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HomeMy WebLinkAboutStreet Cut Permits 617 Pleasant Valley R (2) 1500232 TOWN OF SOUTH WINDSOR CT PERMIT NUMBER , STREET CUT PUBLIC UTILITY DATE: 09/29/2015 GIS ID: 72900617 MUNIS APPLICATION# 201501366 - FEE: 0.00 EXPIRATION DATE: APPLICANT LOCATION NAME: EVERSOURCE ADDRESS; 'PLEA ANT VALLEY ROAD ADDRESS: 112 PROSPECT HILL RD OWNER. CASE)JOSEPH R JR&KIMBERLEY A EAST WINDSOR, CT 1I608$ 6L7`PL SANT VALLEY PHONE 860-292-2242 SOUTH WINDSOR, CT 06074 WORK DESCRIPTION: EXCAVATE TO"INSTALL GAS SERVICE STREET TO HOUSE APPLICANT AGREES TO FURNISH THE TOWN OF SOUTH WINDSOR THE AMOUNT OF BOND REQUIRED AND TO REIMBURSE THE TOWN OF SOUTH WINDSOR FOR ANY I XPENSES 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'Zn7,rcufP ERMITMANUAL. ;4� 5 ISSUED BY DATE INSPECTED INSPECTED BY 9/29/2015 9:31 AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES*** TOWN OF SOUTH WINDSOR INSPECTION REPORT PERMIT NO:: j,:;'0 0,A CONTRACTOR: F.y erso v eC e LOCATION: &17 P -C 1 a ) TYPE OF WORK: DATE INSP NEEDED: DATE INSP: 11lit" I/3 INSPECTED BY: WORK IN PROGRESS:_ A We, /J r SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO AS-BUILT: INPUT: DATE: S/molioy/forms 2014 Town of South Windsor INPSECTION REPORT 14 Y - AVA TION PERM. Appt, No TpWt d' S01T1 W t.D; OR Permit NQ. f PUBf.IClirlOR1� IEARTMNT z _ J`�`©SUt..1AN ARIRS lat1te, f �S O 'I t 'WIN1?SOft,C 'OD r ,Q Natrle of firmv�r s�ct G Rhone Address 4firrrf I l Ord � �l Ltd /a s rat Zap.Cade C G E Lotj op o€'propo sed wo �G� t ? fi f aw t r� Describe#idly nature of permit rclgstede r v r c tre � a � _ 4 Stet l nc daire � � z t " A lot, r : Chit Before;Yoct pig No O tee �i 0 7/ existing Water SuSply [ Rt �c VNafer �1 WeA Exist Sewage service: [�(,Pubk Sewer, [�Septic PLI ASE.IVOTE THE DEPOSIT FOR THE P[i*RNIANENl` E' PA CHAND CURB R1=RL,1`CEMENT`IS A'. PRELIMINARY BSTIN[ATE Tif APPLICAI!IT IS RESPCtNSIBLiE FOR.Tt#E FULL FINAL 00� T OF THE . PERMAN> NT PATC AND CURB REPLACEIVIENT Jk&UDINta AN1f INCREASES IN:PATCH AREA,CURB i.6IVGTH,7RAF1=t CQNTR+II�.AND 'HE YtyllfiN'S CONTRACT COSTS:_ THE�RERMANi;.NT BATCH 1$TYPICALLY 'CO PLO WITHIN A EAR DF THE:fiF.MP�7RARY PATCH BUT IT CQULD`BE i.MEh THA1�1.A�(E/#R .Show sketch of proposed work or famish This section to be,fitled out Iry two copies of separate:drawing , . Indcate North Tcswn of_South Windsor` 6.2O R6S� New }� Est:Patch Size(s) sf. Est.-Pvt.Thickness, Est,Patch Unit Price Fs# Patch Cost S Est.Curb Replacement ft Est.W40hit Price-$ /ft i i ' Est.Curb Cost S 4 . Est Traf#rc Unit Cost$ Itrr Est Traffic Control S Amt of i}eposit$ Totot Due$_ ( j Cash` O Check#: Applicant is responsible for contacting Paid By the Police De t.and`9 YoD i AaREE TO:FURNISH TO THE TOWN OF SOUTH WINLISOR THE AMOUNT OF BOND REQUIRED ANO TQ.REIIIABURSE<THE TOWN OF SOUTH.WINDSOR-FOR ANY":E-XPENSES.INCURRED BY THE TOWN FOR:MAINTENANCE OR REPAIR WORK IN -WI CONNECTtQ1U TH THIS PERMIT AND THAfi LAM FAMILIAR WITH AND WILL ABIDE;BY THE RULES AND REGULATIONS FOR PERMITS AS OUTLI ED IfV THE TOWN OF SOUTH WINDSORTS STREET COT<PERMIT MANUAL, Signed Date: Arl Title: , S C7 - Cv n.sir u r.�`S o `I"p c Driver's License#: PLEASE ALLOW AT LEAST TVIf0'WORKING CLAYS AFTER APPLICATION FOR ISSUANCE OF.PERAAIT WORK MAY NOT.BEGIN UNTIL A PERMIT HAS BEEN ISSUED PERMIT SHALLI PE,KEPT-ON JOBSITE AT ALLTIMES; I StY�et Eaccsveo6h Pergtit:d$ t% f.0-22-©8 LL9 '�— Qrgov eck G45 SerVlc.Q- �-- - I W � CAA- Gas Tr en ck It 6 IP 1979 3 Y- 'i 'X 14 x C G v 5 I coin f Lc'ASA1J T VA- LL L y f S vc 617 9/25/2015 4UPleasant Valley Rd-Google Maps RN � s - Google k � vry i I Image capture:Aug 2012 ®2015 Google ttPs:/M,ww.go?gle.com/maps/@41.8145312,.72,5953289,3a,75y,216.3h,72.02Vdata--l3m6lleil3m4!lsLignLUG4Rtcgwjj8m3-WacQl2eOl7i 1331218665616m 111e1 2l2 CBYD Locate Request Routine (CALL BEFORE ,YOU DIG - CT) 0.9/25/2Q15 13:27:49 24=5G YANK/G : -C1 -F5 -OT' -SW -W3 Date: 09/25/2015 Time: 13:28 Request #: 20153904712 Prev: Request #: Latitude: 41.8147084 Longitude: .-72.5955775 Address: 617 Street: PLEASANT VALLEY .RD Town: SOUTH WINDSOR Nearest Cross Street: HOLLIS RD` Type of Work: EXCAVATE 'TO INSTALL GAS SERVICE.- Area is ;Marked: YES' Remarks': WORKING FROM STREET TO THE FRONT OF THE HOUSE. Start Date: 09/30/201`5 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? IR'es ❑ No ........ What facilities were marked? ,Main ❑ Service ❑ Both._.w,..__. W_.,w.._w..... ... __ _.,,,.,_._,_ ,........ ,_ _,..._.,_,,._,_,......_....._...._......................._,........... ..................... .............. ..._..... .......... _ _. ..__. Main facility material type? steel ❑ Plastic ❑ Cast Iron . ._�.w_.....__.�..__... .., �_.,.-,........ ...............__ _.w.............................................. .............. ..........w.._...................................................................._.._.................................... Service facility material type? ❑ Steel ❑ Plastic ❑ Cast Iron How were the gas facilities located? Conductive ❑ Inductive Measurements __._...._............. _..,..... .............................................................................................._............................. Where was the connection made? Ik Meter value ❑ Test wire in box ❑ Tracer wire on service ❑ Direct connect to pipe Did measurements match the signal? K-Yes ❑ No What was used for measurements? CIS © Service Card How was the area ._��...�_....._. marked? ❑ Paint ❑ Stakes [Roth u.......,.,_.,_... _...... ... _ .. Who was the site verbal contact? h►�l Work completed by: M, - _.__._...... ......... .., ... . . __._._...... ...m __.... .,......._...,.m. CI-��t