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HomeMy WebLinkAboutDrain Layers Permit 103 Palmer Drive (2) TOWN OF SOUTH WINDSOR INSPECTION REPORT Permit No. 7377 Contractor COVEN CONSTRUCTION CO. Location 0103 PALMER DRIVE Address P .O. BOX 427 Type Work SAN MAIN COVENTRY CT 06238 Phone No. (860 )282-0526 Date Insp Needed o� L3 oZ " ;-_ Date Irtsp ._`/ '�oZ Time Insp Needed T me Insp .r Inspected By { Work in Progress y��zy�� �c��� ' 7-� %✓ �', i r �.s Input` l' �/�� Date Permit t 7377 Town ��f Soutn Windsor , CT Permit -Date 01 /22/2002 Expiration Date 02/21/2.002 Drain Layer Permit Descrip: CLOUTIER SUBDIV. MAIN TO SULLIVAN AVE . Applicant location Name COVEN CONSTRUCTION CO. Addr-0-103 PALMER DRIVE Addr. P.O. BOX 427 �>�; er. tLQUTIER LINDA V COVENTRY CT 06238 Phone No. ( 860)282-0526 The Drain Layer assigned phis permYt has a Val ;d license issued by the state and hereby agree tti� zl 1 the terms. and oond'i t'16n,s set forth �i n the attached 'Conditions .',AJ I ��**k shaj l ; be i n dc-or with Town of South Windsor standards, all,r0SH r.equj;, ,Ont8' ;and the- attached conditions. Issued By _ � -� , ,- T •,� .�,�_.•�- -. Date Inspected - ----- -._ - inspecte, by — - -� ' APPLICATION FOR DRAIN LAYER PERMIT TOWN OF SOUTH WINDSOR PUBLIC WORKS DEPARTMEN-r TOWN HALL 1540 SULLIVAN AVENUE SOUTH WINDSOR, CT � _� E`$25 00-:� ' Location of proposed work: b S rp �` �� Lot # Street No. Street Name Premises owned by: � Name of Firm: 1 Jt A_) C012 1± (. f 'P� Phone: 2 7 Address of Firm:too .3 TYPE OF WORK: Lay House Drain ; Repair House Drain ; Lay Main ; Lay Lateral for Commercial/Industrial Building of acres Connection will be made with Existing Water Supply: Public Water Well Proposed Start Date stimated time for completion O ALL WORK TO BE INfACORDANCE WITH TOWN OF SOUTH WINDSOR ST NDARDS, ALL OSHA REQUIREMENTS AND CO ND ONS ATTA HED TO THE PERMIT Permit is to be issued to crs the older of Drain Layer's License No. ;Lo'7 G S -b . Only holde s of P1 or 0 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. CBYD No. 01 3 S� Signed: Print Name: /141c,I'l ice sed Dra" yer Date: Standard Forms\Per its\APPLI TION FOR DRAIN LAYERS PERMIT.doc IUvvlIA MUUItNu. PMT.21344tV 8100 DATEOFISSUE PERMIT NO. _ South Windsor 1 .74 (3 DEPARTMENT OF 6-0386)TRANSPORTATION 08115101 NAME OF HIGHWAY BUREAU OF ENGINEERING TRANSPORTATION 8 HIGHWAY OPERATIONS DATE EFFECTIVE 159946 STATE OF CONNECTICUT Ellington Road ENCROACHMENT PERMIT LOCATION OF WORK,OR BEGINNING AND ENDING POINTS: DATE OF EXPIRATION AMT OF SURETY BOND 2321 Ellington Road, 450 feet north of Bridlewood Load 08/15/02 , CERTIFY CHECK SURETY COMPANY/BANK National Grange Insurance TO BOND NUMBER S208638 Coven Construction Company Inc. PERMIT IS NOT VALID UNTIL YELLOW COPY IS P.O. Box 427 SIGNED AND RETURNED TO THIS OFFICE. Coventry, CT o6238 PLEASE RETURN AT ONCE. FEE: 100.00 DATF R�D I� J P.OJW.O.NO. Permission is hereby granted to do the following work under the control and direction of*the Department of Transportation, Bureau of Engineering and Highway Operations at the location designed hereon,subject to the statements made on the application for permit,and to the pertinent provisions of the current Highway Encroachment Permit Regulations manual,including amendments thereto. This permit does not become effective until all necessary local and State licenses and permits are obtained by the Permittee of his agent,and further the Permittee shall be subject to all Federal,State and local regulations. This permit Is issued in strict compliance with,but not limited by,the following specific requirements,referenced attachments and the current edition of Department of Transportation's Standard Specifications for Roads,Bridges and Incidental Construction as are applicable. The Department of Transportation Permit Inspector G•Payne 258-454o MUST BE NOTIFIED AND THE CALL BEFORE YOU DIG REQUEST NUMBER RECORDED 48 HOURS IN ADVANCE OF STARTING WORK ON of PtRO.JE aT13. sanitaRrEQsUEST No. g Y Y do necessary landscaping as delineated on plans entitled "CLOUTIER - SITE OF DEVELOPMENT/ SPECIAL EXCEPTION/RESUBDIVISION - FELT ROAD - SOUTH WINDSOR, CONNECTICUT" dated February 29 2001 with the following stipulations: 1. No work that will interfere with the flow of Route 74 traffic will be permitted before 8:30 a.m. and after 4:00 p.m., Monday thru Friday. 2. All vehicular and pedestrian traffic will be adequately protected through the use of appropriate traffic control patterns. Uniformed police officers, or personnel who are certified for traffic control to a level equivalent to the National Safety Council certification, shall be employed to direct traffic through the work area. 3. Traffic control personnel should familiarize themselves with the attached traffic control patterns and the attached guide entitled "Control of Traffic through Work Areas." Stop/Slow paddles are recommended. 4. Hot bituminous will be required for ALL pavement excavations. The permittee will make certain that hot bituminous concrete is available before starting work. If it is not available, this permit is null and void until such time as it becomes available. 5. Requirements of this permit are subject to change as field conditions warrant. CALL Before you DIG! TOLL FREE, STATEWIDE 1-800-922-4455 Any and all liability for injury, damage or loss resulting from such work as may be undertaken under the terms of this permit is assumed by the Permittee. The Permittee is hereby designated responsible for all future maintenance of all installations or encroachments constructed under this Permit,which in the sole judgement of the State are not part of the highway appurtenances normally maintained by the State. Permittee hereby agrees to indemnify and hold harmless the State of Connecticut for any and all such injury,damage,or loss that may be incurred,either directly by,or as a result of said work and to reimburse the Department of Transportation for any expenses incurred due to the performance of any such work undertaken under the terms of this permit. This permit is revocable at the discretion of the Department of Transportation Commissioner or his designated representative. PERMITTEE'S SIGNATURE DATE DEPARTMENT OF TRANSPORTATION BUREAU OF ENGINEERING J65�e7140A G O PERATIONS BY 11 DISTRICT MAINTENANCE DIRECTOR `.:"�.•yw,-- r Teo-e:-iC.�ac.-' ;•v.'au:;..�.ra�.xi:=_:=v.sm .....:�a�..ia�,._.<+..��.MiN.:b.�.t..... .. ... „ <.y,,X., ..r•.r ti.. Tt.•-,,:fi5�:. •,�.:::�;����'•,�Ntm'YrFtin .�.:�. THEJACK CONSTRUCTION MATERIALS PHONE 860-243-9714 97 OLD POQUONOCK ROAD 1-800-423-0112 FARRELLY • BLOOMFIELD,CONN.06002 FAX 860-286-0867 COMPANY 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 149 SOUTH WEST CUTOFF PHONE 508-762-PIPE WORCESTER,MA 01604 FAX 508-797-4455 WATER/SEWE�R�fTE�S��T REPORT > PROJECT/LOCATION: AIM" 40"IvC �yu.�fi WPI�U'7+�� ff INSPECTOR: o f "t r a TESTED BY: r l V T!t S.► DATE OF TEST: r J CONTRACTOR: HYDROSTATIC TEST WATER MAIN TEST 0 SEWER MAIN TEST [11 LENGTH OF TEST: STATIC PRESSURE: TEST PRESSURE: ALLOWABLE LEAKAGE: ACTUAL LEAKAGE: TEST RESULTS: PASSED UK 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 14-1 3 .L % 7.36 oo ' JX4 Cp 9ii c. oo , N fw 3 r-L /2 0 7. 3G a s „ IC I© FJ I certify that the above information is a true and accurate account of SIGNED: �► INSPECTOR TESTER l LJwIN ur So UTH WINDSOR INSPECTION REPORT PROJECT: DEVELOPER: STREET: CONTRACTOR: DATE: -- .° WEATHER: WORK IN PROGRESS: iavt £� /PVC �_ ���.3� L jk-z �� v ✓) `c�' (_�. Imo'�- lv✓ '" nQ 6;:;,am �z f %lit/ r vA S `�-= 12c"c v4? ,-� fi�t i4 --V--, 3 1y'+N i � �'3� `.S�c�►� 1�'lrfiy (�...� ��/, �i� �.�' m 4&r3Jai f. c � ;mac.. 1 �c Al" 1-1 f e lT AREA OF CON SPECIAL INSTRUCTIONS: