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Home My WebLink About405 Sound RdDate: 09/14/06 Town Of Southold P.O Box 1179 Southold, NY 11971 * * * RECEIPT * * * Receipt: 7242 Transaction(s): I 1 Permits Reference Subtotal 464 $170.00 Check~: 7242 Total Paid: $170.00 Name: Keyspan, Energy - Gas Cont Dept 175 E Old Country Rd Hicksville, NY 11801 Clerk ID: LINDAC Internal ID: 464 Permit No. File No. RECEi~/,.O TOWN OF SOUTHOLD HIGHWAY DEPARTMENT PeconieLane SEP ] 4 2006 Peconic, New York 11958 (631) 765-3140 Sou~to~d T~¥;n Clerk APPLICATION/PERMIT FOR HIGH3VAY EXCAVATION AND REPAIR Re£#T100673220 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, New York, and other applicable laws, ordinances or regutstions for the excavation herein de~crthed. The applicant agrees to comply with all applicable laws, ordinance.n, codes and regulations, and to permit authorized inspectors to make necessary inspections of the job site. Print or Type 1) KEYSPAN ENERGY - GAS CONSTR. DEPT. - 175 E. OLD COUNTRY RD. - HICKSVILLE. NY 11801 Name of Applicant 2) 405 Sound Road, Greenport Address Name of Owner of Premises Address 3) Sound Road - beilhole on the W/s 125' s/o Sutton Place to install a gas service to #405 Sound Rd. 4) 4)Buiider's License No~ Electrician's License No. ' Work Description and Location (Street Number, Hamlet, Cross Street) (a) Is construction located within 75 feet of tidal wetlands? *Yes No *If yes, other Town permits may be required. Plumber's License No. Other Trade's License No. Signature of~Applica~t 09-11-06 Date 5) a) ARach plot plan showing location of proposed excavation and relationship to adjoining premises or public streets or areas, and giving a detailed description of layout of excavation. 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: Section .,Block ~ Lot 7) Starting Date: Completion Date: 8) Work Schedule: Phase Excavation ......................................................................... Pavement Replacement ......................................................... 9~ Under which authority is the application made: Completion Date 10) Estimated Cost of Proposed Work: $ !1) Remarks: W.O. #T100660593 12) Insurance Coverage (Attach Copy) a) Insurance Company: b) Policy # c) State whether policy ofceffffication on file with the Highway Depamnant: 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 or Certified Check provided in the total amount of $ b) Maintenance Bonded provided: 2 years or 3 years 14) Fees for applications and hermits: Basic Application Fee Al. I /Service Connections excavations ~ $20.00 = $20.00 $150.00 A2. /Additional Excavations same service ~ $10.00 = No. B. Excavations 18" in depth or less: 0-100 l.f. = $10.00 - i.f. @ $0.10 = Additional Excavations 18" in depth to 5' in depth: 0-100 l.f. = Additional If. ~ .30 = D. Excavations 5' in depth and over: 0-100 l.f. = $50.00 1.~ @ $0.50 = $ Additional 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 ptior to issuance of permit. TOTAL COST = $170.00 Authorization is hereby granted to the Town Clerk of the Town of Southold to issue a Highway Excavation Permit to: KEYSPAN ENERGY DELIVERY in accordance with this application. SUPERINTENDENT OF HIGHWAYS TOWN,.,th'~IYI'HOLD, NEV~ YORK Peter W. Harris Date Received by the Town Clerk ~ - / ~/- 19 (- Permitlssued ~,_ / fT/-O~' Date PermitNo. Note: Permit expires one (1) year from Date of Issuance. No work to start without 48 hour notice to the Superintendent of Highways. Permit must be available for inspection. D-39 Page 2 of 3 Copy Distribution: Highway Department Inspector Applicant Town Clerk INSPECTOR'S RECORD Inspection Date 1~t 2nd 3rd Findings (use code) Applicant Notified (To Permit Clerk) REMARKS 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 ofexcavation RFR- Ready to Repair D-39 Page 3 of 3 ~EYSPAN GAS CONSTR KEYSPAN REQUEST FOR STREET OPENING PERMIT 631 ?58 5136 P.04 PERMIT LOCATION STATE ~ NASSAU COUNTY ~ SUFFOLK COUNT MIS JOB ,....,~, DEPkRTMENT GAS CONSTR. MAINT. & SERVICES REASON FOR OPENING W.O.IPA NO. REQUESTED BY APPROVED SKETCH DATE OF DIVISION DATE N Town Of Southold P.O Box 1179 Southold, NY 11971 Date: 04/08/09 * * * RECEIPT * * * Receipl~: 44898 Transaction(s): 1 1 Permits Reference Subtotal 621 $170.00 Check-#:16948 Total Paid: $170.00 Name: National, Grid - Gas Constr. Dept 175 E Old Country Rd Hicksville NY 11801 Clerk ID: LINDAC Internal ID: 621 Permit No. File No. TOWN OF SOUTHOLD RECEIVED HIGHWAY DEPARTMENT Peconic Lane Peconic, New York 11958 (631) 765-3140 /~[:,~! 7 2009 APPLICATION/PERMIT FOR HIGHWAY EXCAVATION AND REPAIR ReE.#T100963204 APPLICATION IS HEREBY made to the Superintendent of Highways of the Town of South#Id for the issuance of an Excavation Permit pursuant to Chapter 83 of thc Code of the Town of South#Id, 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 permit authorized inspectors to make necessary inspections of the job site. Print or Type 1) NATIONAL GRID - GAS CONSTR. DEPT. - 175 E. OLD COUNTRY RD. - HICKSVILLE~ NY 11801 Name of Applicant Address 2) 405 Sound Road Greenport Owner of Premises Address 3) 4) 5) 6) 7) 1-4'x4' bellhole on the W/s (grass area)~ of Sound Rd.~ approx. 250' n/o C. IL 048~ to install a gas service. tidal wetlands? *Yes No X *If yes, other Town permits may be required. Builder's License No. Plumber's License No. Electrician's License No. Other Trade's License No. Date 5) a) Attach plot plan showing location of pr#posed excavation and relationship to adjoining premises or public streets or areas, and giving a detailed description of layout of excavation. 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: Section ,Block 7) Starting Date: Completion Date: 8) Work Schedule: , Lot Phase Excavation ......................................................................... Facility Installation ............................................................... Backfill & Compaction ......................................................... Pavement Replacement ......................................................... Completion Date 9) Under which authority is the application made: 10) Estimated Cost of Pr#posed Work: $ 11) Remarks: 12) Insurance Coverage (Attach Copy) a) Insurance Company: b) Policy # c) State whether policy of certification on file with the Highway Deparlment: d) Coverage required extended to the Town: 13) Security: a) Bodily injury and property damage: $300,000/$500,000 Bodily Injury, and $50,000 property damage. Surety Bond or Certified Check provided in the total amount of $ b) Maintenance Bonded provided: 2 years or 3 years 14) Fees for annlications and permits: Basic Application Fee $150.00 Al. I /Service Connections excavations ~ $20.00 = $20.00 A2. /Additional Excavations same service ~ $10.00 = No. B. Excavations 18" in depth or less: 0-100 l.f. = $10.00 - l.f. ~ $0.10 = Additional Excavations 18" in depth to 5' in depth: 0-100 I.f. = Additional If. ~ .30 = D. Excavations 5' in depth and over: 0-100 l.f. = $50.00 if. @ $0.50 = $ Additional 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. TOTAL COST = $170.00 Received by the Town Clerk L?'/- 7 - O ~' Permit Issued /7/ - ~"- 0 ~ Date Permit No. ~ ,x~ / Authorization is hereby granted to the Town Clerk of the Town of Southold to issue a Highway Excavation Permit to: KEYSPAN ENERGY DELIVERY in accordance with this application. SU,~Z~DENT OF HIGHWAYS Peter W. Harris lo ? Not~e: Permit expires one (1) year from Date of Issuance. No work to start without 48 hour notice to the Superintendent of Highways. Permit must be available for inspection. D-39 Page2of3 Copy Distribution: Highway Department Inspector Applicant Town Clerk INSPECTOR'S RECORD Inspection Date 3rd 4th Findings (use code) Applicant Notified (To Permit Clerk) REMARKS 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 ofexcavation RFR- Ready to Repair D-39 Page 3 of 3 MAR-29-2009 NO. LOOATION APPROVED 8KETCH 08:29 KEYSPAN GAS CONSTR 631 ?58 51J6 P.02 REQUEST FOR STREET OPENING PERMIT ~'t STATE ' ~'] NA,SSAU · COUNTY ~ SUFFOLK I GAS ~STR. MAINT. & SERVICE8 DATE I "f'- TOTAL P.02