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Home My WebLink About11 Osprey Nest RdDate: 05/16/06 Town Of Southold P.O Box 1179 Southold, NY 11971 * * * RECEIPT * * * Receipt'g: 317 Transaction(s): 1 1 Permits 1 1 Permits 1 1 Permits Reference Subtotal 448 $150.00 447 $150.00 446 $150.00 Check#: 317 Total Paid: $450.00 Name: Verizon, Communications 501N. Ocean Ave Patchogue, NY 11772 Clerk ID: LYNDAB Internal ID: 448 TOWN OF SOUTHOLD HIGHWAY DEPARTMENT. Pecenlc Lane pe~onlc: NeW York 1,19S9; .A~LI.CA'~ION/PERM!T FOR HIGH~AY, F..XGA¥^'T, ION AND REPAIR, APPLICATION I$ HEEEI~Y made re.the Superlnte~dent ef Highways ~ ~e Town ~ld for t~ is~n~ ef ~ ~tie~ P~it 'p~m~nt to char 83 ....... ~ --..-~/d Suf~k ~. N~ Yo~ and 0th~ appli~e laws, ~ or ~ 10w~ u. ~.~ ,_ -- _.._- .... ~n d~b~ The ~pli~nt mmp~ wi~ all appli~ble laW~, or~n~s~ ~ a~ ~la~fl~ and to ~z~ Insp~ors ~ ~ke] ~ry insp~ions of ~e i~ a~. Print er Typ~. I~aml¢ of Applicant 2~ Address --Name of Owner'~f premise~ Werlr..}Descriptien arid' I_~:atlon (Street Number: Hamlet, Cro~s StreeLI ~J aL¢ y~, ot~ Town ~1~ ~Y ~ r~ulr~. ~) gu;Idds ~]cen~ Ho. pl~ Li~e No. .. El~r;~a6~ ~c~;e No. Other Tradgs Li~n~ ~ of la--'of ~vatlon. b) A~ch all ot~r ~es~ per~ and IJ~s~ for ~is'pmJ~t, ' c) ' ~ .,~e~ by ~ appli~fl mY ~t ~m~ before ~n~ of a Highway Ex~va~ofl Petit ~ ~e Town Cl~k. · 6] Tax Map: S~l~ . BIo~ , .., 7) Sta~ing Date: C~pletloh ~te . , 8J Work Sch~ule: ~v~nt Rapidest Und~ which au~orlty I~ ~ appll~h ~) 10) E~tlmated Cost of Proposed Work:: . 11) Re~arks: D*3~ Pag~ ! of 3 PRGE.04 6314A7~116 , , VERIZON 501 N OCEAN 1/0,1~*06 ~*E~) 3.3:58 F,Lq: 631 7ss e[¢.~ .-- .di,1~4,:4.4_._ 05-09-2006 4/5 1~ _Security: a) Surety Bond o~ C=rtlfiea Check pr~,id~ed In'the total a[nm4nt M $ b) ~ln~a~e ~nd p~vld~: 'Z y~rs or ,.] ~r~, for appIl~tlohs and ~i~: ~ ....... }150.00 A2. IA~i~al Ex~a6ons Ex~va~s le' in d~.ar 0-100 I,f. = $10.~a' C. ~V~ lr' in d~th to ~ in d~h: E. Utili~ Repair ~v~ehs ~O0, ~ S -- F. HQta~ ~ ~lic'~ili~ pr~f ~ls'a~li~6o* prior ~ i~an~ AuU~orlzalUon Is hereby granted to t~e Tovm Clerk s~ a Highly Ex~ ~mlt 'to: TOW ~H rear Re~eNed by the Town Clerk ~-1(~-(~ Date Date P~rmit expires one {~} yc~r .fr~m. O~ o,f. [l~.uan_ce._ ...... ~--' of Highways- Permit 'mus~ be evailal=le for Ingpf~'ci~, Page, 2 of 3 ~RR ~4 20g~ 15:~ P~GE.05 ~ay 4, 2006 8:43AM Notification of Request For EmerGency Permit Eastern Suffolk, MUST f-ax completed form to: Elizabeth Brady Fax # (631) Village: State Road ~ Count~ Road ~'-]Vlllage Road Out of Service r--] Tamp Service No, 6188 ?, ~ I.nformation R.eq, uired: 2. Distance tO, neareSt cross street " {P. /~f'P .~ , '. ~::.', >. - L . , · , 4. Excavating op:~che=k one)' ~' I'Sld~lk~Road ' ~G~ss ~ · ,-,'. NOT~'-...,. ~o~ worR belng pe~o~ed l~ ~e tow~ of ~rookhaven, ... [ , .... ~ :,.,~..:,,~,....~, ... ,., ~ ~.-.. ..... I ~ ...... '[* ....~-'~ .,. ..... I~. , 1~~'' H~Y ~4 2~6 88:49 PRGE.~5