HomeMy WebLinkAbout650 Eagles Nest Ct
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Date: 10/18/01
Transaction(s):
Name:
Clerk ID: L YNDAB
1 Permits
Check#: 3728
Key, Span Energy
448 East Main Street
Patchogue, NY 11727
Town Of Southold
P.O Box 1179
Southold, NY 11971
* * * RECEIPT * * *
Receipt#:
Total Paid:
'" 11J'?
~
3728
Subtotal
$45.00
$45.00
IntemallD: 41326
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File No. \~ 'b
Ref.
TOWN OF'Si,(J1'HOLD
HIGHWAY DEPA~TMENT
Peconic " Lane
Peconic,. New.~ York .t1958
(~16) 765c31 qO
P.o. f2,o~ 176
J..
APPLICATION/PE~MIT FO~ HIGHWAY EXCAVATION AND ~EPAI~
g TI00094734
APPLICATION IS HE~EBY made to the 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 County, New York, and other applicable laws,
ordinances or regulations for the excavat,~n heretn described. The applicant agrees
to comply with all applicable laws, ordina~'~s, codes and regulations, and to permit
aut~orlzed inspectors to make; necessary<~.~spections of the job site.
\,
Print or Type
1) KEY SPAN ENERGY
Name of Applicant
175 E. Old.Country Rd.. Hicksville. NY 11801
. Address
2)
Name of Owner of Premises
Address
3)
650 EAGLES NEST CT. - LAUREL
Work Des!,ription and Location (Street, Number, Hamlet, Cross Street)
".",
(a) \fs construction J~pted withii1\7S:,feet of tl~al wetlands7 *Yes_No X
*If yes. other-Iown permits .:J1\ay be required.
4) Builder's License No.
Plumber's License No.
Electrician's License No.
5) a) Attach plot plan showing locatlo,n ,of' proposed,'elrcavation and relationship to
adjoining premises or public' stre,ets or areas, and giving a detailed descrlp-
~ tion of layout of excavation. .: :';
b) Atfach all other necessary perm~~'s and licenses for this project.
c) Work covered by this 'applicatIO.~. may not commence before issuance of a
Highway Excavation Permit by ,.tlJe Town Clerk.
6) Tax Map: Section
Block
, Lot'
7) Starting Date:
10/26/01
, Completion Date
11/26/01
8) Work Schedule: ,,'
\. ~ '\. Completion Date
.:..\
Excavation.................. ,;"~.'~ .';..................
, \,
Facility Installation. .........;:...,.................
Backfill & Compaction........:.....................
Pavement Replacement........ . . . . . . . . . . . . . . . . . . .
9) . Under which authority is the applieatlon made:
10) Estimated Cost of Proposed Work: :"$'
11) Remarks: BELL HOLE N/S GRASS AREA APPROX., 755' W/O wmTE EAGLE DR.
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12)
Insurance Coveraqe: (Attach
a) Insurance Company:
b) Policy t
c) State whether policy
ment:
copy ).\ '
Tl00094734
",
of cer,tJflcatlon on. file with the Highway Depart-
d) Coverage required extend~'~':to the Town:
Bodily Injury and prope.i;~y damage: $300,000/$500,000 Bodily Injury,
and $50,000 property da')'~ge.
13)
Security:
a) Surety Bond
total amount of $
b) Maintenance Bond
or, Fertifled Check
provided in the
3 years
2 years or
provided"
14) Fees for applications and permits: ":. " Basic Application Fee........ $25.00
AI. 1 /Servlce Connections',:excavatlons @ $20.00 = $ 20.00
~
A2. /Addltional Excavations same service @ $10.00 = $
~
i3. Excavations 18" in depth or, 'less:
0-100 l.f. = $10.00 >"
.... I.f. @ $0.10 -'_~$';'
Additional
. c. Excavations.-~111" in depth. -19 :.51 in depth:
0-100 I.f. =.$30.00
I.f. @ $0.30 <$
Additional
D. Excavations 5' In depth and over:
0-100 I.f. = $50.00
l.f. @ $0.50 7'$-
Additional
45.00 '
E.
Utility Repair":Excavations @$10.00, = $
No.
."-;
Repairs same service '@ $5.00..= $
.--
Additional
F. Notice to public 'utilities prciof must be provided and attacl)edto
this application prior to Is.llance of permit.
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* *' :-*,"?
,
TOTAL COST: 9
.." .
Authorization is hereby granted to the Town Clerk of the Town of Southold to
Issue a Higl'lway Excavation Permit to: ~e..\1 ,""Ol".n
in accordance wlth,thls application. .,'> \ 1
.....,.
SljlPER INTENDENT OF H lGHWA YS
TOWN SOUTHOLD" NEW YORK
.;:':,;:
Received by the Town Clerk
\O~tO\
ate _:.'
Permit Issued,'
10\ Vl'>\cn
Date \
,.'.'
,Permit No. 133
~:
Permit expires one (1) year fr.cim Date of Issuance.
No work to start without 48 h()~r notice .to the S"perintendent of Highways.
Per,mlt must be available for 'h,"pectlon.
Page 2 of 3
n ,"
Copy Distribution:
Highway Department
Inspector
Applicant
Town Clerk
I nspection Date
1st
,:'
INS P E C TOR ':5
.-t"
.,:'
R E COR D
Findings {use code)
.-
2nd
3rd
J.
4th
,/
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REMARk~
CODE
'.
, -
Tl00094734
Applicant Notified
(To Permit Clerk)
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IB - Improper barricades
IL - Improper 1ight~\
ST - Sunken trenc!l{..,~'r\ excavation
UTM - Unable to measure (due to backfilling)
BUC - BUIlding unde,.:. CO'lstructlon -
WIP - Work In' progress
DB - -Improper bacl(flli' (too high) (not sufficient)
HFS - Inspector holqlng for final settlement of excavation
RFR - Ready to rep8lr'
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KEYSPAN/&A..r
REQUEST FOR STREET OPENING PERMIT
FC-6111.4
D STATE
D
NASSAU
COUNTY
D SUFFOLK
COUNTY
~ S"~71IDlJ:)
PEN'6~IT ~~ JOBI1ooo94734
LOCATION ~~U:. ;I&s'r 6-'; ~ ~#1t'L- f//f~. ~
R~~~~~~OR .&. f!:> U);h 'Ii. ~ ~,t. (Iv U-t.du.
W.OJPA FOREMAN
NO.
REQUESTED
BY
o)C
I ~ II __ DEPARTMENT
VJ;..! ..Jc.RtI./Z- GASCONSTR. L.-Z,)
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APPROVED
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