HomeMy WebLinkAboutCrown Land Ln & Spur Rd
Date: 10/02/03
Transaction(s):
,
1 Permits
Check#: 2120
Town Of Southold
P.O Box 1179
Southold, NY 11971
* * * RECEIPT * * *
Receipt#:
Total Paid:
Name:
Keyspan, Energy. Gas Cont Dept
175 E Old County Rd
Hicksville, NY 11801
Clerk ID: L1NDAC
2120
Subtotal
$171.00
$171.00
InternallD: 82522
~I~E No.048 09/25 '03 08:16
ID:
H1X:
PAGE
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TOWN OF SOUTH OLD
HIGHWAY DEPARTMENT
Peconic Lane
Pe<:onic, New York 11 958
(631) 765-3140
APPLICA nONIPERMIT FOR HIGHWAY EXCA V A nON AND REPAIR
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Ref.#Tl00305S0S
APPLICA nON IS HEREBY made to tb~ S"peri.ce.ndent of fliahwIYIIi (J( lhe Town of S"uthold tOt the luuante "f
an Enlvatio" Pennlt punuaat ro Chaptu 83 oftbe Code ofthe Town of SouCbold, Suffolk: CpuntY, New York, and other
.ppUuble law$, prdinanCf;S or reiuladaps for tbe excavation herein described. Th4t .ppU~nt agrees Co tlImply' with all
.pplicatll~ 'aw~ ordlaaReM, ,pdta &nd regulatiQn$, and to permit authorUcd inspecton to mak43 nt(;~r)' Inspection!J of tbCl
jolt site.
Print or Tvne
I) KEYSPAN ENERGY - GAS CONSTR. DEPT. -175 E. OI.,D COUNTRY RD. - HICKSVIU.K NY 11801
Name of Applicant Add1"1l$"
2) Crown Land Lane IlL Spur Road, CUlebog.e
Namet of OWuer of PremiU:$
Addre$:11
3) CrOWD L...ILane &. SDur Road-. 420' trench in the eJs PraiS area of Crown Land La.. And across th. tift
Sour Road and a It&t trench in the s/s 2r8s& area ofSDur Rd. and a 211' trench in the navement D2nllel to curh
alonS! tbe dratnue sumo to a'VoId bmD to instan Pas: mains and ..rvlee
Work Dac:ripflO. aDd Loeathnt (SJr'UtNumber, Ramlet, Cross Street)
<a> .. ~nstl'lkctloD lantod. witlQ.Q 75 feet of tidal wttl..ncb? .Ves
*'fyes, otber Town permitl may be requited.
No_X_
4) BaUdec's Uceosc: No.
Plamber'. Licease No.
Elec.tric:ian's LiceQse No.
Oilier Trade'. I.,lcen.. No.
SigDatlll'e ut Applicanl
08-19--03
Date
5) a) Attach plot plao alIowine 1....1100 of proposed e~""valloD and relatioaship to adjoining premis<s or
public meets Or areas, and giving a detailed dC$criplion of laYOUt of ....vatio..
h) AtIllcb aU other ueccnary perlDilS aad IIceosco for tbis pcojeel,
c) Work covered by this application may oot commenee before i$&~aue. of a Higbway Excavation Permit
by lbe Town CIeri<.
6) Tax Map' Section
1) Staning Dal.'
8) Work Scbedal.:
, Block
. Lot
Completion Date:
fII!!!! ComDletio. Date
Excavatio.. .........................................................................
FaciliC)" Installatioa.. ... ............ ...... ... ........... .... ........ .OJ...... '0__
lla<kfjll "eo.......'"'..........................................................
P."emea.t ReplacotnCltf... ....... ....." ................ ...... ..... ,.,......"....
9) UDder wbleb autbority is Ihe applleallon made:
to) EsIImated Cosl nfProposed Work: 5
II) Remarks:
12) Insurance Coveraee: (Attach Copy)
a) Insurance Company:
b) Policy #
c) State whether policy of celtification on file with the Highway Department:
d) Coverage reqUired extended to the Town:
Bodily injury and property damage: S300,OOo/S500,()()() Bodily Iqjury. and S50.()()() property damage
. FIlE ~Jo.048 119/25 '03 08:16
ID:
FAX:
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a) Surety Bond or Certified Check
of5
b) Maintenance Bonded provided: 2 years or
Pagl! 1 01'3
T1 00305505
3 years
provided in the total amount
14) Fees for a,pDlications and oermil<: Basic Application Fee .. ........... .... $15.00
AI. _1_/SelVice Connections exc.Vlltions@ 520.00 ~ $20.00
A2. ---,Additional Excavations same service@ 510.00 ~ S
No.
B. Excavations 1&" in depm or less:
0.1001.f.; SIO.OO-
I.f @ SO.10 ~
Additional
C. Excavations 18" in depth to 5' in depth:
0-100 J.f, = $30.00
320 J.f @ SO.30; $96.00
Additional
D. Excavations 5' in depm and o""r:
0.100 I.f = 550.00
IJ. @SO.50=5
Additional
E.
Utility Repair Excavation. @ $\0.00 ~ 5
No.
Repairs same liOnlice @ $5.00 ~ S
Additional
. . .
F, Notice to public utilities proof must be provided and .ttached to this application prior to issuance of
permit.
TOTAL COST 5171.00
PAGE
3/ 10
Authoriution is bereby granted to !he Town Clerk of Ihc Town of Southold to issue a Highway Ex.cavarion Permit to:
KEYSPAN ENERGY DELIVERY in lCCOtd>nee with this application.
Received by the Town Clerk
Permit Issued c; 1.J.!>foJ
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Permit No.
o2cfO
~: Permil expires one (J) year ftom Date of biSWllU;t:. No WQ(k 10 'tMn witholol-l48 hour norice to thf: S~n~dt3:nt of HighWl)/S,
Permit must Ix: available for in:lp<Clion.
11-39
Page Z of3
. ,cILE ~Jo,048 09/25 '0308:16 ID: FAX:
AUG, cIS' 03J~lONI 10:02 SU GAS DESIGN PATCH TEL:516 i585136
KEYSPAo/6AS
REQUEST,FOA STReET OPENING P,ERMIT
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FAX: PAGE 6/ 10
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I' FILE No.~8 09/25 '0308:16
ID:
FAX:
PAGE
2/ 10
Permit No.
{9)
FileNo.
TOWN OF SOUTHOLD
IDGHW AY DEPARTMENT
Peconit Lane
PecoDie. New York 11958
(631) 765-3140
APPLICATIONIPERMIT FOR. IDGHW AY EXCJ\ V ATION AND R.EPAlR
Ref.#Tl 00305585
APPUCA nON IS IlElU:lIY made to the S.peri....d.... or lIiabw.Y' or lbe Tow. of SouthOld for tbe Iu..... of
.. t.....lio. l'ermlt pan.OIIIIO CIlapter 83 or tbe Code or tbe To... ofSo.tbold, S.ffolt Co.at)!. Now Yorl<, ..d other
*ppUc.able lawt, ontm.aaces or replatioD' for dae tlCl-vatioa berd. dcaeribed. TbO' .ppU~Dt agr", to eQmp!y with all
applieabJ~ taws. ordlDa~ ~ a"d rq:glatioM, and to permit audaari#4 iMpec:ton to make: ~I')' Inspection, of tbe
jot;lsi.te.
Prio. or Tvoe
J) KtYSPAN ENERGY - GAS CONSTR. DEPT. - J7S E. OLD COUNTRY RD. - HlCKSVlLLF.. NY \1801
1'1.... of Applicant Add....
2) Crown Laud Wae ill Spur Road, Cutebogue
N~ ofOwaer of Pr~
Address
3) CrowllWnJWnelll. SDarRo.d-. 420' treocb iD t~e efs....... ....of Crown Land La. ADd across the i/.
SDur Road md a 198' treaeb iD the sit moass area of Sour Rd. and a 211' trench in the navemeut oaralle. to eurh
.IOD. tbe drat.He suma to avoid bUD to instan P'U mains and serviee
Wo,k l>OO<ripti.. .ad L.",tio. (StrtotN.mber, RamleI, Cro.. Street)
(.) .. .........etto. loc.ted wilbio 75 feel or tidal wttlonds? "Y..
"'fy... other Towa pe'mit> may be ,....Ired.
No_X_
4) BoUde,'s Lleea.. No.
Plumb,,', Licease No.
E1ectridaa's Licease No.
Olber Tnde's License No.
SigDature of Applieallt
08-19-03
Dale
S) a) Altaeb plot plall showiogloeatloa of proposed enavatloa aad rel_tioasbip to adjoi.iD~ premises or
pubUc streets Or ar.... a.d givio~ a detailed descriptio. of layout of escavatioa.
b) Attacb an olber Deeenary perlDits aad Uc..... for Ibis p,ojee!.
c) Work eovered by Ibis appUcatioa may .ot.ommeau before issuanee of a Higbway Excavation Permit
by tbe Towa Clerk.
6) Tas Map' Seetioa
1) Starting Date'
8) Work Sehedale'
,Block
. Lot
Completion Date:
fII!!!! Comuletion Pate
Excavatiotll ..... ......., ......... ...... ...... _... ............... ...... ........... '0_
F.ciUI)' Jatalladoa.. ...... ........ ....... .0' ........... ....... ..... ...... .... ..._
Backfill &. Comp............. ...... ...... ....... ......._ _.u...... ..........
P.l'emea.t Replacotneq~....... ,., .... 0".... ............n... n.... .... ,.__
9) Uader wbleh autbority is tbe appllcatloa _de:
10) EstImated Coat of Proposed Work: S
II) Remarks:
F.I~E No.0~8 09/25 '03 08:16
lD:
FAX:
PAGE
3/ 10
1l-39
Page 1 ofJ
T1 00305505
12) Insurance Coverage: (Anach Copy)
0) loslll'llnce Company:
b) Poliey #
c) State whether policy of cenificalion on file with the Highway Department:
d) COverage rc<lllired exumded to the Town:
Bodily ugury and property damage: 5300,00015500,000 Bodily Il\iury. and 550,000 property damage.
Ll)~:
a) Surely Bond or Certified Check
of5
b) Main_ce Bonded provided: 2 years or
provided in the total amo..t
3 years
14) Fees for ,,!,Dlications and oennilS: Basie AIlllUe2110n Fee ................. $25,00
AI. _I--'Service COnnections excavations @ 520.00 ~ 520,00
A2, ~Addirional Excavations same service @510,ooa 5
No.
a. Excavations 1 g" in depth or less:
0-100 I.t.; $10.00-
1.1'@$O.lO=
Additional
C. Excavations 18" in depth to 5' in depth:
0-100 I.f. ~ 530.00
120 1.1' @ SO.30 = $96.00
Additional
D. Excavations 5' in depth and over;
0-100 I.f. = $50.00
IJ. @50.50=5
Additional
E.
Utilily Repair Excavations @ 510.00 ~ $
No.
Additional
Repairs same service @ $5,00 ~ 5
F. Notice to public utilities proof must be provided and attached 10 this appliOlllion prior to issuance of
permit.
. . .
TOTAL COST 5171.00
AuthoriU.UOo i~ hereby araated 'tQ the Town C1etk of the To'Nll of Southold to ismc .. Highway ExeavariOJl Permir to:
KEVSPAN ENERGY DELTVERY in aooordanee willl Illi. opplication.
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Received by the Town Clerk
P~lwued 9/~~fD~
9) ()::s /1>3 ..
Date .
P~INo.
02~
~; fermitcxpircs one (1) year tram Due of b:SUaDI;C:, No wwL: to IiWt withou~ 48 hour notice to t~ Superintandtltlt of llighWSl.)'S.
Permh must be amiable rot inopection.
1).39
Page 2 of3
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F'Il:E No,Otl8 09/25 '0308:16 ID: FAX: PAGE 5/ 10
AUG. -la' 031MONI 10:02 BU GAS DESIGN PATCH TEL:516 i5&5]36 P.004
. !<EYsPAo/'6As
REQUEST FOR &TRE OPENING PERMIT.
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AUG. -18' 03IMON) 10:02 BU GAS DESIGN PATCH
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