HomeMy WebLinkAbout595 Nutmeg Rd N - Permit, Inspection Report, Application, & Drawing - 5-13-191900053
11 f'MIT NUMBER
TOWN OF SOUTH WINDSOR, CT
STREET CUT PUBLIC UTILITY
DATE: 05/13/2019
GIS ID: 65100595
MUNIS APPLICATION # 201900944
APPLICANT
NAME: EVERSOURCE
ADDRESS: 112 PROSPECT HILL ROAD
EAST WINDSOR, CT 06088
PHONE
WORK DESCRIPTION: CUT AND CAP STUB AT MAIN
FEE: 50.00
EXPIRATION DATE: 05/12/2020
LOCATION
ADDRESS: 595 NUTMEG ROAD
OWNER: WALDO BROS COMPANY
202 SOUTHHAMPTON ST
APPLICANT AGREES TO FURNISH THE TOWN OF SOUTH WINDSOR THE AMOUNTOFBOND 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 W INDSOR'S STREET CUT PERMIT MANUAL.
G /Yh9// 1)IA 120 � t // I
ISSUED BY DATE INSPECTED INSPECTED BY
5/13/2019 11:43 AM
*** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
S/m6lloygorms 2014 Town of South Windsor INPStMON REPORT 14
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.D G1�S CONTRACTOR: r� �� a
:_ >�
LOCATION:
TYPE OF WORK: C M
DATE INSP NEEDED: DATE INSP.i l „ i �T
INSPECTED BY: s3r�
WORK IN
PROGRESS: ✓�So�'� ce �1 C"�Y` n s
i 5*a t✓ Men
SEPTIC TANK PUMPED, SMASHED, FILLED_ _—WITNESSED El YES El N0
AS -BUILT:
INPUT:
DATE: Q
S/moltoy/forms 2014 Town of South Windsor INPSELf ON REPORT 14
,I. No.
Name of Firm
Address of Firm
Location of proposed
APPLICATION FOR STREET EXCAVATION PERMIT
TOWN OF SOUTH WINDSOR PUBLIC WORKS DEPARTMENT Permit No.
TOWN HALL 1540 SULLIVAN AVENUE SOUTH WINDSOR, CT 06074 FEE $50.00
Describe fully nature of permit
Starting date Call Before You Dig No A0t j1 f Q b X3 q
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: El No Pavement, Curb or Sidewalk Cut ❑ Pavement Cut E�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 Indirate North
This section to be filled out by Town
two copies of separate drawing
No. cuts
0
Est. Patch Sizes) sf
Est. Pvt. Thickness in.
Tires �T�
Est. Patch Unit Price $ !sf
Est. Patch Cost $
Est. Curb Replacement It
Est. Curb Unit Price
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 $
DRIVEWAYS must be aft or more from the property line per
Amt. of Deposit $
section 2.17 of the zoning regulations
Total Due $
Applicant is responsible for contacting the Police Dept. and C.B.Y.D
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES
( ) Cash ( ) Check #
Paid By
I AGREE TO FURNISH TO THE TOWN OF SOUTH WINDSOR THE AMUUNI Uh UUNU RtUUmtU ANu iU ntiMcunbt int iuvvn ur owin vvmuaun run Wvi
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 AN R ULATIONS FO APE MITS AS OUTLINED IN THE TOWN OF SOUTH[cWINDSOR'S STREET CUT PERMIT MANUAL.
Signed: /' Print Name G(� * A&Vt5/ ILV Date: �3
Engineering/permits/Street Exca tion Permit 2017
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The material contained on this mop Title:
shall be considered proprietary to
Eversource Energy and user (which is
sal,defined purchase,
any person 9 , gift,
9 �® ' �y `� e . ��
who has received the ma through Information shown is not guaranteed and Eversource Ener V 'L`j V
sale, se) steal exchange, i in on or 9 9Y
otherwise) shall keep o in confidence assumes no responsibility. Contractors are urged to coil ENERGY
and shall not furnish or disclose it Eversource Energy for further information at 7-800-989-0900
to any third party without the prior
written permission of Eversouce Energy. Plotted: 30—Apr-2019 I By: gisewrl