HomeMy WebLinkAbout1800 Aldrich LnDate: 07/12/06
Town Of Southold
P.O Box 1179
Southold, NY 11971
* * * RECEIPT * * *
Receipt'8: 329
Transaction(s):
1 1
Permits
Reference Subtotal
450 $150.00
Check~: 329
Total Paid: $150.00
Name:
Verizon, Communications
501 N. Ocean Ave
Patchogue, NY 11772
Clerk ID: LINDAC Internal ID: 450
03/24/2006 FRI 16:27 FAX
TOWN OF SOUTHOLD
HIGHWAY DEPARTMENt' ·
peconl~
p~m~c; ~ York
lo)
11!
~AFPL?A'~".IONIP£P-MIT FOR NIGHWAY. I~cGAyAT'ION AND REpAI~
S HE~£BY' made to.th P . (::ha r 83 of the
APPLICATION I ...... ~:~* Permit p~r~uant to pre
thoJd for the york and ot P .
0¢ So~ - . .~ Southold, Suffolk ~ty. Ne~_ ,~-~ The a~l~lcant agrees
Cede of th~ TOW:, v- . . .L- -a~lo6 hereln oe~c.n~eu ..... ·
b) A~ch ~11 ot~r ~es~ per~ and Ii.sm for ~is'p~J~t.
. ~.~a~ by ~ aPPli~ ~Y ~t ~m~n~ before
' c) Highway Ex~vn~o~ Pe~lt ~ ~a Town CI~K. .
. ~ Tax Map: S~I~ .~'
7) Sta~ing Date:~ C~pietio~ ~te _ - ,
8~ Work ~ch~ui~:
P~.
Fa~ll~ lns~lle~oA ................................. '" "'*
Page. ! ~f 3
P~GE.~4
03/24/2006 FR[ 16:z8 UA~
,'06 ~-~ 13:55 F~. 631 786 6[45
~: (Attach c~r) ..
a) Tnsur3nca C~rnpany:
c) S~e whaler ~l[~y ~f ce~ifl~tloh on fil~ with ~e H~ghwa~ ~'
~ge r~uir~d ~[~d~ ~ the Town:
B~lly tnJu~ snd p~pe~y ~gc=
an~ SS0, OOE pretty
~urlty:
a) Sure~ Bond
b) ~lnt~a~e ~nd pravid~:
for ~ppli~tions and permit~:
A2. /Addi~a[ Ex~a~ons ~me se~l~
AdUTti~
E- Ut~i~ Rcpalr
~i~ ~me ~e~ice
AuthorizAtion Is hercby granted to the Town Clerk of the ToWn of S6u'&o~d
IsSue = Hlghwa~ Ex~vat~ pe~it 'to:
In'a~an~ with
~eter ~, Harris
RecetWed by the Town Clerk 7//~'Z//D
p~;t I~U~Date
' ~ ires one (1) y~ f~m D~e of
~i~rk ~; ~ wight . ~u( ,otlce to the ~uperlnt~d~t ~ Highways-
pem~'mus~ be available for
page 2 of 3
P~GE.05
03/24/2006 FHI 16:28 FAX
~/03' '06,WED 13:57 FA[ 63[ 785 6145
sOLTItOLD TO~ cLERK
~ UU3
Highway Department
Appll¢=nt
To~n Clerk
2nd
~'d
i.~H,s p E C T O R',5 R E C O R D
Applicant Notified
RE,LARKS
CODE
lB - Improper barri~.~d~
IL -.Improper ll~ts
~ - Sun~n ~ ~ ~Y~tio~ ......
UTM Unable to m~su~ (due to
BUC - Bulldln~ under ~n~
WIP - Work
DB Impm~ ~it ' [~ high) (~t
HFS -' I~r h~dlng for ~1 s~t of ~vat~n
RPE - R~ to repair
0-39
Page 3 of 3
Verizon
EMERGENCY PERMIT REQUEST
In the East Fax Completed Form to:
Permit #
Karen
Fax # (631) 687-8512
Foreman: William Temme
Office Phone: (631} 924-9924
Cell Phone: (516) 672-0621
Beeper: .NONE Address:
Tech: EC# G
TT~/Job# ~- ~
Central Office:
Tax Distr~gt: .5~_~c
Town:
*Specify:~sut.
(C~l~
Info ,rmafion Required: /
1. Distance to nearest cross street
2. Opening in -Dirt - Road - Sidewalk i~) ~ c--~-
3. Size of o
4. Called for Tone and Marking Yes
Case #
5. Give exact location of splice pit (in~nt of house #)
6. Emergency Yes ~
7. Out of Service
8. TempOrary Service ~ No (.~,,
North Arrow ** Mark dig location with an
~nd revision If addi~ionial pit~ are dug.