HomeMy WebLinkAboutStreet Cut Permits 73 Autumn Drive (2) 1600118 TOWN OF SOUTH WINDSOR
PERMIT NUMBER C T
STREET CUT PERMIT
DATE: 06/28/2016 -
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GIS ID' ..-
. 0 _60 00 0'7 3
MUNIS APPLICATION# 201600888 FEE: 25.00
tEXPIRATION DATE: 06/28/2017
APPLICANT LOCATION
NAME: BOUTIN&SONS x
ADDRESS: 121 WINDSORVILL R€A� ADDRi✓SS; 73 AUK UMN DRIVE
BROAD BROOK,CT 06b 16 OyVNER GREEIBERG MAXINE B TRUSTEE
73 ATJT'UMN DRIVE
PHONE 860-623-2526 ; ,SOUTH°WINDSOR, CT 06074
WORK DESCRIPTION: DRIVEWA�I
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APPLICANT AGREES TO FURNISH THIa,TOWAT OF SOUTH WINpSRTHE'AMOUNT OF BOND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR A g I�XPENSIaS INCURRED$Y THE TOW4F R MAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND T11$AI'FLICANT IS F �fiAR WITH Al*Ip AIL L ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN MF.SOUTH WIND S.......R'.:S..STRt ET:;CUT.PEI2MITMRNUAL.
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ISSUED BY DATE INSPECTED
INSPECTED BY
6/28/20I69:55AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT No;: CONTRACTOR:
4
LOCATION:
TYPE OF WORK:
DATE INSP NEEDED: DATE INSP:
INSPECTED BY:
WORK IN
PROGRESS; - '�
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SEPTIC TANK PUMPED,SMASHED, FILLED WITNESSED [I YES ElNO
AS-BUILT:
INPUT: DATE:__ '
S/molloy/forms 2014 Town of South Windsor INPSFOftON 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 $25.00
BOUTIN AND SONS CONST Name of Firm Phone No.8 623 25_26
Address of Firm 12j W BROAD. BROOK CT 06016 Zip Code
Location of proposed work 7 3 A
Describe fully nature of permit requested REMOVE AN-D �� _�X?ST.ING
Starting date 116 _ Call Before You Dig Na 01 62104606
PLEASE NOTE`. THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A PRELIMINARY ESTIMATE. THE
APPLICANT 1S RESPONSIBLE FOR THE FULL FINAL COST OF THE PERMANENT PATCH AND CURB REPLACEMENT.INCLUDING ANY
INCREASES IN PATCH AREA,CURBLENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS, THE PERMANENT PATCH IS
TYPICALLY COMPLETED WITHIN,A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR
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Check Applicable: ❑ No Pavement,Curb or Sidewalk Cut ❑ Pavement Cut ❑ Curb'Cut ❑ Sidewalk Cute
-a Existing Driveway,No Changes ❑ Proposed Driveway Widening ❑•Proposed New Driveway
Water Supply: ❑ Public Water ❑ Well. Sewage Service: ❑ Public Sewer ❑ Septic
Show sketch of proposed work or furnish Indicate North This section to be fillers out by Town
two copies of separate drawing
No.cuts
Est. Patch Size(s) sf
Est. Pvt.Thickness in.
Est. Patch Unit Price$ Isf
Est.Patch Cost$
Est. Curb Replacement ft
Est.Curb Unit Price$ /ft
Est.Curb Cost$
Est.Sidewalk Replacement sf
Est.Sidewalk Unit Price$ Isf
Est.Sidewalk Cost
j
Est.Traffic Hours hr
Est.Traffic Unit Cost$ /hr
Est.Traffic Control.$
Amt.of Deposit$
DRIVEWAYS must be 3ft or more from the property line per Total Due$
section 2.17 of the zoning regulations
( )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 PE MIT MANUAL.
Signed: M —
Print N
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Street Excavation Permit 2014
BOUTIN & SONS PA COMPANY, INC.
121 Windsorville Road, Broad B k Connecticut 06016
Tel. (860) 623-2526
Date of Call: f"�`��f 1i� Scheduled Work Date:
Date of Estimate: Completion Date:
Date of Acceptance: 's" -J.
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Name: v
Address: A-1.� �,�'Y� •
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Tel: � � � � � -
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Job Location : Rip �
Description:.
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Quote Good fo 0 Days.
Special Attention: 1/2 Payment Upon Starting, Balance Upon Completion.
Contract - "/ Permit
ONE YEAR GUARANTEE ON WORKMANSHIP&MATERIALS. Pres.
CBUD �` �Vl Date