Loading...
HomeMy WebLinkAboutStreet Cut Permit 855 Chapel Road 1000173 TOWN OF SOUTH WINDSOR, CT PERMIT NUMBER STREET CUT PERMIT DATE: 08/24/10 GIS ID: 18000855 y � y MUNIS APPLICATION# 201001110 � FEE: 25.00 ���� 4 IRATION DATE: 08/24/11 APPLICAN _ = LOCATION NAME: GERBER CONSTRUC �qI 00 RE s 8V'6114EL ROAD ADDRESS: I NUTMEG DRIVE o - = LQNAL POINT CHRISTIAN CHURCH INC ELLINGTON,CT 06093 = 145 PHONE 860-875-6684 � -bV VINDSOR,CT 06074 jel WORK DESCRIPTION: INST CURCH X Al r APPLICANT AGREES TO FURNISH THE TQ F`�»OTTH 3 rAMTrJD REQUIRED AND TO REIMBURSE THE TOWN OF SOUTH WINDSOR FOR ANI�` AINTENANCE OR REPAIR WORK IN TIT CONNECTION WITH THIS PERMIT AND T _U AV FOR PERMITS AS OUTLINED IN THE TOWN OFEIfT L ABIDE BY THE RULES AND REGULATIONS IDS FPIIT MANUAL. ISSUED BY DATE INSPECTED INSPECTED BY 8/24/201010:15AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES*** -... --- - --------.... ....-. er- A x Ad- --'jw ri—m- Nor �iY a I�ii ? '� EMIR Uj- s Y N £ y ss >/f TOWN OF SOUTH WINDSOR INSPECTION REPORT PERMIT NO.:/ cw 1 ,73 CONTRACTOR: (per-be(L. Cony _ LOCATION: Chaaal Poo TYPE OF WORK:_ __YG516/1 tkb4at r Cb 41IaC.Q G UIrc DATE INSP NEEDED: DATE INSP: INSPECTED BY: t1J WORK IN PROGRESS: Ifo•z�. ca Se`TT D rc CGS t�,l to Cb tafi to 4v LJD 171a,4 SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO AS-BUILT: INPUT: C UV v DATE: 1011,3 b'J9 S/FORMS/TOWN OF SOUTH WINDSOR INSPECTION o/r�0lit APPLICATION FOR STREET EXCAVATION PERMIT /000/ 73 Appl. No, TOWN OF SOUTH WINDSOR Permit No. PUBLIC WORKS DEPARTMENT 0-Z�-- - 1540 SULLIVAN AVENUE Date: SOUTH WINDSOR,CT 06074 FEE$25.00 �,��` Name of Firm �^�'`�� ��� Phone No. d 7� y Address of Firm ' l� i ' E7eQ Zip Code_0 66r Z. Location of proposed work e� ' ✓t Describe fully nature of permit requested Starting date 7 Z-- Approx.time for completion Call Before You Dig No. Existing Water Supply: ' P is Water ❑Well Existing Sewage Service: Public Sewer, ❑ Septic PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A PRELIMINARY ESTIMATE. THE APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY INCREASES IN PATCH AREA,CURB LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS TYPICALLY COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR. Show sketch of proposed work or furnish This section to be filled out by two copies of separate drawing Indicate North Town of South Windsor No.cuts Est.Patch.Size(s) '8 p 6-- 510, sf l Est.Pvt.Thickness in. jr-L `Est.Patch Unit Price$ /sf Est.Patch Cost$ 1 Est.Curb Replacement ft Est.Curb Unit Price$ /ft G�� `�'>�rkfz0 a2 `� Est.Curb Cost$ ►`^Gt+� iG f Est.Traffic Unit Cost$ mr Est.Traffic Control$ - Amt.of Deposit$ Total Due$ L�, ( )Cash KCheck# Applicant is responsible for contacting Paid By ea)or, the Police Dept.and C.B.Y.D. I AGREE TO FURNISH TO THE TOWN OF SOUTH WINDSOR THE AMOUNT OF BOND REQUIRED AND TO REIMBURSE THE TOWN OF SOUTH WINDSOR FOR ANY,EXPENSES INCURRED BY THE TOWN FOR MAINTENANCE OR REPAIR WORK IN CONNECTION WITH THIS PERMIT AND THAT I AM FAMILIAR WITH AND WILL ABIDE BY THE RULES AND REGULATIONS FOR PERMITS AS OUTLINED IN THE TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL. Signed: Date: Title: / J-C-c Driver's License#: PLEASE ALLOW AT LEAST TWO WORKING'DAYS AFTER APPLICATION FOR ISSUANCE OF PERMIT WORK MAY NOT BEGIN UNTIL A PERMIT HAS BEEN ISSUED PERMIT.SHALL BE KEPT ON JOBSITE AT ALL TIMES Street Excavation Permit 08 REV 10-22-08 i e ,gg. FEE moil Sol son 11 monsoon in ONE 0 (• P I ' n •i g 1- ® I ® ®I!®A ®®®®®Nunn 411101111801 ®®®�� an on o®® O ®®���! ®'� ��. Rd am ONE MIN 0 so oil son mum ®�®®®�®®®�®lid■®®:®®®�®ill.®®®®�i■®®®® Molloy, Catherine From: CallCenter@CBYD.com Posted At: Monday,August 23, 2010 9:22 AM Conversation: Locate Request-20103500186 Posted To: CBYD Subject: Locate Request-20103500186 (CALL BEFORE YOU DIG - CT) 08/23/2010 09:21:58 -3W -5G -C1 -G5 -GV -OT 2-SW SWINDS -T5 -W3 -------------------------------------------------------------------------- ***** ROUTINE ***** TIME. .09:21 DATE. .08/23/2010 REQUEST NO. . .20103500186 PREVIOUS REQUEST NO. .20103002057 LATITUDE. .41.8032256 LONGITUDE. .-72.5853757 TOWN. . . . . .SOUTH WINDSOR ADDRESS. . .855 STREET. . . .CHAPEL RD NEAREST CROSS STREET. .BETTY DR -------------------------------------------------------------------------- TYPE OF WORK. . . . .EXC TO INST DRIVEWAY , PARKING LOT AREA IS MARKED. . .YES REMARKS: INST NEW BLDG FOUND, ELE, TELE, CATV , WTR, SWR, DRAINAGE, GAS, GRADING & STUMPING . . . . . . .WORKING ON A PROP LOC ACROSS THE STREET FROM THE INTR WORKING FROM THE STREET & GOING OVER THE ENTIRE PROP -------------------------------------------------------------------------- START DATE. . . . . .08/26/2010 START TIME. .07:00 CALLER. . . . . . . . . .CAROLINE RANSOM CALL BACK. . ... . . .8-5 PHONE #. . . . . . . . .860-875-6684 FAX #. . . . . . . . . . .860-870-9453 ALT. PHONE #. . . . EMAIL ADDRESS. . . CONTRACTOR. . . . . .GERBER CONSTRUCTION INC. ADDRESS. . . . . . . . . 616 DART HILL RD CITY. . . . . . . . . . . .VERNON STATE. . . . . . . . . . .CT ZIP. . . . . . . . . . . . .06066 -------------------------------------------------------------------------- EXCAVATOR DOING WORK. .SAME ISSUED TO: DATE: TIME: BY: DATE/TIME ARRIVED: TIME LEFT: COMPLETED BY: CALL BACK: 1) DATE: TIME: BY: 2) DATE: TIME: BY: 1 MA PT � ORIGINAL , Lill TOWN ROUTE NO. PMT 2B-REV 8/00 DATE OF ISSUE PERMIT NO. SOUTH WINDSOR 291 (302-0e-0386) 7/29/2010 1008421 DEPARTMENT OF TRANSPORTATION NAME OF HIGHWAY BUREAU OF ENGINEERING&HIGHWAY OPERATIONS DATE EFFECTIVE Page 1 of 2 CHAPEL ROAD STATE OF CONNECTICUT ENCROACHMENT PERMIT LOCATION OF WORK OR BEGINNING AND ENDING POINTS DATE OF EXPIRATION AMT.OF SURETY BOND 855 CHAPEL ROAD 7/29/2011 CERTIFY CHECK BTWN POLES#5204&5209 10,000.00 AT BETTY DR SURETY COMPANY/BANK Hartford Fire ins.Co. TO: GERBER CONSTRUCTION INC. COLONIAL POINT CHURCH BOND NUMBER 1 NUTMEG DRIVE 855 CHAPEL ROAD 02SBAF4477 ELLINGTON,CT 06029 SOUTH WIN DSOR,CT 06074 PERMIT IS NOT VALID UNTIL SIGNATURE COPY IS SIGNED AND RETURNED TO THE OFFICE. PLEASE RETURN AT ONCE. FEE:25.00 DATE REC'D:7/2 912 0 1 0 PO/WO 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 designated 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 or designated 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 applicable. The Department of Transportation Permit Inspector, Robert Waldner 860-258-4544, MUST BE NOTIFIED AND THE CALL BEFORE YOU DIG REQUEST NUMBER RECORDED 48 HOURS IN ADVANCE OF STARTING WORK ON THE PROJECT. REQUEST NO. -2PIO 3&0-2a57 Excavate within the highway right of way to install drainage,to remove all brush and debris from a state owned detention basin and install a new gate to the non-access fence as delineated on the plans entitled,"Colonial Point Christian Church"dated 4-30-08.All work shall be in accordance with the current publication of the Department of Transportation"Standard Specifications for Roads, Bridges and Incidental Construction",and including the following stipulations A CQ,g„Ysa©. THIS PERMIT-M.UST BE AVAILABLE ON SITE AT ALL TIMES. -No work that will interfere with the flow of Interstate 291 traffic will be permitted before 9:00a.m.and after 3:00 p.m., Monday through Friday.Any work which will affect the traveling portion of Interstate 291 will not be permitted. Holiday restrictions will be in accordance with Section 13B-17-23 of the Highway Encroachment Permit Regulations dated 1992 which states,All work shall be stopped at 12:00 noon on the day before a legal holiday and no work shall be resumed untill 12.00 noon on the day following the holiday. -The Drai - � t that accom anies,this ermit ust the t wn rt ` f3r� f f e permittee s` ,,a.;e �ii -t py_ #t ry. - 6rtied to r expense.The town the volume,and the page number must appear In t e esignated s �c In the bottom lefthand corner of the document. `(three copses)riiitst"ke^ISFrtrided`to t11tt't ` tlt prior to the p i�itt1i 5mplete. ' The Permit inspector must be notified upon completion of work for final inspection and approval. �, },3 i:0 t3: ct #1 � CALL Before you DIG! TOLL FREE, STATEWIDE 1-800-9224'455 1101 Cr ��1�► Any and all liability for injury,damage or loss resulting from such work as may be undertaken unde the terms�ermlt Is assumed by t=,Permlft&,�Permittee is hereby designated responsible for all future maintenance of all installations or encroac ents constructed under.bits Permit;whic in the sole judgement of the State are not part of the highway appurtenances normally maintained by the State. The 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,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 designated representative. P ITTE 'S SIGN E DATE DEPARTMENT OF TRANSPORTATION 17 / BUREAU OF ENGINEERING HIGHWAY OPERATIONS ( 9 /<u BY Ronald P.Cormier DISTRICT MAINTENANCE DIRECTOR ORIGINAL TOWN ROUTE NO. PMT 2B-REV 8/00 DATE OF ISSUE PERMIT NO. SOUTH WINDSOR 2g1 (302-06-0386) 7/29/2010 1008421 DEPARTMENT OF TRANSPORTATION NAME OF HIGHWAY BUREAU OF ENGINEERING&HIGHWAY OPERATIONS DATE EFFECTIVE Page 2 Of 2 CHAPEL ROAD STATE OF CONNECTICUT ENCROACHMENT PERMIT LOCATION OF WORKOR BEGINNING AND ENDING POINTS DATE OF EXPIRATION AMT.OF SURETY BOND 855 CHAPEL ROAD 7/29/2011 CERTIFY CHECK BTWN POLES#5204&5209 SURETY COMPANY/BANK 10,000.00 AT BETTY DR Hartford Fire Ins.Co. TO: GERBER CONSTRUCTION INC. COLONIAL POINT CHURCH BOND NUMBER 1 NUTMEG DRIVE 855 CHAPEL ROAD 02SBAF4477 ELLINGTON,CT 06029 SOUTH WINDSOR,CT 06074 PERMIT IS NOT VALID UNTIL SIGNATURE COPY IS SIGNED AND RETURNED TO THE OFFICE. PLEASE RETURN AT ONCE. FEE:26.00 DATE REC'D:7/29/2010 PO/WO 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 designated 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 or designated 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 applicable. The Department of Transportation Permit Inspector, Robert Waldner 860-258-4544, MUST BE NOTIFIED AND THE CALL BEFORE YOU DIG REQUEST NUMBER RECORDED 48 HOURS IN ADVANCE OF STARTING WORK ON THE PROJECT. REQUEST NO. o2010 30b-7 /,7 The owner(s)of the property containing the detention/bio filtration basin agree(s)to maintain this basin and associated drainage appurtenances and to ensure that they are kept in proper working condition and operating as designed and that the site drainage system be cleaned and inspected on an annual basis so that no damage occurs to State drainage systems.The owner or his successors,in interest, agree to save the State harmless from any and all claims which may arise due to the operation of this basin or associated drainage appurtenances. -Vehicular and pedestrian traffic must 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 shall be utilized to direct traffic through the work area.All traffic control signing and appurtenances shall be in accordance with the latest edition of the"Manual on Uniform Traffic Control Devices"and must meet NCHRP 350 requirements. -The storing of pipe, excavated materials or other construction materials within the highway right of way will not be allowed. Equipment shall be removed from the right of way when not in use. -All areas disturbed as a result of this operation will be restored to the equivalency of their original condition.Turf must be established prior to this permit considered complete -Requirements of this permit are subject to change as field conditions warrant. INSURANCE EXPIRES: B=3-25-11 -PRIOR TO THE INSURANCE EXPIRATION DATE,THE PERMITTEE MUST SUBMIT A FORM CON 32 TO DOCUMENT APPROPRIATE CONTINUING INSURANCE COVERAGE. The Permit Inspector must be notified upon completion of work for final inspection and approval. 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. The 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,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 designated representative. P ITTEE'S SIG AT�Ep DATE DEPARTMENT OF TRANSPORTATION -- � �'/l/, BUREAU OF ENGINEERING&HIGHWAY OPERATIONS BY Ronald P.Cormier DISTRICT MAINTENANCE DIRECTOR