HomeMy WebLinkAboutStreet Cut Permits 2422 Ellington Road (2) 1`*vul(�uo 1 U WN OF SOUTH WINDSOR, CT
PENT NUMBER STREET CUT PUBLIC UTILITY
DATE: 07/21/2014
GIS ID: 30302422 FEE: 0.00
MUNIS APPLICATION# 201400973 = >`XPIRATION DATE:
APPLICAMT = LOCATION
NAME: YANKEE GAS ADDRESS 24=2 EILINGTON ROAD
ADDRESS: 112 PROSPECT HILL 115 OWNER AJENK6WSKI PAUL L&KATHLEEN M
EAST WINDSOR,C Q�0842EI INGTON ROAD
` fU`PH VINDSOR,CT 06074
PHONE 860-292-2242 = =
i
WORK DESCRIPTION: INSTALL&AS SERVICE(OFF FOSTEK ST I I )�fOffE4212134
APPLICANT AGREES TO FURNISH THE OBI OF SOUTH WINDS TbF B€)ND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANy FEN'SES INCURRED BY THE TQ�VNf $ VIAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND TFIE APPLICANT IS FAMILIAR WIhH AND WTI L ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN OF SOUTH WINDSR'SSTREET°CUT PERMIT MANUAL.
ISSUED BY DATE INSPECTED INSPECTED BY
7/21/2014 9:30 AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.:_ y0b A OR CONTRACTOR: _in Q a aj
LOCATION:
TYPE OF WORK: S
DATE INSP NEEDED: DATE INSP:
INSPECTED BY: C
WORK IN
PROGRESS:
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: DATE:_
S/2014 Town of South Windsor INPSEMON REPORT 14
APPLICATION FOR STREET EXCAVATION PERMIT
Appl. No. TOWN OF SOUTH WINDSOR PUBLIC WORKS DEPARTMENT Permit No.
TOWN HALL 1540 SULLIVAN AVENUE SOUTH WINDSOR, CT 06074 FEE $25.00
Name of Firm a.w /'�e GCtS Ser +»c s Co 44 //
Phone No.19,60� 212 - 2 L-f?
Address of Firm 117, T ros e.t (#:(( (Z 4 s e W,ndsod Zip Code 04008
Location of proposed work 'f Z Z G(� nufo� '[�cQ . Sv✓th W;,n s d r
Describe fully nature of permit requested_64 n s c1 0 FF Fos"fe t-
C-4 +Cn,t 6 VA) jj
Starting date Oa s. 4 20 i 91 Call Before You Dig No ZO f 44 2 9 y 2(2 S
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A PRELIMINARY ESTIMATE. THE
APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY
INCREASES IN PATCH AREA,.CURB LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS
TYPICALLY COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Check Applicable: ❑ No Pavement,Curb or Sidewalk Cut 2r Pavement Cut ❑ Curb Cut ❑ Sidewalk Cut
❑ Existing Driveway, No Changes ❑ Proposed Driveway Widening ❑ Proposed New Driveway
Water Supply: ❑ Public Water ❑ Well Sewage Service: ❑ Public Sewer ❑ Septic
Show sketch of proposed work or furnish Indicate North This section to be filled out by Town
two copies of separate drawing
No.cuts
u/. U S ; 14 2. 1 23 c.f Est. Patch Size(s) sf
A 7!�) Pp,0 0 Est. Pvt.Thickness in.
Est. Patch Unit Price$ /sf
Est. Patch Cost$
Est.Curb Replacement ft
Est. Curb Unit Price$ /ft
Est.Curb Cost$
Est. Sidewalk Replacement sf
Est.Sidewalk Unit Price
Est.Sidewalk Cost$
Est.Traffic Hours hr
Est.Traffic Unit Cost$ /hr
Est.Traffic Control$
Amt.of Deposit$
Total Due$
( )Cash O Check#
Applicant is responsible for contacting the Police Dept:and C.B.Y.D
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES Paid By
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: Ak4z 4 � Print Name � C� C,le �Tahec"t it Date: Z4(E r
Street Excavation Permit 2014
5
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CBYD Locate Request (Routine)
(CALL BEFORE YOU DIG - CT) 07/16/2014 13:33:22 �
28-5G YANK/G -C1 -CW -GV I
-OT -SW -T5
'Date: 07/16/2014 Time: 13:33
Request #: 20142902628 Prev. Request #:
..Latitude: 41.8436585 Longitude: .-72.5296941
,Address: 2422 Street: ELLINGTON RD Town: SOUTH WINDSOR
Nearest Cross Street: FOSTER STREET EXTENSION M
Type of Work: EXCAVATE TO INSTALL GAS SERVICE.
Area is Marked: YES
Remarks: WORKING FROM GAS MAIN BEHIND CURB LINE ON FOSTER STREET EXTENSION TO THE
WEST SIDE OF THE HOUSE.
Start Date: 07/21/2014 Start Time: 07:00
= Caller: MIKE HANECAK Call Back: 7:30-4
" Phone Number: (860) 292-2247 Alt. Phone:
. Fax #: 860-292-2269 Email:
Contractor: YANKEE GAS Excavator: YANKEE GAS
6. Address: 112 PROSPECT HILL RD City: EAST WINDSOR State: CT Zip: 06088
Were pre-construction marks visible? .,Yes ❑ No
I..
...... ......... ......... ........ ......... ......... ......... .......... ...... ......... ......... ......... ..._...... ..........
What facilities were marked? Main ❑ Service ❑ Both
Main facility material type? Steel ❑ Plastic ❑ Cast Iron
......... ......... ........ ......... ......... ......... ......... ......... .......... ......... ..... ......... .__....._
Service facility material type? ❑ Steel ❑ Plastic 1_7 Cast Iron
_....__- _..,. _.__.. .._,_. .,.
How were the gas facilities located? 1XGonductive ❑ Inductive EkMeasurements
....... ....... .. ....... ........ ... ......... ......... ........ ........ ........ ..... .. .......... . . ......... ........ ...
Where was the connection made? Meter Value ❑ Test wire in box U Tracer wire on service ❑ Direct connect to pipe
Did measurements match the signal? KYes ❑ No What was used for measurements? R] GIS 'Service Card
........ .... ......... ........ ..........
How was the area marked? ❑ Paint I_J Stakes L oth
Who was the site verbal contact? rf
..... .................................................
Work completed by: CX`
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