HomeMy WebLinkAboutDrain Layers Permit 1715 Ellington Road i
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
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Permit No. 6813 Contractor SIMSCROFT ECHO FARMS
Location 1715 ELLINGTON ROAD Address P.O. BOX 581
Type Work SAN MAIN SIMSBURY CT 06070
Phone No. (860)651 -0231 �
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Permit No. 6813 Town of South Windsor, CT
Permit Date 05/21/1998 Drain Layer Permit
Expiration Date 06/20/1998
Descrip :
Applicant Location
Name SIMSCROFT ECHO FARMS Addr,,: 1715 ELLINGTON ROAD
Addr. P.O. BOX 581OWner 1EL�� Y RICHARD S
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SIMSBURY CT 06070 .
Phone No. (860)651-0231
The Drain Layer assigned thi.e permtt..has a Yal'i"d .1i"cense issued by the
state and hereby agree tp,.al;l ;'the terms, and afvd fitio ijb set forth in the
attached 'Conditions A l IV-'work shall '-'bel In accbr'dance with Town of South
Windsor standards, ali OSHA;""requir+ mer�ts and the "attached conditions.
Issued By Tfi"tl,e
Date Inspec ed �'~ rPU — Inspected By
APPLICATION FOR DRAIN LAYERS PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
/ ��. FEE$25.00
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Location of proposed work ��j I roc �� �rwrK� 6'�lC.CE Lot #
Street No. Street Name
Premises owned by: k i 6,,g
Name of Firm: r�
� r �.f' ;� �C�,1:.� Phone:
Address of Firm:
er
TYPE OF WORK.
Lay House Drain Repair House Drain ;
Lay Main_�; Lay Lateral for Commercial/Industrial
Building of� - acres
Connection will be made with
Proposed Start Date �i 1 stimated time for completion fd 6
AL L %raR r 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 `� {� s� xzT t`- �-� ,A-" ` , � the holder of Drain
layer's License No. 00 Z(z t Only holders of Pl, P7 & W9 licenses will be
issued a permit. Permit will expire thirty (30) days after date of issuance. The
undersigned Drain Layer hereby agrees to all 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
Licensed Drain Layer
Date:
THE JACK CONSTRUCTION MATERIALS PHONE 860-243-9714
FARRELLY .. 97 OLD POOUONOCK ROAD 1-800-423-0112
COMPANY BLOOMFIELD,CONN.06002 FAX 860-286-0867
150 UNIVERSAL DRIVE(Rear) PHONE 203-777-5548
• NORTH HAVEN,CT 06473 FAX 203-777-3147
COLTON ROAD PHONE 860-739-5457
EAST LYME,CT 06333 FAX 860-739-8513
39 JOLMA ROAD PHONE 508-752-PIPE
WORCESTER,MA 01604 FAX 508-797.4455
WATER/SEWER TEST REPORT
PROJECT/LOCATION. U I'v ///r-- 6115iSV. V t.h
INSPECTOR: ✓c In ! {r TESTED BY: Of A P, �`
DATE OF TEST: j� CONTRACTOR: F UO / C40 P'�Y;' & t i
HYDROSTATIC TEST
WATER MAIN TEST❑ SEWER MAIN TEST❑ LENGTH OF TEST:
STATIC PRESSURE: TEST PRESSURE:
ALLOWABLE LEAKAGE: ACTUAL LEAKAGE:
TEST RESULTS: PASSED ❑ FAILED ❑
REMARKS:
AIR TEST
MANHOLE TEST PRESSURE TEST RESULTS
NUMBER IN P.S.I. TIME OF REMARKS
OR STATION START STOP DROP IN MIN. TEST
I certify that the above information is a true and accurate account of the tests performed at this loca' n.
SIGNED:
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INSPECTOR TESTER