HomeMy WebLinkAboutDrain Layers Permit 035 Cambridge Drive TOWN OF SOUTH WINDSOR INSPECTION REPORT Ij
Permit No. 6585 Contractor L iMJ CONSTRUCTION CO.
Location 0035 CAMBRIDGE DRIVE Address 658 ELLINGTON ROAD
Type Work NEW SAN LAT SOUTH WINDSOR CT 06074
Phone"No. (861j )528-7889
Date Insp Needed Xnsp,: �q_! --
Time Insp Needed /� _ _ Tme Insp
r,
Inspected By �
Work. in Progress
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Date
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pe �l t No. 656b i own of South Windsor , C.1
Permit Date 04/03/ 1 997 Dr,ai n Layer Permit.
_xp i ration Date o5/o 3/1997 j
Descr i p: CONNE.C,-1 F[A.- ALREAC11,- PAIL) t
App I i r:;arrt: i_oc-at i on
Name JMJ CONSTRUCTION CO. A'dlr . 000-5 CAMBRIDGE DRIVE
Addr. 658 ELLINGTON ROAD rlwner ;6AAFtS L�ZRk: M & L�RENDA i� SUHV
SOUTH WINDSOR CT 06074
Phone No. ( 860 )528-7889
The Drain Layer assigned thi,_ permit has a Valtd -icense issued by the
state and hereby agrees to a } I ttie terrtis' i3nd cond 1 t-1 o' s set Forth i n the
attached 'Conditions Ai.l %wtirk I'ShcipTr b6 art acorJrdaric
e with Town of South
W i ndsot standards , a I 1 OSHA : ran i i rerrwntr� and; h.c 'attached conditions .
Issued By �r _ V' lu t,1Q_ TI I',:t
Date Ins ected
p / Inspected fay
APPLICATION FOR DRAIN LAYERS PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE$25.00
Location of proposed work: S ; , � Lot # ,3
Street No. Stre Name
Premises owned by:
Name of Firm: Phone: 2 9'2,- 0 Zg
Address of Firm: �5 Aviv-7
_ TYPE OF WORK:
Lay House Drain Repair House Drain ;
Lay Main Lay Lateral for Commercial/Industrial
Building of acres
Connection will be made with 5 Dk ,3 5S
3
Proposed Start Date Estimated time for completion �l�b
ALL WORK TO BE IN ACCORDANCE WITH TOWN OF SOUTH WINDSOR
STANDARDS, ALL OSHA REQUIREMENTS AND CONDITIONS ATTACHED TO
THE PERMIT
Permit is to be issued to the holder of Drain
layer's License No. ?fig 3 . Onlyyall
rs of P1, P7 & W9 licenses will be
issued a permit. Permit will expire thir days after date of issuance. The
undersigned Drain Layer hereby agrees the terms and conditions set forth
in the permit and attached thereto. Applicant has received Town Street
Excavation Permit No. and/or ConnDOT Permit No.
Signed: Print Name
Licen#D in Layer
Date: 3 q 7
�� ���'►�f�1^�/ D�f�� TOWN OF SOUTH WINDSOR
�l Yf
7SANn!A Y SEWER INSPECTION CHECKLIST
FUNCTION NO YES N/A DATE INSPECTED
1. Is Permit On Job Site �3 C7
2. Police Notified ' L �/3
3 . Safety Items In Place �� �/3 Q7
a. Shoring, Trench Box, Ladder
b. Hard Hats _
c . Pumps _?/� tit
4 . Proper Material
a . Pipe RD_ 19/ 3
Gb. Pipe Bedding Jc . Backfilld. Warning Tape �e. Pipe Cap or Plug 0f . -Cleanouts elg. Fittingsh. Manhole b
i . Cover & Frame
5 . Existing Lateral Cap Removed 7/3
in Presence of Inspector
6 . Lateral probed and found
to be clear
7 . Pavement Cut Properly
8 . Trench & Bedding OR a� y
9 . Joints Properly Done
10 . Backfilling (12" Lifts) f3
& Compaction
11. Manhole Inverts Built �� 3
12. Subbase Material Placed KD ly L
13 . Base Material Placed
14 . Blacktop (Temp) w/Proper
Grades & Slopes
15 . Pressure Test A I �� 3
16 . Mandrel Test
�l
17 . Installation agrees with plan 46
18 . As-Built plans recorded y�3