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255 Eagle Nest Ct
Town Of Southold P.O Box 1179 Southold, NY 11971 Date: 09/21/06 * * * RECEIPT * * * Receipt'8: 384 Transaction(s): 1 1 Permits Check~: 384 Reference Subtotal $15o.oo Total Paid: $150.00 Name: Verizon, Communications 501 N. Ocean Ave Fatchogue, NY 11772 Clerk ID: LINDAC Internal ID: 465 n~,'24/2005 FR! 16:27 6314470416 VERIZON 501 N OCEAN Per. It R£CEI¥~D APPL{.CA.TJON/pEPJ~I, !T. FOR HIGHWAY, E.X(~AVA*~ION AND R_F. PAIP-_ the $ erint~dent of HIgh~r~¥a of the Town APPLICT~TIDH !$.HELa. EI~Y. mad~e.~,~ ~ ~'~it 'purSuant .to .¢ ~out.~dd for the ,ssuanee o7 aha. ,~a,,~_.,_ ;...t~h... N~ York, and omar -- ---..~_- -~ .. ~ ~,thold. SUt~K V~.~'X. "--, .~' The at~Uc~nt agr~a .0 7) 5¥ Attach all arbor n,~ces~arY per~iL~ and II~ Car ~is'pmJ~t, Tax M~: S~ ~ B~ j ~t_ . Und~ whl~ ~u~orlty Is ~e appIl~h ~do:___ Estimated Cost ~ P~p0s~ Wor~: ~ - adk~inln~ pt, e~ls.e~.~,r public st.r~ets o s.r~c~ee~_s.~.-~ ;) ]o) . F~g~. 1 of' 3 6314470416 VERIZON 501 N OCEAN :35:46 09-20-2006 ]~/b~ '0§ '~I) ~-;]:~ r~-~ ~ ....... · ~2) Inauraflee CoVe.~: (Arch ~) ~ ~nd ~sO, O0~ p~Y ~ , a~ 5uroW B~d_~ ,. b) ~lnt~e~ ~nd pr~ld~: ~ '~ y~rs or ~ ymra . ~ ~~n F~ ........ Eo Ut~ib/ Repair 7/8 Aut~orll{tl~n Is hereby .g~nt---d t.o ..?.~ Town Cle'k of the ToWn of :~aue = HlqhWay Exc=n'~..Jolt .Pn~rm~. to._ ' - sUPERINTENDENT OF HIGHWAY~ Toff ~HoLD, N~ yORK ~e~r~ ~, Harris ' ReceiVe~ by the Town C~erk - p~r-r~;t issued ~' ~/-O~ Per~itNo.. Note: p~it ~plr~ one (1) y~r from D~e - " No work to ~ Wight ~ ~f not[~ to the 5uperlnt~d~t ~ Hl~wayS- Pe~*must be available for n~P · page 2 of 3 pqGE,~S ~o~ ~'~ ~ ~:oa c~ TO 6878512 ~ .~.~ P.01/01 6314470416 VERIZON 501 N OCEAN :3515 09-20~2006 518~ ._~ ..-.: . .,:.~ '),.~ . . ' . Di Mgr Mike Maresc~ I ~,,,~e ~..~/ ~20 t r~. ~ -~o/-~h ~., Date: ~'ff' ~ Tel#:.2-?~" Tech Name: Requesting Field Manager: ~o/~,,~. ~'/-T-FN #: ~2_c~3-_<'.~c-FrN: B.C. -7C c.o. ~ Office Tel #: -;7~7,~ _~ Emergency ? ,C,.yes no (~//'/~/~__//~, LOCATION Address: ¢--5~' ~¢"~r~ /t~L~'1- ~ Town: Out of Service ?..'-¢~ yes no Cross Street: (.~+¢... ~",~z. ~)¢-... EQUIPMENT & MANPOWER REQUIREMENTS, Laborers: ~ Compressor: Backhoe: Trencher: Sneaker: Missile: v''/' Other: 'indicate north Work Needed: - TOTAL PAGE.01 ** 6314470416 VEPdZON 501 N OCEAN [ns~or Applicant T~n Clerk 2nd__ AppliCant NQ CODE lB = Imprc~:.er barri~d~ iL -Impr~r I~h~ BUC - Bulld;~ u~ ~n~ WlP - Work in'p~;s (~t ~uf~d DB - -Imp~ ~1' [~ high) of ~vat~n HFS -' In~P~ h~din~ for final c~t , , FPGE. ~