HomeMy WebLinkAboutStreet Cut Permits 87 Natsisky Farm Road (2) 1300189 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PUBLIC UTILITY
DATE: 07/25/2013
GIS ID: 62300087 FEE: 0.00
MUNIS APPLICATION# 201301043 EXPIRATION DATE:
APPLICAN I
NAME: YANKEE GAS
1 �! LOCATION
DRES 8Z N1TISKY FARM ROAD
ADDRESS: 112 PROSPECT HILL` = = '
i� R RdBERA GARY J&KAREN M
EAST WINDSOR, CT J6 8 1-8- 1 :�TShSKY FARM RO
- % OJT I WINDSOR,CT 06074
PHONE 860-292-2242
WORK DESCRIPTION: RECONNECT- AN
APPLICANT AGREES TO FURNISH THE I`�W �F SQUTI� �I OR%I OU T QF B9ND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANI*E-PENISI;&114 wHF T FWN R 1+fAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND TH&PftwAN2�IS 1�A Im IAR W H�1N?WILL ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OPS6U'f'WIN�SRag�TIWI fctU-TP1 1311-IT MANUAL.
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ISSUED BY DATE INSPECTED INSPECTED BY
7/25/2013 9:13 AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
----------------
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: 1300 t'99 CONTRACTOR: �a in Yew
LOCATION:
TYPE OF WORK: c Yg" A & d®VYA 9 ct S S-aw L C-0,
DATE INSP NEEDED: DATE INSP:
INSPECTED BY: Sh
WORK IN
PROGRESS: ('���.-�_��r f-�1�c�✓�ed �,, �. � q C:s SQr y
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: DATE:
W/2007 Town of South Windsor INPSECTION REPORT 07
APPLICATION FOR STREET EXCAVATION PERMIT
Appi. No. TOWN OF SOUTH WINDSOR Permit No.
PUBLIC WORKS DEPARTMENT
1540 SULLIVAN AVENUE Date:
SOUTH WINDSOR,CT 06074
FEE $2500
Name of Firm - /—CV%V\ee Cos Sec v(Ce S Co n� 0.n Phone No.�� � 2q 2 "Z2�
Address of Firm 6 t 2 f�ysl rzrz, (( R� —qs W ,1 otro�' Zip Code OG o$8
Location of proposed work S 7 N 4 1 S A
Describe fully nature.of permit requested sic'
S S< rg1Ce -
Starting date s u k� Approx.time for completion �-�q• 20 l
Call Before You Dig No. 2013 2q O 1 9 7 Existing Water Supply: Public Water ❑Well
Existing Sewage Service: ❑ Public Sewer ❑Septic
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A
PRELIMINARY ESTIMATE. THE APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE
PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY INCREASES IN PATCH AREA,CURB
LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS TYPICALLY
COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
-Show sketch of proposed work or fumish This section to be filled out by
two copies of separate drawing Indicate.North Town of South Windsor
W, 0 . 8 G 3 2 0 ? No.cuts
4 O Est,Patch Size(s) sf
Est.Pvt.Thickness in.
Z D t 3 2 9 0 2 Est.Patch Unit Price$ /sf
Est.Patch Cost$
S e e A-H-o,c l eGQ Est.Curb Replacement ft
Est.Curb Unit Price
Est.Curb Cost$
Est..Traffic Unit Cost$ Ihr
Est:Traffic Control$
Amt.of Deposit$
Total Due$
O Cash O Check#
Applicant is responsible for contacting _ _ __ Paid BY
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,THETOWN OF SOUTH WINDSOR'S STREET CUT PER/MIT MANUAL.
Signed: A-44p - Date:
Title: �/` CO'"S'�. 7'PG - 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
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CBYD Locate Request (Routine)
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Date: ..! (3712�133 �' Time.`?_. 15: 7
Request #: 2013290189:7 Pre�r.,Request #:-
Latitudes 41.8 458.4.3: Longitude'. .-72.503 1:97
Aiidresss ' 87., '; Street: NATSISKY �FARM 13D �ows�: > SOUTf WINi? OR
'Nearest Cross Street: DEBI3T DR.
Type of Work: EXCAVATEz.To,INSTALL GAS SERVICE,
Area is Marked: YE•S .
ftemerks: ', WORKING IN ,GRA,a,S„AND CROSSING STREET TO HOUSE.
Start' Date: 07l19.✓2013 Start Time: 08.00
Caller, MICE H1 NECAK Call Back !,.
£�kigne Huber
(850) 292,`22,U n �
E at; #: Email'.
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Contractor.., • YANKEE GAS :E�icarrator 1'G, ;RHni
Address:.; 112 PROSPECT HITL I2D.. .: City:', EAST WINDSOR State:. CT Zip, 06Q88,
Were pre-construction marks visible? ❑ Yes ❑ No
................................_.................,...,...._.,_...,._,_......,....._............................................_.............................................._...._.w.........,..._........................................................................................................
What facilities were marked? ❑ Main ❑ Service ❑ Both
Main facility material type? ❑ Steel �❑ Plastic ❑ Cast Iron M.x....�.,�___._.�.�.....,.,_.....��� ..�_ ..�_....__
......................................................................._......_.._...........................................................................................................................I.._........_..
❑ ❑ ^ ... ................................. .................................... _ �......._�
.......................................�...�....�.........................................................._................................._•..�......��........._...,_� �....��..�...�.. __...........
Service facility material type? Steel Plastic ❑ Cast Iron ....
How were the gas facilities located? ❑ Conductive ❑ Inductive ❑ Measurements
.......... _ _. .........._.__,.�...........................I .............._..............................................._._.....•_.. ..._._.............................................................._..._....._....................................................................................................._._.._.........,.,............................._.._............................................._..__..._._.._.._.......................................................
_......._.__..._..
Where was the connection made? ❑ Meter Value ❑ Test wire in box ❑ Tracer wire on service ❑ Direct connect to pipe
Did measurements match the signal? ❑ Yes [I No What was used for measurements? FIGIS �_.i Service Card
..... . ....... ..... . ...... ......... ......... ..... ......... _..._.. ......... ..................
How was the area marked? ❑ Paint ❑ Stakes ❑ Both
Who was the site verbal contact? ...._.,,.._, ��...�,...�.._...,�..�._.,..� .. m.,.......,.,.��.__.,._...,� .��.�.. .________��._�_µ_��.�.�...�._,_._....m...,�....
........_........._..............................................._.........................._..............................w_......_._........._.............._........._......... ._.__.._.........................
... .._.._,.,..,..
Work completed by: