FILED: ORLEANS COUNTY CLERK 02/01/2022
`NYSCEF DOC. NO. 4
`
`INDEX NO. 21-47386
`
`RECEIVED NYSCEF: 02/09/2022
`
`REQUEST
`
`FOR JUDICIAL
`
`INTERVENTION
`
`SUPREME
`
`COURT, COUNTY OF ORLEANS
`
`.
`
`Index No:
`Date Index Issued:
`Enter the complete case caption. Do not use et al 0.r et anoi
`If more space is needed attach a caption rider sheet.
`CAPTION
`AB 524 DOE
`
`21/47386
`
`06/11/2021
`
`(rfo
`
`o19
`
`Fer Court Use Only:
`
`IASEntry Date
`
`-against-
`
`Lyndonville
`
`Central
`
`School
`
`DiStrict,
`
`Lyndonville
`
`Elementary
`
`School,
`
`Plaintiff(s)/Petitioner(s)
`
`JudgeAssigned
`
`RJIFiled Date
`
`Defendant(s
`
`Respondent(s)
`
`NATURE OF ACTION OR PROCEÈDING
`COMMERICIAL
`O BusinessEntity (includes corporations, partnerships, LLCs,LLPs,etc )
`O Contract
`O Insurance (where insurance company is a party, except arbitration)
`O UCC(includes salesand negotiable instruments)
`O Other Commercial (specify):
`NOTE:For Commercial Division assignment requestspursuant to 22 NYCRR202.70(d),
`complete and ottach the COMMERCIALDIVISIONRJIADDENDUM (UCS-84OC).
`REALPROPERTY
`Specify how Inany properties the appication includest
`O Condemnation
`O Mortgage Foreclosure (specify):
`Property Address:
`NOTE:For Mortgage Foreclosureactions involving a one to four-family,
`owner-occupied residential property or owner-occupied condominium,
`complete and ottach the FORECLOSURERJIADDENDUM (UCS-840F).
`O TaxCertiorari
`O Tax Foreclosure
`O Other RealProperty (specify):
`OTHERMATTERS
`O Certificate of Incorporation/Dissolution
`O EmergencyMedical Treatment
`O HabeasCorpus
`O LocalCourt Appeal
`O Mechanic's Lien
`O Name Change
`O Pistol Permit Revocation Hearing
`O Saleor Financeof Religious/Not-for-Profit Property
`O Other (specify):
`STATUS OF ACTION OR PROCEEDING
`
`O Residential
`
`O Commercial
`
`[see NOTEin COMMERCIALsection]
`
`Check only one box and specify where indicated.
`MATRIMONIAL
`O Contested
`NOTE:If there ore children under the age of 18, complete ond attach the
`MFR!^ ^Gi-iiâLRJIADDENDUM(UCS-840M).
`For UncontestedMütrimcñ|ol actions, use the Uncontested Divorce RJi(UD-13).
`TORTS
`O Asbestos
`@ Child Victims Act
`O Environmental (specify):
`O Medical, Dental or Podiatric Malpractice
`O Motor Vehicle
`O Products Liability (specify):
`O Other Negligence(specify):
`O Other ProfessionalMalpractice (specify):
`O Other Tort (specify):
`SPECIALPROCEEDINGS
`O CPLRArticle 75 (Arbitration) [see NOTEin COMMERCIALsection]
`Q CPLRArticle 78 (Body or officer)
`O Election Law
`O Extreme RiskProtection Order
`O MHL Article 9.60 (Kendra's Law)
`O MHLArticle 10 (SexOffender Confinement-initial)
`O MHLArticle 10 (SexOffender Confinement-Review)
`O MHLArticle 81 (Guardianship)
`O Other Mental Hygiene(specify):
`O Other SpecialProceeding(specify):
`
`.._..
`
`. .
`
`Answer YESor NO for every Questic n and enter 2df!T±
`YES
`NO
`@
`O
`If yes, date filed:
`®
`O
`If yes, date served:
`@ If yes,judgment date:
`O
`
`|nfá=:t:n
`
`where ;o‰icJ.
`
`06/11/2021
`07/01/2021
`
`Hasa summons and complaint or summons with notice been filed?
`Hasa summons and complaint or summons with notice been served?
`Is this action/proceeding being filed post-judgment?
`NATURE QFKlDICIALWWI
`II
`O Infant's Compromise
`O Extreme RiskProtection Order Application
`O Note of Issue/Certificate of Readiness
`O Notice of Medical, Dental or Podiatric Malpractice
`@ Notice of Motion
`O Notice of Petition
`Q Order to Show Cause
`O Other Ex Parte Application
`O Poor PersonApplication
`O Requestfor Preliminary Conference
`O Residential Mortgage Foreclosure Settlement Conference
`O Writ of HabeasCorpus
`O Other (specify):
`
`di
`
`Date IssueJoined:
`Relief Requested:
`Relief Requested:
`Relief Requested:
`Relief Requested:
`
`(
`
`}
`
`ed
`
`Return Date:
`Return Date:
`Return Date:
`
`Compel
`
`1 of 2
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`

`

`FILED: ORLEANS COUNTY CLERK 02/01/2022
`NYSCEF DOC. NO. 4
`
`INDEX NO. 21-47386
`
`RECEIVED NYSCEF: 02/09/2022
`
`RELATLD.CASES
`
`CaseTitle
`
`List any related act ons, For Matriracñjal
`If add;t;vúe
`space s reqú{red,r¼mp!eté
`Index/Case Number
`
`ca$és,,list any related criminal or Family Court cases.
`the RJi ADDENDOM (UCS-840A),
`andattach
`Court
`Judge(if assigned)
`
`If none,
`
`leave blank.
`
`loe'2t½mMp to instant case
`
`check the "Ori±Rep" box and enter
`For parties without ar attorney,
`the party's address, phone nt mber and email
`If add!t!ongi space is required, complete and Itfath the RJI ADDENDUM (UCS440A),
`.^Mamays and Unrepresented Litigants
`For repicaenied parties, provide attorney's name, firm name, address, phone and
`email. For u,ircpicalited
`parties, provide party's address, phone and email.
`
`in the space provided.
`
`Insurance Carriers
`Issue Joined
`For each defendant, For each defendant,
`indicate insurance
`indicate if issue has
`been joineD.
`Carrier,If applICable
`
`PARTIES
`
`Un- Parties
`Rep List parties in same order as listed in the
`caption and indicate roles (e.g., plaintiff,
`defendant, 3rdparty plaintiff, etc.)
`Name: AB 524 DOE
`Role(sh
`Plaintiff
`Name: LyndonvilleCentralSchoolDistrict
`Role(s):
`Defendant
`Name: LyndonvilleElementarySchool
`Role(s):
`Defendant
`
`Name:
`Role(s):
`
`Name:
`Role(s):
`
`Name:
`Role(s):
`
`Name:
`Role(s):
`
`Name:
`Role(s):
`
`Name:
`Role(s):
`
`Name:
`Role(s):
`
`Name:
`Role(s):
`
`Name:
`Role(s):
`
`Name:
`Role(s):
`
`Name:
`Role(s):
`
`Name:
`Role(s):
`
`Leah Costanzo,
`Esq., Steve Boyd, PC, 40 North Forest Road,
`NY 14221 716-400-000
`Iconstanza@steveboyd.com
`Williamsville,
`
`O YES O NO
`
`Shannon B. O'Neill, Esq., Webster Szanyi LLP, 424 Main St, Suite 1400,
`::3bsterszanyi.com
`Buffalo, NY 14202 716-842-2800 sene!!
`
`® YES Q NO
`
`Shannon B. O'Neill, Esq., Webster Szanyi LLP, 424 Main St, Suite 1400,
`Buffalo, NY 14202 716-842-2800 soneill@websterszanyi.com
`
`@ YES O NO
`
`Q YES Q NO
`
`O YES O NO
`
`O YES O NO
`
`O YES O NO
`
`O YES O NO
`
`O YES O NO
`
`O YES Q NO
`
`O YES O NO
`
`Q YES O NO
`
`Q YES O NO
`
`O YES O NO
`
`O YES Q NO
`
`I Al FIRM UNDER THE PENALTY OF PERJURY THAT, UPON INFORMATION AND BE EF, THERE ARE NO OTHER RELATED ACTIONS OR PROCEEDINGS,
`VIOUSLY FILED lhl THIS ACTION OR PROCEEDING.
`BEEN
`EXCEPT AS NOTED ABOVE, NOR HAS A REQUEST FOR JUD!C!AL INTERVEN I
`
`Dated:
`
`01/28/2022
`
`5405311
`Registration
`
`Number
`
`Attorney
`
`Signature
`
`Shannon B. O'Neill
`Print Name
`
`2 of 2
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