HomeMy WebLinkAboutStreet Cut Permits 565 Rye Street (2) 1500009 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PUBLIC UTILITY
DATE: 03/13/2015
GIS ID: 78600565 FEE: 0.00
MUNIS APPLICATION# 201500190 EXPIRATION DATE:
APPLICANT LOCATION
NAME: EVERSOURCE ADDRESS: 565 RY9=STREET
ADDRESS: 112 PROSPECT HILL RD OWNER: VALLIERROBERT J&KAREN D
EAST WINDSOR, CT 06088 565 RYE ST
SOUTH WINDSOR,CT 06074
PHONE 860-292-2242
WORK DESCRIPTION: INSTALL SAS SERVICE,
APPLICANT AGREES TO FURNISH 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 THE APPLICANT IS 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.
C, ll® ( C
ISSUED BY DAT INSPECTED INSPECTED BY
3/13/2015 1:20 PM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
------- -------
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: 09CONTRACTOR: -Z0�e1.
LOCATION: S Ye
el
TYPE OF WORK:
DATE INSP.NEEDED: DATE INSP: L�
INSPECTED BY: b-0
WORK IN
PROGRESS: k-)0 r(/
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: C - DATE:
S/molloy/forms 2014 Town of South Windsor INPSECTION REPORT 14
APPLICATION FOR STREET EXCAVATION PERMIT
Appl. No. TOWN OF SOUTH WINDSOR PUBLIC WORKS DEPARTMENT Permit No.
TOWN HALL 1640 SULLIVAN AVENUE SOUTH WINDSOR, CT 06074 FEE $26.00
"Name of Firm !y e r yy V r c Phone No. a o) Z k Z - 2 2 f 7
Address of Firm__ I 12 Q r D S D e cf ly I { t2 ct: t. W en ats o r Code 6 6 G OP2
Location of proposed work 5 6 �* Ry e Si-
Describe fully nature of permit requested Ary e 4v cfe, fv r'rI s a a 4s s e ytc e ,
Starting date 3 ! ,s e r j4 e r Call Before You Dig No O 15 3 5
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A PRELIMINARY ESTIMATE. THE
APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE PERMANENT PATCH AND CURB REPLACEMENT,INCLUDING ANY
INCREASES IN PATCH AREA,CURB LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS
TYPICALLY COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Check Applicable: XNo Pavement,Curb or Sidewalk Cut ❑ Pavement Cut ❑ Curb Cut ❑ Sidewalk Cut
❑ Existing Driveway,No Changes ❑ Proposed Driveway Widening ❑ Proposed New Driveway
Water Supply: ❑ Public Water ❑ Well Sewage Service: ❑ Public Sewer ❑ Septic
Show sketch of proposed work or furnish Indicate North This section to be filled out by Town
two copies of separate drawing
No.cuts
0 Est. Patch Size(s) sf
W. 0. 8ic52023 �
Est.Pvt.Thickness in.
( ( Est. Patch Unit Price$ /sf
S e� Q �4�h� 8���eT�V} . 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 ( )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:_ Print Name_ M I K, Dater/3 S
Street Excavation Permit 2014
565
t Fri ,, w I cle GoS
�--- Tr-cw c- v 1
ST-HP
R Y 1 ' i.
CBYD Locate Request Routine
(CALL BEFORE YOU DIG - CT) 03/13/2015 08:13:21
1-5G YANK/G -C1 -CW -F5
-J1 -OT -SW
Date: 03/13/2015 Time: 08:13
Request #: 20151101535 Prev. Request #:
Latitude: 41.8651462 Longitude: .-72.5747977
Address: 565 Street: RYE ST Town: SOUTH WINDSOR
Nearest Cross Street:WINDSORVILLE RD
Type of Work: EXCAVATE TO INSTALL GAS SERVICE.
Area is Marked: YES
Remarks: WORKING FROM GAS MAIN BEHIND THE CURB LINE TO THE NORTH SIDE OF THE HOUSE.
Start Date: 03/18/2015 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: EVERSOURCE GAS Excavator: EVERSOURCE GAS
Address: 112 PROSPECT HILL RD City: EAST WINDSOR State: CT Zip: 06088
Were pre-construction marks visible? &<Yes ❑ No
_...._..............._..._._....................................._..................................._...._......._......_........._......................................................,....._.._......................................................................................................................................
What facilities were marked? Main ❑ Service ❑ Both
......... ___,_.,__ _.. .,__., __,....,.._,__.,....._........ ....._,_ ,_ ___........_._..._...........,.._..,.,,._.,_.._.
Main facility material type? Steel ❑ Plastic ❑ Cast Iron
........................ ...... __................_................... .... .,, .... _,.. ... .... ............. ................., .......... ........ ................................................
Service facility material type? ❑ Steel ❑ Plastic ❑ Cast Iron
M.........._.,,,,,_............_,,..___..__.,.__,.,__.___ _ _..__,._.w__,, ., .,..._w._.._.w...... ......... „ � _,__,. ........
How were the gas facilities located? ❑ Conductive 5�inductive Measurements
_._._........................................._..._................................_......_.._......._._.........._......_............................_.........................................................,...............................................................................................................................1.. ....
Where was the connection made? ❑ Meter Value ❑ Test wire in box ❑ Tracer wire on service ❑ Direct connect to pipe
.____ ..........w., _... .... ,,,,,_...... ............ _._...w....,k_ M_., .,........
Did measurements match the signal? 5:1(es ❑ No What was used for measurements? ;"IS l�'Service Card
. .. ... , .. _....... _. ................ . .... ....... .................... .......... .........
How was the area marked? ❑ Paint ❑ Stakes .Both
Who was the site verbal contact? tJ A
._._r.�......................_�_... ...._..... _ ...__....._ ,....,.. w, ._...__.,. ,,. ...,....__._. __.__... .......... _..� _.....,..
Work completed by:
M �.
r,
t �` r �• ,.
e
3r
l
AK
Zz
j•1 -�u+ids.t aY/.�lrl
NE
la
lam g
4'
low
int
Aomg
x
j
ti tCw
a
- 3t� f ��;X' J�7.�'n�`'_ Y�j�' 'ice ,� •�� "��y �'si �i