HomeMy WebLinkAboutStreet Cut Permits 383 Deming Street (3) 1500267 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PUBLIC UTILITY
DATE: 11/19/2015
GIS ID:27600383 FEE: 0.00
MUNIS APPLICATION# 201501717 EXPIRATION DATE:
APPLICANT LOCATION
NAME: EVERSOURCE ADDRESS: 383 DEWING STREET
ADDRESS: 112 PROSPECT HILL RD OWNER: JACQUES CONTRUCTION LLC
EAST WINDSOR, CT 06088 67 RIDfE RD
SO-Lj SOR, CT 06074TH WIID
PHONE 860-292-2242
WORK DESCRIPTION: INSTALL NEW GAS 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.
r
ISSUED BY DATE INSPECTED INSPECTED BY
11/]9/20153:22PM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO:: LSL Dd-4 7 CONTRACTOR: f\)� SQ
LOCATION:
TYPE OF WORK:
DATE INSP NEEDED: DATE INSP:
INSSPECTED BY'.,—
WORK IN
PROGRESS: 'i t�o Cis a Jp 6'1�->
SEPTIC TANK PUMPED,SMASHED, FILLED wiTNESSED El YES ❑ NO
AS-BUILT:
INPUT: DATE:T I S S
S/moiio A ms 2014 Town of South Windsor WSWWN RR. W 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 4 de c S.0 v r C e_ Cs 4 5 Phone No. $60 Q 9 Z -
Address of Firm 112 'Fro: 2ge. t (,( CQ Eas_r W r n rJ(ro!' _ C-r Zip Code 06088
Location of proposed work 3S3 t r
Describe fully nature of permit requested i n
Starting date Nov. c. 2015, Call Before You Dig No 2 0 1,9 'V 7 0 19 7 6
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 9 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
Est.Patch Sizes) sf
- Est.Pvt.Thickness In.
S r
W: 0. $ L' `S2 ( ODD
Est.Patch Unit Price$ /sf
� q v40C � - Est.Patch Cost$
w s e a
Est.Curb Replacement ft
4 Est.Curb Unit Price$ /ft
Est.Curb Cost$
Est.Sidewalk Replacement sf
3$3 Est.Sidewalk Unit Price
�..
Est.Sidewalk Cost$
K 3 Est.Traffic Hours hr
Est.Traffic Unit Cost$ /hr
Est.Traffic Control$
i Amt.of Deposit$
I Total Due$
Sz .> GIA�
thao� { )Cash ( )Check#
Applicant is responsibie.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
iMNDSOR 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
:.:.:,'V111NDSOR'/S�STREET
/CUT PERMIT MANUAL �l
Signed M_ 4L 1'T l< Print Name n c�r e l Kl CAL e.ca Date: l l t t
Street Excavation Permit 2014
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CBYD Locate Request Routine
(CAIL BEFORE YOU DIG CT) 11-/ij/2015• 16:11:30
49-5G YANK/ -Cl Gil =F5
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Date 11/1720L5; Time: 16:,11
Request t- 2015470197& Prev. Request #:
Zatitudo: ' 4L.,$1770.66., Longitude: -72:5441734
Address ` 3$3 '; Street: DEMING•ST Town: SOUTH WINDSOR
Nearest 'C os`s Street-CARDINAL WAY
EXCAVAT, ,0 INSTALL GAS SERVICE.
Area, is;`Marked- . YES
Remarks: WORKTIJG FROM' GAS 'MAIN BEHIND CURB:. CROSSING THE STREET TO
THE ;RIGHT 1RONT„OF NEW. HOUSE�AT 383 DEMING ST.
Start Date: 11/2,0';/2,015 Start Time: 07:00
Call Back:71
`
Phone Numbar: {,8.50)' 292-22,47 Alt. Phone:
•Fax #: Email:
"< Contractor: EVER310uRCE,',GAS Excavator: EVERSOURCE GAS
Address•: 112 '.PROSI? CT HILL RD; City: 4 EAST WINDSOR State: CT Zip: 06088
..
Were pre-construction marks visible? 5<Yes ❑ No
What facilities were marked? ['--Main ❑ Service ❑ Both
Main facility material type? El Steel Dd'lastic El Cast Iron ������� �� �..,._.._.,._._.�..._....�. M.m._
_...__._....._....._..._._....._......_........_......._.,__,.._.......... ...............
Service facility material type? ❑ Steel ❑ Plastic ❑ Cast Iron
How were the gas facilities located? ❑ Conductive Lkinductive 19 Measurements
.................................................................................
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 ❑ No What was used for measurements? L;;-f IS Service Card
How was the area marked? ❑ Paint ❑ Stakes XBoth
Who was the site verbal contact?
Work completed by: