HomeMy WebLinkAboutMoores Ln N
Date: 11/07/01
Transaction(s):
1 Permits
Check#: 3754
Name:
Key, Span Energy
448 East Main Street
Patchogue. NY 11727
Clerk ID: L1NDAC
Town Of South old
P.O Box 1179
Southold, NY 11971
* * * RECEIPT * * *
Receipt#:
Total Paid:
(
*,lD
3754
Subtotal
$162.00
$162.00
Internal 10: 41778
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TOWN OPS;.l1;,'HOLD
HIGHWAY DEPARTMENT
Peconic La'ne
Peconlc;. New:"York .:t 1958
, (S.J6) 765'-3140
P. O. /boY- /7b.
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APPLICAT.ION/PERMIT FOR HIGHW'AY EXCAVATION AND REPAIR
. Ref. , Tl00095580
"-:
APPLICATION IS HEREBY made to t'h.~ Superintendent of Highways of the Town
of Southold for the Issuance of an Excav#,tlon Permit pursuant to Chapter 83 of the
Code of the Town of Southold, Suffolk C.,unty, New York, and other applicable laws,
ordinances or reglJlatlons for the excava.t1~n herein described. The applicant agrees
to comply with all applicable laws, ordinapces, codes and regulations, and to permit
. aut~ol;'ized inspectors to m1ake; necessarY.il~spections of the job site.
\.
Print or Type
1) KEYSPAN ENERGY DELIVERY
, Name of Applicant
-17S E. OLD COUNTRY RD. - mCKSVlLLE. NY 11801
Address
2)
Name or Owner of Premises
Address
3) (NEW HOUSE) _ MOORE'S LA. NO. & HOMESTEADY WAY - BELL HOLE W/S PAVED AREA AT THE NORTH
lNTERSECTlON OF HOMESTEAD WAY & A 360' TRENCH WESTERLY IN THE N/S GRASS AREA OF HOMESTEAD
WAY & A 30' TREN H NORTH IN THE W/S GRASS ON WESTWOO LA. IN REENPORT.
rK ue, p'tlon a l:5tT". u e ,Ra e, ross Street) "
",,',
(a) .\ fs construction 10J'llted within :jS,feet of tidal wetlands? 'Yes No X
*If yes, other!own permits::-~a-y be required. -
q) Builder's License No.
Plumber's License No.
,.,'
Electrician's' License No.
Other. Trade'
No.
...,
,'"
S) a) Attach plot plan showing locatio." ,of proposed,"el<cavatlon and relationship to
adjoining premises or public' stre.ets or areas, and giving a detailed descrip-
~ tion of I~yout of excavation. ....-:.
b) Attach all other necessary permhs 'and licenses for this project.
..,,'
c) Work covered by thisapplicatiG;;. may not commence before issuance of a
Highway Excavation Permit by:tl;1e Town Clerk.
6)
7)
8)
Tax Map: Section
BIQ~k
, Lot'
, t'ompletion Date
Starting Date:
Work Schedule: , .
Phase ')\ . Completion Date
Excavation. ... ... ... ... . .. . . "'~:~,';':'~\. .. .... ." ...... ..
Facility .Installation..........; ~;. ~. ~.................
Backfill & Compaction........ .:.....................
Pavement Replacement........ . . . . . . . . . . . . . . . . . . . .
9) Under which authority Is the applica.tlon made:
10) Estimated Cost of Proposed Work: "'r.
.: ,'~'
11)
Remarks:
\
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Pane 1 of :\
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........ .
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12)
Insurance Coveraqe:
. ;;~).
(Attach copyi.::r
Tl000955!
,
Insurance Company:
Poli cy D
State whether polley of cei;tJflcatlon on, file with the Highway Depart-
ment:
d) Coverage required extend~i:i:' to the Town:
,...
Bodily Injury and prope,!tydamage: $300,000/$500,000 Bodily Injury,
ard $50,000 property datjl'~ge.
aJ
b)
c)
13) Security:
a) Surety Bond or., Fertlfl~d Check provided In the
total amount of $ ,
b) Maintenance Bond provided" 2 years or 3 years
"
14) Fees for applications and permits: ,:; " " Basic Appllclition Fee........ $25. DO
AI. 1 /Servlce Connectlons\.xcavatlons 0 $20.00 = $ 20.00
Nii- " - -
O. L...
/Addltlonal Excavations same service @ $10.00 = $
No.-',.'
A2.
B.
Excavations 18" in depth ,o'r. '~Iess:
0-1.00 I.f. = $10.00 "'
./ I.f. @ $0.10 -:<$'-
Additional
'C. Excavatlons--l'8" in depth ,tei:,5' In depth:
0-100 I.f. =-$30.00"
390 I. f. @ $0.30 <$ 117.00
Adcfltionar' ,,-
D. Excavations 5' In depth all~ over:
0-100 I.f. = $50.00"
I.f. @ $0.50,;,:$
Additional
E.
Utility Repalr"Excavatlons 0$10. DO, = $
: .:~\-,::,
No.
....,
Repairs same ..,,,,,Ice'@ $5.00--= $
Additional
".--
F.
Notice to public 'utilities prciO( must be provided and
this application prior to Is~,uanceof permit.
,.:!'\.',.
* *.i;*:"~'
atta cf:>ed to
''-..'
,
TOTAL COl!'r-.J:., 1,62.00
.'.'
Authorization Is hereby granted to the Town
Issue a Highway Excavation Permit 'to:
in accordance with ""this application.
CI~ of the Town of Southold to
'I .s,!? o~ <t
,
St:lPERINTENDENT OF HIGHWAYS
Tg)vN OUTHOLD, NEW YORK
.:,;.<...., .
,
,
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//- 02- 01
Date
Received by the Town Clerk
/1 /~?
ate,:'
....../'~Permit No.
Note:
J/tft
Oft
Permit expires one (1) year (r.om Date of Issuance.
No work to start without 48 hQyr notice 'to the Stlperintendent of Highways.
Permit must be available for ,i1'lspectlon.
/:30-
Permit Issued,'
" ,"
Page 2 of 3
JCT-29'01IMONI U~55
BU GAS DESIGN PATCH~
TEL:516 7585136
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LOCA TIOt>l
~EASOt>l FOR
OPENING
W.O'/PA
NO.
REQUESTED
BY
APPRowro
SKETCH
KEYSPAN/~".r
REQUEST FOR STREET OPENING PERMIT
o STATE
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O SUFFOLK r;;l
COUNTY ~
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Date: 12/11/00
Transaction(s):
1 Permits
Check#: 1074
Name:
Key, Span Energy
448 East Main Street
Patchogue, NY 11727
Clerk 10: L1NDAC
Town Of Southold
P.O Box 1179
Southold, NY 11971
* * * RECEIPT * * *
Receipt#:
Total Paid:
1074
Subtotal
$151.50
$151.50
InternallD: 20655
permit' ~o;n,
File NO'~
TOWN OF' S,'U ,'HOLD
H IGHWA Y DEPARTMENT
Peconic La ne
Peconic, New York 11958
(516) 765c31IIO
Po.l2>o1- /75
Ref. 11,;J?f-/l'1 d.1
APPLICATION/PERMIT FOR HIGHWAY EXCAVATION AND 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 83 of the
Code of the Town of Southold, Suffolk County I New York, and other applicable laws,
ordinances or regulations for the excavation herein described. The applicant agrees
to comply with all applicable laws, ordinances, codes and regulations. and to permit
authorized inspectors to make: necessary <inspections of the job site.
Print or Type
1) KEY SPAN ENERGY 44R EAST MAIN STREET
Name of Applicant
PATCHOGUE. NEW YORK.
Address
11727
2)
Address
:;) '7 '" I /..II (J 6,- ,J '"
(Street Number I Hamlet, Cross Stre~)
LA
Name of Owner of Premises
3) Ne.1..J S<-.r'?",-IC. I+v-
Work Description and Location
(a)
Is construction located within 75 feet of tidal wetlands? *Yes No
*If yes, other~T~wn permits may be required.
4) Builder's License No.
Plumber's License No.
Electrician' 5 License No.
Other Trade's License No.
~eltK~
I L- b' U>
Date
5) a) Attach plot plan showing location of proposed- e:li(cavation and relationship to
adjoining premises or public streets or areas, and giving a detail.ed descrip-
tion of layout of excavation.
b) Attach all other necessary perrnits 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)
7)
Tax Map: Section
Block
, Lot
Starting Date:
Completion Date
8) Work Schedule:
Phase
'\,
Completion Date
Excavation...................... ...,..................
Fadl ity Installation.................................
Backfill & Compaction..............................
Pavement Replacement........ '.' ~............,......
9) Under which authority is the application made:
10) Estimated Cost of Proposed Work: $
11) Remarks:
\
0- 39
Paqe 1 of 3
'..
12) Insurance Coverage: (Attach copy)
a) Insurance Company:
b) Policy #
c) State whether policy of certification on file with the Highway Depart-
ment:
d) Coverage required extended to the Town:
Bodily injury and property damage: $300,000/$500,000 Bodily Injury,
and $50,000 property damage.
13) Security:
a) Surety Bond
total amount of $
b) Maintenance Bond provided:
or Certified Check
provided in the
2 years or
3 years
14)
Basic Application Fee........ $25. 00
excavations @ $20.00 = $ ;?o..o
Fees for applications and permits:
A 1. /Service Connections
~
A2. /Additional Excavations same service @ $10.00 ;::: $
~
B. Excavations 1811 in depth ()r less:
0-100 I.f. = $10.00
I.f. @ $0.10 - ,$
Additional
Excavations,"l8" in depth to 51
0-100 I. f. = $30.00
,...., - /
d "55 L f. @ $0.30 = $
Additional
D. Excavations 51 in depth and over:
0-100 I.f. = $50.00
I.f. @ $0.50 =, $
C.
in depth:
7r....S-U
Additional
E.
Utility Repair Excavations @$10.00 = $
No.
Repairs same service@ $5.00-:::: $
Additional
F. Notice to public utilities proof must be provided and attached to
this application prior to issuance of permit.
* * *
TOTAL con' $ J:>/. .s<-
Authorization is hereby granted to the Town Clerk of the Town of Southold to
issue a Highway Excavation Permit to:
in accordance with .this application.
ENDENT OF HIGHWAYS
SOUTHOLD, NEW YORK
Date
Received by the Town Clerk
/ ,J/It! 9-
[)'ate
NO'~
Permit Issued,' /02/11 / /)0
.Dat~
Permit
Note:
Permit expires one (1) year from Date of Issuance.
No work to start without 48 hour notice .to the Stl'perintendent of Highways.
Permit must be available for inspection.
~ on
Page 2 of 3
FC-6111.4
PERMIT
NO.
LOCATION
REASON FOR
OPENING
W.O.lPA
NO.
REQUESTED
BY
APPROVED
SKETCH
...
KEYSPAN/6-AS
REQUEST FOR STREET OPENING PERMIT
D STATE
D
1# Is
let/iN ~ HulL
NASSAU
COUNTY
MIS JOB
NO.
D SUFFOLK
COUNTY
. J7"~-;
DEPARTMENT
GAS CONSTR. MAl NT. & SERVICES
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