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Home My WebLink About19995 Soundview AveTown of Southold P.O Box 1179 Southold, NY 11971 Date: 09/08/10 * * * RECEIPT * * * Receipt~: 91654 Transaction(s): 1 1 Permits Reference Subtotal 671 $200.00 Check#: 1196 Total Paid: $200.00 Name: L, IPA 117 Doctor's Path Riverhead, NY 11901 Clerk ID: LINDAC Internal ID: 671 T101157228 TOWN OF SOUTHOLD HIGHWAY DEPARTMENT RECEIVED P.O. Box 178 Peconic, NewYork 11958 ~:~_{~ 8 2010 (631)765-3140 Soulhol~ Town APPLICATION / PERMIT FOR HIGHWAY EXCAVATION AND RE~i~" APPLICATION IS HEREBY made to the Superintendent of Highways of the Town of Southold for the issuance of an Excavation Permi 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 excavation herein described. The applicant agrees to comply with all applicable laws, ordinances, codes and regulations, and to perm/t authorized inspectm-s to make necessary inspections of the job site. Print or Type LIPA 117 Doctors Path, Riverhead, NY 11901 1. 'Name of Applicant Address of Applicant Russell Mc Call - 19995 Soundview Avenue, Southold 2. Name of Owner of Prem/ses Address of Owner a 4'X8' bellhole on the S/S of Chardonnay Drive 380' e/of Chablis Path. 3. ~ 1'×50' t. rench across Chardonnay Drive 380' e/of Chablis Path Work Description and Location (Stxeet Number, Hamlet, Cross Street) (a) Is construction located within 75 feet of tidal wetlands? * Yes No ·If yes, other Town permits may be required. 4. Builder's License No. Plumber's License No. Electrician's License No. Other Trade's License No. · / - -- /~ Signature o'~'~pplicant 8/26/10 Date (a) Attached plot plan showing location of proposed excavation and relationship to adjoining premises or public slzeet or areas, and giving a detailed description of layout of excavation. (b) Attach all other necessary perm/ts 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. TaxMapNo.: Section 1000 .,Block 51 ,Lot 03-4.10 7. Starting Date: Completion Date: 8. Work Schedule: Phase Completion Date Excavation Facility Installation Backfill & Completion Pavement Replacement 9. Under which authority is application being made: 10. Estimated Cost of Proposed Work: $ 1 I. Remarks: D-39 1 of 3 12. /~urance Coverage: (Attach Copy) (a) Insurance Company: (b) Policy#: i (c) State whethe~ policy of certification on file with the Highway Department: (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 (b) Maintenance Bond provided: 14. Fees for Applications and permits: Basic Application Fee or Certified Check 2 years or Al. / /Service Connections excavations ~ $20.00 No. A2. ' / Additional Excavations same service ~ $10.00 No. B. Exc:avations 18" in depth or less 0-100 i.f. -- $10.00; Additional i.f. @ $0. I 0 C. Excavations 18" in depth to 5' in depth 0-100 i.f. = $30.00; Additional i.f. ~ $0.30 D. Excavations 5 ~n depth and over 0-100 i.f. = $50.00 Additional i.f. ~ $0.50 provided in the total Amount of $ 3 years. $150.00 $ 7_~>. ~:~ $ $ No. Additional Utility Repair Excavations ~ $10.00 Repairs same service @ $5.00 $ $ TOTAL Notice to public utilities proofmnst be provided and attached to fl'tis application prior to issuance of penrfit. Authorization is hereby granted to the Town Clerk of the Town of Southold to issue a Highway Excavation perm/~ to: in accordance 'Mth this application. Date Received by the Town Clerk Date Permit Issued Permit No. ~ 7/ SUPERINTENDENT OF HIGHWAYS (~,:.~Peter W. Harris Date NOTE: Permit expkes one (1) year from date of issuance. No work to start without 48 hour notice to Superintendent of Highways. Perm/t must be available for inspection. D-39 2 of 3 C~opy Distribution: Highway Department Engineer (with page 3) ' Applicant Town Clerk (Original) 1St 2nd 4th Inspection Date INSPECTOR'S RECORDS Findings (use code) REMARKS Applicant Notified (To Permit Clerk) CODE IB Improper Barricades IL Improper Lights ST Sunken Trench or Excavation UTM Unable to Measure (due to backfilling) BUC Building Under Construction WIP Work In Progress DB Improper Backfill (too high, not sufficient) HFS Inspector Holding for Final Settlement of Excavation RFR Ready for Repair D-39 3 of 3 N THIS WORK ORDER IS REQUIRED FOR A NEW ELECTRIC SERVICE OFF CHARDONNAY DR.,SOUTHOLD, LIPA TO INSTALL A 37 KVA GRP.169 BG TRANSFORMER, LIPA TO INSTALL 50' 2C#2ALXLPE DB-PRI. & 50' OF 3/0 ClC. * "Mark Out Required" * "Caution underground facilities in area as per facilities maps" 9 PROJECT NAME LOT~ & LOT~2 CHARDONNAY DR COMMUNITY SO(JTHOLD JOB SUPT Ron Sacher PHONEf 793-3404 ORID~10713 ITAX DIST. 1300 SERVICE REQ'D BY PERMIT BY lipA YES · NO0 EASEMENTS BY UPA YES 0 NOl~lI CAW YES 0 PRIMARY VOLTAGE 13.2K¥~ 4KvO ClRCUITf 8./-d85 I R/PE PREPARED BY: CIUBRASI 8-11-10 APPROVED A I BY: PHONE~ 631-548-7234, CUSTOMER INSTALLED SECONDARY AND H-FRAME. EXISTING BGt~851 EXISTING GRP- 169 ~ KVA 75 GRP-169 BUSS//4998 ~Nsr,~ 2 ~ p~. w/~ Et~C~OfllC KVA 75 ~s ~ BUSS~5958 GRASs AREA ~ +-3~0'~ CUR~ UNE ~ GRASs AREA INSTALL GRP-169 KVA 57 BUSS#1151 VOLTS 120/240 HWY rLOT#I NEW-HOUSE PROPERTY-LINE~ ~ LOT#2 CONST. ~0~ AREA 58 1 ASSOC. I ORDERS W.O.~l T101157228 NYT CO RE:F,~ ~OB# B f ELECmlC/UNIT~ILOAD DATA II~GAS./UNIT LOAD CONDI'nON~ CUST. CONI~IBU~ON REQ. YES · NO0 NYT CO ~'.ue~c.f ENG. UPA LEAD 0 N.Y.T LEAD 0 UPA ONLY · Town of Southold P.O Box 1179 Southold, NY 11971 Date: 10/29/10 * * * RECEIPT * * * Receipt~: 93701 Transaction(a): 1 1 Permi~ Reference Subtotal 676 $192.00 Check~: 1200 Total Paid: $192.00 Name: L, IPA 117 Doctor's Path Riverhead, NY 11901 Clerk ID: LYNDAR Internal ID: 676 V~rrv~.t No. ~'-/~ TOWN OF SOUTHOLD HIGHWAY DEPARTMENT P.O. Box 178 Peconic, New York 11958 (631)765-3140 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 Perrm 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 excavation herein described. The applicant agrees to comply with all applicable laws, ordinances, codes and regulations, and to ~ermit authorized inspectors to make necessary inspections of the job site. Print or Type LIPA 117 Doctors Path, RJ_verhead, IqY 11901 1. 'Name of AppliCant Address of Applicant Russell Mc Call - 19995 Soundview Avenue, Southold Name of Ownei of Premises Address of Owner see attached sheet V~ork Descriptibn and Location (Street Number, Hamlet, Cross Stree0 (at Is constyuction located within 75 feet of tidal wetlands? * Yes No *If yes, other Town permits may be required. Builder's LicenSe No. Plumber's License No. Electrician's License No. Other Tmde's License No. Date 9/23/10 (a) Attached pl0t plan showing location of proposed excavation and relationship to adjoining premises or public street or areas, and giving a detailed description of layout of excavation. (b) Attach all other necessary perm/ts 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. Tax Map No.: Section 1000 , Block 51 , Lot 03-4.10 7. Starting Date: Completion Date: 8. Work Schedule: Phase Excavation Facility Installation Backfill & Completion Pavement Replacement Completion Date 9. Under which authority is application being made: 10. Estimated Cost of Proposed Work: $ 11. Remarks: D-39 1 of 3 Revised permit 1) a 4' x 8' bellhole on the southside of Chardonnay Drive, 335' east of Chablis Path. 2) a 1' x 30' trench across Chardonnay Drive, 335' east of Chablis Path. 3) a 1' x 75' trench on the north side of Chardonnay Drive, trench to start 335' east of Chablis Path then trenching in an east direction for 75'. 4) a 1' x 35' trench across Chardonnay Drive, 410' east of Chablis Path on edge of pavement. 1,2. 'Insurance Coverage: (Attach Copy) (a) 'Insurance Company: (b) Policy #: (c) State whether policy of certification on ~e with the Highway Department: (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 (b) Maintenance Bond provided: i4. Fees for Applications andpennits: or Ce~ified Check 2 years or provided in the total Amount of $ 3 years. Basic Application Fee $150.00 Al. __/Service Connections excavations ~ $20.00 No. A2. __/Additional Excavations same service ~ $10.00 No~ B. Excavations 18" in depth or less 0-100 i.f. = $10.00; Additional i.f. ~ $0.10 $ $ C. Excavations 18" in depth to 5' in depth 0-100 i.f. = $30.00; Additional /'//c""fl /' i.f. ~ $0.30 D. Excavations 5' in depth and over 0-100 i.f. = $50.00; Additional i.f. ~ $0.50 No. Additional Utility Repair Excavations ~ $10.00 Repairs same service @ $5.00 Notice to public utilities proof must be provided and 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 Excavation permk to: in accordance with this application. Date Received by the Town Clerk~P a~ [~0 '~}'~~O Date Permit Issued ~0 ~c,~ -I O Perm/t No. SUPERINTENDENT OF HIGHWAYS TOWN ~D~fRK Date NOTE: Perafit expires one (1) year from date of issuance. No work to start without 48 hour notice to Superintendent of Highways. Perm/t must be available for inspection. D-39 2 of 3 Copy Distribution: Highway Department Engineer (with page 3)~ Applicant Town Clerk (Original) 1st 2nd 3rd 4th Inspection Date INSPECTOR'S RECORDS Findings (use code) REMARKS Applicant Notified (To Permit Clerk) CODE IB Improper Barricades IL Improper Lights ST Sunken Trench or Excavation UTM Unable to Measure (due to backfilling) BUC Building Under Construction WIP Work In Progress DB Improper Backfill (too high, not sufficien0 HFS Inspector Holding for Final Settlement of Excavation RFR Ready for Repair D-39 3 of 3 N THIS WORK ORDER IS REQUIRED FOR A NEW ELECTRIC SERVICE OFF CHARDONNAY DR.,SOUTHOLD, LIPA TO INSTALL A .37 KVA GRP. 169 BG TRANSFORMER, LIPA TO INSTALL 60' 2C#2ALXLPE OB-PRI. & 185' OF .3/0 CIC. * "Mark Out Required" * "Caution underground facilities in area as per facilities maps" 9 EXISTING EXISTING cRP- ~ 6g ~ KVA 7.5 GRP- 169 BUSS#4998 KVA 75 BUSS#sg58 GRASS AREA CURB - 2C~I2AL----_.__. CHARDONNAY DR INSTALL GRP'169 KVA 57 8USS#6106 VOLTS120/240 HWY 75' IN AREA) GRASS AREA EXISTING BG#851~8 GRP-169 KVA57 BUSS#5526 PROJECT NAME LOT#I & LOTi~2 CHARDONNAY DR COMMUNITY SOU 31-1OLD lOB SUPT Ron Sacher PHONEi~ 793-3404 GRID~10714 ]TAX DIST. 1300 SER~ICE REQ'D BY PERMIT BY UPA YES · NO0 EASEMENTS BY UPA YES 0 NO CAW YES 0 NO· PRIMARY VOLTAGE 13.2K'V~ 4KvO ~IRCUITi~ 8./'-685 I R/p~I PREPARED ! 9- 21 -I 0 BY: CIUBRASI APPROVED BY: PHONE~I 631-54-8-7234 CONST. AREA 58 W.O.# T101157228 NYT CO JOB# LOAD DATA LOAD CONDI]IONt~ RE',.CUST' C&,¢$U'",O0"o NYT CO ENG, UPA LEAD 0 N.Y.T LEAD 0 UPA ONLY · CUSTOMER INSTALLED SECONDARY AND H-FRAME. LOT#1 NEW-HOUSE PROPERTY-LINE~ (" LOT#2