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HomeMy WebLinkAbout1026 Jackson St Town of Southold P.0 Box 1179 Southold, NY 11971 * * * RECEIPT * * * Date: 09/08/20 Receipt#: 274549 Quantity Transactions Reference Subtotal 1 Excavation Permits 1414 $550.00 Total Paid: $550.00 Notes: Payment Type Amount Paid By CK#27040 $550.00 Alternative, Cable Construction Inc. Southold Town Clerk's Office 53095 Main Road, PO Box 1179 Southold, NY 11971 Name: Alternative, Cable Construction Inc. 2 Cobblestone Court Farmingville, NY 11738 Clerk ID: LYNDAR Internal ID• 1414 1 Permit No. Vl �� RECEIVED TO)KN OF SOUi HOLD HIGHWAY DEPARTMENT , # Peconic Lane SEP - 4 2020 ti Peconic New York 11958 5 4 (631)765-3140Sou$hold Town ClerEt � � .�►�� ` y APPLICATION/PERMIT FOP ITI�T1BVAY EXC A17AT! N Al°—REPAIR APPLICATION IS HEREBY made to the Superintendent of Highways of the Town of Southold for the issuance of an Excavation Permit pursuant to Chapter 237 of the Code of the Town of Southold,Suffolk County,New York,and other applicable laws,ordinances or re-Antions for each individual contiguous excavation project herein described. The applicant agrees to comply with all applicable lar%rs, ordinances,codes and regulations,the attached"General Conditions of Permit"and"Special Conditions",if any and to permit authorized inspectors to make necessary inspections of the job site. Print or Tvpe ,- Acct Gal- cols - &R'gq Z C0G&gsf6ME 0001 1r4(e 1UJE W11 111M Name of Applicant/y, Phone Number - Address of Applicant 2. er �s 0.5 466\16 Name of Contractor Phone Number Address of Contractor 3. �1�r1 1 WA(W)A I b&. '.�Pj C_tc-j�jNs`i y lel Y�Lo � .i( Name of Property Owner Requesting Service(if applicable) Address of Owner 4. UAD 9)� PK i d2b Sf)bLC lCK s'. Cls 444 'S�f . Work Description and Location(Street Number,Hamlet,Cross Street) (a) Is construction located within 75 feet of tidal wetlands? *Yes No C *If yes,other Town permits may be required. NOTE: AN inforination requested uy ihi$ Signature of pplica:nt Application/;'er7iit;a7"dli is �� ��I�� Required for a complete application! Date 5. (a) Attached plot plan to reasonably and adequately describe the proposed work. Provide accurate schematic site plan showing the location of all proposed excavations and relationship to adjoining premises,public streets or areas,and give a detailed description of all site and pavement restoration work (b) Attach all other necessary permits and licenses for this project. (c) Work covered by this application may not commence before issuance of a Highway Excavation Permit by the Town Clerk. 6. Tax Map No.: District 1000 Section ` Block 16 q Lot 9 . 2-- 7. Staiung Date: 11�I `20 LU Completion Date: 8. Work Schedule: Phase f f Comiplo1ion Yate Excavation �l`�l�b�L Work Schedule Facility Installation y 2cw Must be provided Backfill&Completion q)L-1 2CL, for consideration as a Pavement Replacement I ci 2G2b _ U 1 S L1 i Complete Application. Ph OLL 15l. 9. Under which authority is application being made: See Town Code Chapter 237(E)-Provid Resolution by,or authority from,the Utility being modified. P 10. Estimated Cost of Proposed Work: Paw em (� 11. Remarks: 1 OCPO K& D OAA&W/ D�J l 0l� CW14 CRC-Xj? D-39 1 of 3 12. Insurance Coverage:(Attach Copy) 111J�A1L nce Vonlp�yll� (b) Policy#: (c),State whether policy of certification on file with the Highway Department: (d) Coverage required extended to the Town: Any Loss including Bodily injury,property or commercial ir.}u-v caused b cit'attributable to the Nvoflk pe:forma d: ip'.`L�zQVJ 17C:'Occurrence and $2,00C,000 general a3g-regate. ` 1 Securiq: (a)Surety Bend or Certified Check provided in the total Amount of$ (b)Maintenance Bond provided: 2 years or 3 years. 14. Fees for Applications and permits: Basic Applteation Fee fe:Each Project Location A Project Location would include each Bell Hole and/or every road opening or excavation within any 50'Radius whether or not they may be inter-connected by open trench or directional boring. The total number of Project Locations shall be subject to the approval of the Hig way Superintendent. Atr Al. 1 /Service Connections excavations @$50.00 P Uu ho A2. /Additional Excavations same service(cv$20.00 $ No. B. Trench Excavations 18"in depth or less Total Lineal Footage of Excavation; L.F.@$10 00 $ C. Trench Excavations 18"in depth to 5' in depth Total Lineal Footage of Exca v&fiat.; L.F.@;$30.00 $ D. Trench Excavations 5'in depth and over Total Lineal Footage of Excavation; L.F.@$50.00 $ E. Utility Repair Excavations @$1,000.00/Each $ No. Additional Repairs of Same Service @$500.00%Each $ No. r TOTAL$ �SSO F. Official Notice to public utilities-proof must be provided and Shall be attached to this application prior to issuance of permit. Authorization is hereby granted to the Town Clerk of the Town of Southold to issue a Highway xcavation permit to: Achedher this application and subject to the"General Conditions"and"Special Conditions"of permit(if nSUPERINTEND TOWN OF SOU Vincent kOrlin Z LIU o Lk Received by the Town Clerk Date Permit Issued ® �V Permit No. 1 NOTE: Permit expires one(1)year from date of issuance. h.v^yror;;w StuY"t y'itlivTtt 24 hC'1r nfitiw t�Supei'Intendeit cf 1flolhti:uyS. Permit must be available at all times for inspection,on site,during construction. Ti-'IQ 2 of 3 C Capt Distribution: I I Per- 4 _1 I ighway Depaa anent Engineer(with page 3) Applicant Twwn Clerk (Original) INSPECTvR°S RECORDS Inspection mate Findings (use code) Applicant Notified 1st 211LLa 3rd 01 (To Permit Clerk) REMARKS M1 CODE IB Inipro-per Marr.icades IL Improper Lights ST Stinken Trench or Excavation UTM Unable to'Measure(due to backfilling) BUC Building Under Construction WIP Work In Progress D'a unproper iBackfill(too high,not sufficient) f-fFS inspector Holding for Final Settlement of Excavation RFR Ready for Repair GENERAL CONDITIONS OF PERMIT APPLICATION/PERMIT FOR HIGHWAY EXCAVATION AND REPAIR , 1. Permittee's Contractors to Comply with Permit Requirements: The Permittee is responsible for informing its independent contractors,employees,agents and assigns of their responsibility to comply with this permit,including all special/site specific and general conditions imposed by the Highway Superintendent while acting as the permittee's agent with respect to the permitted activities,and such persons shall be required to comply_with all permit requirements. 2. No Right to Trespass or Interfere with Private Property Rights: This permit does not convey to the -permittee any right to trespass upon the lands of adjacent property owners in order to perform the permitted work nor does it authorize the impairment of any rights,title,or interest in real or personal property held or vested in a person not a party to the permit. 3. Protection of the Highway and Future Highway Maintenance: If future operations or highway maintenance projects by the Town of Southold require an alteration in the position of the utility,structure or work herein authorized,or if,in the opinion of the Highway Superintendent the work performed under this permit shall cause unreasonable obstruction to required highway maintenance or endanger the health, safety and/or welfare of vehicular or pedestrian traffic,this permit shall be revoked and the utility, structure,fill,excavation,or other modification of the highway hereby authorized shall not be completed. Additionally,the permit may be revoked if the Highway Superintendent finds that the issuance of the permit was illegal or unauthorized or that the applicant failed to comply with any of the terms and conditions of the permit or Chapter 237 of the Town Code. 4. Revocation of the Permit by the Highway Superintendent: If the Highway Superintendent deems it necessary to revoke this permit and the project hereby authorized has not been completed,the applicant shall,without expense to the Town and to such extent and in such time and manner as the Superintendent may require,remove all or any portion of the uncompleted utility,structure or fill,and restore the site to its former condition. 5. Notice of Commencement: At least 24 hours prior to commencement of the project,the permittee and/or contractor shall notify the Town Highway Department in writing that they are fully aware of and understand all terms and project conditions of this permit. Upon completion of the work,the contractor shall provide photographs of the completed work to the Town Highway Department and request a Final inspection. b. Storage of Equipment&Materials: The storage of construction equipment and/or materials shall be confined within the project work area and/or adjacent areas where permission/legal access has been obtained in a manner that does not interfere with normal highway traffic. 7. Utility Mark-Outs: The Applicant/Contractor shall be responsible for verification of all existing utility mark-outs and shall take all precautions to protect same. Damage to existing utilities shall be the responsibility of the contractor and shall be repaired at the contractor's expense. 8. Road Closures: All scheduled road closures must first receive written permission from the Southold Town Board prior to closing a road. Temporary lane closures may be permitted with the approval of the Highway Superintendent. This item will included but not be limited to the installation of appropriate signage and flag men to stop and start traffic to allow for single lane traffic. -Road Closures due to unforeseen emergencies require immediate notification of the Highway Department and shall be limited to immediate and/or expedited restoration of the Work Zone. 9. No Construction Debris in Road Shoulder Area: All Construction Debris shall be removed from the job site on a daily basis. All stockpiled soil as well as all other project materials that will be staged within the Right-of Way must be delineated with reflective signage or other means to meet the minimum requirements of the NYS DOT Construction Standards. GENERAL CONDITIONS OF PE+RINUT APni 1CAT TCII:*a/P5 Mo�lT F0 R RT=VAS EXCAy A T140-i A_i,;�..i YR-_AIR (Continued) intst;nil,Mft.i-ntaira 'F.rogtola Controls; Reqiiired Erosion Control Measuly-s (;.e. sih fencing) i5 to be p7ar�_-d on the downslope edge of any disturbed area. This sediment barrier is to be put in place before any disturbance of+tie ground occurs and is to be maintained/in good functional condition unt?1 thick vcgetativv cover is esiablis hed. 11. Clean Fill Only: All project back-fill shall consist of clean sand, gravel or soil (TOT asphalt,slag,flyash, �r enc ' Tete Ol' 1 i� l 1l unsuitable Oi excavated e t thea 'tom i de l,aA- g tc.) e t 1, Ok O.lc Or dein It10L deJ S�. A Salta 5 15 e ,.� i d a ,. Si...( . . C y,BOA, e ar O be removed from the site and not used to backfill any excavation within a Town Highway. 12. AN Areas (if Sol!Disturbance : Ali areas of soil disturbance resulting from the approved project shall be stabilized to the satisfaction or the Highway superintendent immediately following project completion. if the project site remains inactive for more than 48 hours or planting is impractical due to the season,-then the area shall be StabliiZed With Sti'a`JJ,hay mulch and/or jute ma hng until.'vveather conditions favor germination. �� fill 7,y 7 3. Bacir—A!&- Compaction of all Excavations. Back FM shad.consist of clean Sill or soils which ey LJlt a well-defined moisture density relationship as determined to be in accordance with AS IMD 695. fill shall be placed in maximum lifts of twelve (12")inches thick and shall be mechanically compacted to a Ninety- liive (75%)percent maximum diy dens:i y. Suitable hydraulic compaction by water jett ng at three-foot intervals will also be permitted subject to a project specific approval by the Highway Superintendent. 14. Restoration of the Read Shoulder Area: All man-made improvements located within existing road shoulder areas must be protected to the greatest extent practical. Items would include but not be limited to driveway&private road aprons,mail boxes, sprinkler systems,trees and ornamental plantings. Excavations through driveways and private road pavements dust be reconstructed to meet all requirements of Southold Town Highway Specifications. All pre-existing road shoulder improvements that have been disturbed during construction must be replaced or repaired by the contractor to the satisfaction of the Highway Superintendent. 15. Schematic Plans with all.Technical information and ScoL3e of Work: To reasonably and adequately describe the proposed work, accurate schematic site plans must be provided to show or indicate all proposed construction activity required under ibis permit. All Pavement surfaces scheduled for excavation must be saw cut to the Aill depth of asphalt and/or concrete pavements. Accurate size of bell holes or width of trenching must be indicated by dimension or labeling. This schematic site plan must provide details on all restoration required to meet the requirements of these General Conditions and requirements fourid in the Southold Town Highway Specifications. 16. Pavement Reconstruction: All Pavement sections must be reconstructed in the following manner; (Note:when Concrete Pavements are Present.Please review Restoration requirements with the Mghway Superintendent) a) Complete all back-fill&soil compaction work as needed to provide a suitable sub-base; b) Over-cut existing asphalt bell hole or trench by twelve(12")inches on all sides; c) Install a compacted lift of 4"thick Stone Blend base(RCA Blend must meet NYS DOT Specification_); d) Install a two and one half(2.5")inch compacted lift of Asphalt Base Course; e) Install a one and one half(1.5")inch of Asphalt(Type 6)Wearing Course. (Provide AC at all joints) All work listed herein must meet the minimum requirements of the Southold Town highway Specifications. 17. Trenching of Pavement Surfaces Exceeding One Hundred (1001 beet in Length: All trenching of pavement surfaces exceeding 100' in length must first be reconstructed to meet the requirements of Item # 16 as noted above. Once all pavement reconstruction is completed to the satisfaction of the Highway S i)erinteadent,the entire road section and/or width of road over the entire length of trench shall be repaved with a two (2")inch lift of Asphalt(Type 6)Wearing Course (Typical,shoulder to shoulder). , ' r jAr + i NIA I I o wI®r-, LO -Am&, (bb ),q I � I ► f