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Home My WebLink About635 Soundview Ave ExtTown Of Southold P.O Box 1179 Southold, NY 11971 * * * RECEIPT * * * Date: 11/08/04 Transaction(s): 1 Permits Receipt#: 4152 Subtotal $45.00 Check#: 4152 Total Paid: $45.00 Name: Keyspan, Energy - Gas Cont Dept 175 E Old County Rd Hicksville, NY 11801 Clerk ID: LINDAC Internal ID: 101651 Permit No. File No. TOWN OF SOUTHOLD HIGHWAY DEPARTMENT Peconic Lane Peconic, New York 11958 (631) 765-3140 APPLICATION/PERMIT FOR HIGHWAY EXCAVATION AND REPAIR Re£#T100439439 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 regulations for the excavation herein described. The applicant agrees to comply with all applicable laws, ordinances, ~odes 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. - H1CKSVILLE~ NY 11801 Name of Applicant 2) 635 Soundview Avenue Ext.~ Southold Name of Owner of Premises 3) 4) Builder's License No. Electrician's License No. s) Address Address Soundview Avenue ExL - s/s Soundview Avenue Ext. ~ 570' e/o Lighthouse Road to install a gas service to #635 Work Description and Location (Street Number, Hamlet, Cross Street) (a) Is construction located within 75 feet of tidal wetlands? *Yes No X *If yes, other Town permits may be required. Plumber's License No. ~'Signat~t~ 1.0ozf~4Appl~antg ' Date a) Attach 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 maynot commencebeforeissuanceofaHighwayExcavationPermit by the Town Clerk. 6) Tax Map: Section , Block 7) Starting Date: Completion Date: 8) Work Schedule: Phase Excavation ......................................................................... Facility Installation ............................................................... Backfill & Compaction ......................................................... Pavement Replacement ......................................................... 9) Under which authority is the application made: 10) Estimated Cost of Proposed Work: $ 11) Remarks: , Lot Completion Date D-39 Page 1 of 3 T100439439 12) Insurance Coverage: (Attach Copy) a) Insurance Company: b) Policy # c) State whether 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 or Certified Check provided in the total amount of $ b) Maintenance Bonded provided: 2 years or 3 years 14) Fees for applications and permits: Basic Application Fee ................. $25.00 Al. 1 /Service Connections excavations ~ $20.00 = $ 20.00 No. A2. __/Additional Excavations same service @ $10.00 = No. B. Excavations 18" in depth or less: 0-100 1. f. = $10.00 l.f. ~ $0.10 = $ Additional Excavations 18" in depth to 5' in depth: 0-100 l.f. = $30.00 = __ 1.f. ~ $0.30 = Additional D. Excavations 5' in depth and over: 0-100 hf. = $50.00 I.f. @ $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 $45.00 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. r~ O~OJ/~D, NE~W/t/YpRK Peter W. Harris Date Received by the Town Clerk '//~tt/O ~'~ Permit Issued J ~ Permit No. Note: Permit expires one (1) year from Date of Issuance. No work to start withou148 hour notice to the Superintendent of Highways. Permit must be available for inspection. I)-39 Page 2 of 3 Copy Distribution: Highway Department Inspector Applicant Town Clerk INSPECTOR'S RECORD Inspection Date 3rd Findings(usecode) 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 WlP - Work in Progress DB - Improper backfill (too high) (not sufficient) HFS - Inspector holding for final settlement of excavation RFR- Ready to Repair D-39 Page 3 of 3 PERMIT APPLICATION SKETCH DATE: LOCATION: WORK ~ I 1~2]g4 12:89:4.3 PM 63.5 SOUND VIEW AV EXT SOUTHCIiD V~LLAGE OF CRO~ ~r~l~lCT: LIOHT HOUSE RD ~'RFACE: ~5 4 x,~ B~I1 Hole SOUND VIEWAv EXT Town Of Southold P.O Box 1179 Southold, NY 11971 Date: 08/08/05 * * * RECEIPT * * * Receipt~: 5296 Transaction(s): 1 1 Permits Reference Subtotal 396 $170.00 Check#: 5296 Total Paid: $170.00 Name: Keyspan, Energy - Gas Cont Dept 175 E Old Country Rd Hicksville, NY 11801 Clerk ID: LINDAC Internal ID: 396 Permit No. File No. TOWN OF SOUTHOLD HIGHWAY DEPARTMENT Peeonic Lane Peconic, New York 11958 (631) 765-3140 APPLICATION/PERMIT FOR HIGHWAY EXCAVATION AND REPAIR Re£#T100526845 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 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 oftbe job site. Print or Type 1) KEYSPAN ENERGY - GAS CONSTR. DEPT. - 175 E. OLD COUNTRY RD. - H1CKSVILLE~ NY 11801 Name of Applicant Address 2) 635 Soundview Avenue Ext., Southold Name of Owner of Premises Address 3) Soundview Avenue Ext- 4'X4' belihole on the s/s of Soundview Avenue Ext~ 570' e/o Liohhouse Road, for a sas service to #635 4) 4) Builder'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 X *If yes, other Town permits may be required. Plumber's License No. Othe~T~de's License ~ fJ [ Sign/a4~re of al~lica~t ' L,/ {/ 07-20-05 Date 5) a) At~ach 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) At~ach 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: 0) Work Schedule: Phase Excavation ......................................................................... Facility Installation ............................................................... Backfill & Compaction ......................................................... Pavement Replacement ......................................................... Completion Date 9) Under which authority is the application made: 10) Estimated Cost of Proposed Work: $ 11) Remarks: D-39 Page I of 3 T100526845 12) Insurance Coverage: (Attach Copy) a) Insurance Company: b) Policy # c) State whether 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 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 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.fi = Additional Iff @ .30 = D. Excavations 5' in depth and over: 0-100 1.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 prior to issuance of perrmt.. 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. SLrPE~.II~T~DENT OF HIGHWAYS Received by the Town Clerk ~(/O~ ~ ¢ Date Pe~it NO. 3 ~ & Pe~it lssu~ Note: Pe~it expires one (I) ye~ from Date of hsuance. No work to s~a ~thout 48 hour notice ~ the Sup~nt~d~t of Highways. P~it must ~ available for in~ecfion. D-39 P~ge 2 of 3 Coov Distribution: Highway Department Inspector Applicant Town Clerk INSPECTOR'S RECORD Inspection Date ist 3ra 4* Findings(usecode) 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 WlP - Work in Progress DB - Improper backfill (too high) (not sufficient) HFS - Inspector holding for final settlement of excavation RFR - Ready to Repair D-39 Page 3 of 3 ~ PF_~MIT APPLICATION SKETCH DATE: LOCATION: TOWN: WOP, K ORDER: 7f20f200 J 11:3~ :05 AM 635 SOUNDVIEW AVEEXT SOUTHOLD T100526~45 VILLAGE OF CROSS STREET: MGHTHOUSE RD ~/RFACE: M~c~da~ Ro~d House NO. ~0' 4 x 4' l~ell Hole SOUNDVIEWAVE EXT