space is required,
`
`NJI bale
`
`YELENA BAKINOVSKAYA
`as Administrator
`the Estate of LlLlYA BAKINOVSKAYA,
`of
`and YELENA BAKINOVSKAYA,
`individually,
`
`deceased
`
`-against-
`
`Plaintiff(s)/Petitioner(s)
`
`CONEY ISLAND HOSPITAL, NEW YORK CITY HEALTH
`AND HOSPITALS CORPORATION,
`
`Defendant(s)/Respondent(s)
`
`rily an0specify where indicated
`COMMERCIAL
`O Business Entity (including corporations, partnerships, LLCs, etc.)
`O Contract
`O Insurance (where insurer is a party, except arbitration)
`O UCC (including sales, negotiable instruments)
`O Other Commercial:
`
`(specify)
`requests [22 NYCRR §
`ror Commercial Division assignment
`NOTE:
`202.70(d)], complete and attach the COMMERCIAL DIV RJi Addendum.
`How many propertiesdoes the applicationinclude?
`REAL PROPERTY:
`O Condemnation
`O Mortgage Foreclosure (spedry):
`Property Address:
`
`O Residential
`
`O Commercial
`
`State
`StreetAddress
`City
`NOTE: For Mortgage Foreclosure actions involving a one- to four-family,
`OWner-Occupied, residential property, or an owner-occupied
`condominium, complete and attach the FORECLOSURE RJi Addendum,
`Q Tax Certiorari - Section:
`Lot:
`Block:
`O Tax Foreclosure
`Û Other Real Property:
`
`(specify)
`
`21p
`
`CTIOkOÈPROCEEDING:
`
`.,
`
`Check ONE böx
`
`NÁÈNE
`MATRIMONIAL
`Ü Contested
`NOTE: For all Matrimonial actions where the parties have children under
`the age of 18, complete and attach the MATRiMONIAL RJI Addendum.
`For Uncontested Matrimonial actions, use RJI form UD-13.
`TORTS
`Û Asbestos
`O Breast
`impiant
`OEnvironmental:
`
`Q» Medical, Dental, or Podiatric Malpractice
`O Motor Vehicle
`O Products Llability:
`O Other Negligence:
`
`O Other Professional Malpractice:
`
`O Other Tort:
`
`(Specify)
`
`(specify)
`
`(specify)
`
`(specify)
`
`(specify)
`
`[see NOTE under Commercial]
`
`OTHER MATTERS
`Û Certificate of Incorporation/Dissolution
`O Emergency Medical Treatment
`O Habeas Corpus
`O Local Court Appeal
`O Mechanic's Llen
`O Name Change
`O Pistol Permit Revocation Hearing
`O Saie or Finance of Religious/Not-for-Profit Property
`O Other:
`
`(opecify)
`
`PROCEEDINGS
`SPECIAL
`O CPLR Article 75 (Arbitration)
`[see NOTE under Commercial]
`O CPLR Article 78 (Body or Officer)
`O Election Law
`O MHL Article 9.60 (Kendra's Law)
`Q MHL Article 10 (sex OffenderConfinement-Initial)
`Q MHL Article 10 (Sex OffenderConfinement-Review)
`Q MHL Article 81 (Guardianship)
`O Other Mental Hygiene:
`O Other Special Proceeding:
`
`(specify)
`
`(specify)
`informat1orrwhere Indicated.
`
`STÅ
`
`U
`
`efÁCTld
`
`Okl5RBSEEDINGC
`
`Has a summons and complaint or summons w/notice been filed?
`Has a summons and complaint or summons w/notice been served?
`Is this action/proceeding being filed post-judgment?
`
`AnswerYES24
`YES
`Q»
`Q»
`Q
`
`dfér EVERY questiori AND enter additional
`NO
`Q If yes, date filed:
`Q If yes, date served: 03/23/2018
`Q»
`If yes, judgment date:
`
`1 of 2
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`

`FILED: KINGS COUNTY CLERK 07/17/2018 03:09 PM
`NYSCEF DOC. NO. 13
`
`Check ONE box only AND enter additional
`
`Date Issue Joined:04/18/2018
`
`INDEX NO. 504751/2018
`
`RECEIVED NYSCEF: 07/17/2018
`information where indicated.
`
`Return Date:
`Return Date:
`Return Date:
`
`INTERVENTION:
`
`OF JUDICIAL
`NATURE
`Q Infant's Compromise
`O Note of Issue and/or Certificate of Readiness
`O Notice of Medical, Dental, or Podiatric Malpractice
`O Notice of Motion
`Relief Sought:
`O Notice of Petition
`Relief Sought:
`O Order to Show Cause
`Relief Sought:
`O Other Ex Parte Application
`Relief Sought:
`O Poor Person Application
`O Request
`for Preliminary Conference
`O Residential Mortgage Foreclosure Settlement Conference
`Q Writ of Habeas Corpus
`Q Other
`(specify):
`CASES·
`RELATED
`CASES:
`
`include any related criminal and/or Family Court cases.
`List any related actions. For Matrimonial actions,
`If none, leave blank.
`If additional space is required, complete and attach the RJi Addendum.
`Index/Case
`No.
`Court
`Judge
`(if assigned)
`Relationship
`
`to Instant Case
`
`Case Title
`
`PARTIES.
`
`Un-
`Rep
`
`For parties without an attorney, check "Un-Rep" box AND enter party address, phone number and e-mail address in space provided.
`If additional space is required, complete and attach the RJi Addendum.
`Litigants:
`and/or Unrepresented
`Attorneys
`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.
`:EYGIN
`ALEKSEY
`
`Parties:
`List parties in caption order and
`indicate party role(s) (e.g. defendant;
`3rd-party plaintiff).
`YELENABAKINOV5KAYAas Administrator
`LastName
`LastName
`of the Estate of LILlYABAKINOVSKAYA WARKM. BASICHAS& ASSOCIATES,P.C.
`FirstName
`PrimaryRole:
`
`233BROADWAY,SUITE2707
`streetAddress
`1(212)476-0999
`Phone
`
`FirmName
`NEWYORK
`City
`
`Fax
`
`EYGIN
`
`ALEKSEY
`
`LastName
`WARKM. BASICHAS& ASSOCIATES,P.C.
`FirmName
`NEWYORK
`CIty
`
`233BROADWAY,SUlTE2707
`StreetAddress
`*1 (212)476-0999
`Phone
`
`FirstName
`
`NewYork
`State
`
`10279
`Zip
`
`e-mall
`
`FirstName
`
`NewYork
`State
`
`10279
`Zip
`
`Iscue
`Joined
`(Y/N):
`
`Insurance
`CaMe
`
`NO
`
`~
`
`YES
`
`NO
`
`~
`
`YES
`
`NO
`
`0 YES
`
`NO
`
`Plaintiff
`
`SecondaryRole(if any):
`
`BAKINOVSKAYA
`LastName
`YELENA, individually
`FirstName
`PrimaryRole:
`
`Plaintiff
`
`SecondaryRole(if any):
`
`CONEYISLANDHOSPITAL
`LastName
`
`FirstName
`PrimaryRole:
`
`Defendant
`
`SecondaryRole(if any):
`
`NEWYORKHEALTHAND HOSPITAL
`LastNama
`
`CORPORATION
`FirstName
`PrimaryRole:
`
`Defendant
`
`SecondaryRole(if any):
`
`FirstName
`LastName
`Acting General Counsel, Office of Legal Affairs-Claims and Litigation
`FIrmName
`NEWYORK
`CIty
`
`Fax
`
`e-mall
`
`Andrea
`
`NewYork
`State
`
`10041
`Zip
`
`Zohen
`
`i5 WaterStreet,26thFloor
`StreetAddress
`91(212)323-2275
`Phone
`
`Cohen
`
`Fax
`
`e-mail
`
`Andrea
`
`LastName
`FirstName
`Acting General Counsel, Office of Legal Affairs-Claims and Litigation
`FirmName
`NEWYORK
`City
`
`NewYork
`State
`
`10041
`Zlp
`
`100CHURCHSTREET
`StreetAddress
`91(212)323-2275
`Fax
`Phone
`I AFF RM UNDER THE PENALTY OF PERJURY
`THAT, TO MY KNOWLEDGE,
`BEEb NO RELATED ACTIONS OR PRO JEEDINGS,
`NOR HAS A REQUEST
`THIS ACTION OR PROCEEDING.
`
`e-mall
`OTHER THAN AS N
`FOR JUDICIAL
`INTE
`
`THERE ARE AND HAVE
`ED ABOVli,
`V NTIO
`PliEVIOUSLY
`BEEN FILED IN
`
`Dated:
`
`07/17/2018
`
`ATTORNEY
`
`5560115
`REGISTRATION
`
`NUMBER
`
`IGNATURE
`Olga Shubina
`PRINT OR TYPE NAME
`
`2 of 2
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