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Home My WebLink About630 Dean Dr * * * RECEIPT * * * Date: 07/01/14 Receipt#: 173570 Quantity Transactions Reference Subtotal 1 Excavation Permits 945 $150.00 Total Paid: $150.00 Notes: Payment Type Amount Paid By CK# $150.00 Keyspan, Inc Ed & C Eastern Suffolk Name: Keyspan, Inc Ed & C Eastern Suffolk Po Box 750 Bridgehampton, NY 11932 Clerk ID: LYNDAR Internal ID:945 Permit No. TOWN OF SOt1'tHO1,D O�FFa ie, 111G14WAY DEPARTMENT PSEG WO T1O1616775 Peconic Lane A. k. Peconic, New York 11958 0 ' (631)765-3140 APPLICATION/PERMIT FOR HIGHWAY EXCAVATION AND REPAIR APPLICATION IS HEREBY made to the Superintendent of Highways of the Town of Southold for the issuance of an Excavation Pennit pursuant to Chapter 237 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,the attached"General Conditions of Permit'and"Special Conditions", if any and to permit authorized inspectors to make necessary inspections of the job site. Print opc Long Island Lighting Company d/b/a LIPA I. through its agent,Long Island Electric Name of Ap Utility Servco LLC and PSEG Long Island Address of Applicant 117 Doctors Path 2. Riverhead,NY 11901 Name of Coi... Address of Contractor 3. ___Cody.-_630_ Dean_Drive . Cutchog-ue ,NY 11935 Name of Property Owner Requesting Service(if applicable) Address of Owner Directionally drill starting on N/S New Suffolk Av intersection }' 4. _ D n__Dr,*__ s.o,uth on _W1S -DeanDr 750_' in dirt grass . ..N_o paving regd . 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. NOTE; All information requested by this igignature of Applicant Application/Permit Form is Required for a complete application! June 20, 2014 Date 5. (a) Attached plot plan to reasonably and adequately describe the proposed work, Provide accurate schematic site plan showing the location of all proposed excavations and relationship to adjoining premises,public streets or areas,and give a detailed description of all site and pavement restoration work. (b) Attach all other necessary pen-nits 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. G. Tax Map No.: District 1000Section_eL,L� Block__w.. Lot—,___ 7. Starting Date: � _�_gl yt 201 I Completion Date: (9� .3c)U- 20 ISO 7 -�- --- -- f— 8. Work Schedule: Phase Com letion Date Excavation Tic (, Work Schedule Facility P Installation �� Must be provided ._.__ - -�y- — Backfill&Completion �lnc / �'" for consideration as a Pavement Replacement 5.0 Complete Application. 9. Under which authority is application being made: See Town Code Chapter 237(E)-Provide Resolution by,or authority from,the Utility being modified. 10. Esti mated Cost of Proposed Work: 11. Re marks: D-39 1 of 3 500/To0n XKd ZS ".6 Rtd VTOZ/OZ/90 12. Ins urance Coverage:(Attach Copy) (a) Insurance Company: (b) Policy 4: (c) State whether policy of certification on file with the Highway Department, (d)Coverage required extended to the Town: Any Loss including Bodily injury,property or commercial injury caused by or attributable to the work performed: $1,000,000 per Occurrence and$2,000,000 general aggregate. 13. SeCUrit y: (a)Surety Bond_ _ or Certified Check provided in the total Amount of$ (b)Maintenance Bond provided:— —__2 years or_— 3 years, M. Fees for Applications and permits: Basic Application Fee $150.00 A I. _ tServiee Connections excavations r@$20.00 No. A2. /Additional Excavations same service ct $10.00 No. B. Excavations 18"in depth or less 0.100 L.F.=$10.00;Additional_ L.F.@$0.10 $ C. Excavations 18"in depth to 5' in depth 0-100 L.F.=530.00;Additional L,F.@$0.30 $ D. Excavations 5' in depth and over 0-100 L.F,-$50.00; Additional L.F.@$0.50 S E. _Utility Repair Excavations @$10.00 $ _ No. Repairs same service @$5.00 $ _.-_.__--_.— Additional Od TOTAL$ s0' F. Notice to public utilities proof must be provided and Shall be attached to this application prior to issuance of permit. Authorization is hereby granted to the Town Clerk of the Town of Southold to issue a Highway Excavation permit to: in accordance with this application and subject to the"General Conditions"and"Special Conditions"of permit(if any)attached hereto. SUPF.,RINT DENT OF G AY TOWN OF O HOL E YO Vince t M. Orlando _ __ d A __...__.___ Date Date Received by theTo n Clerk._ .� .._,_- r Date Permit Issued ( �_,q __-_- T Permit No. NOTE: Permit expires one(1)year from date of issuance. No work to start without 2411our notice to Superintendent of Highways. Permit must be available at all times for inspection,on site,during construction. D-39 2 of 3 s/�y 500/Z001a XVd ZS .6 Ilia 6TOz/OZ/90 Copy Distribution: Permit # Highway Department Engineer(with page 3) Applicant Town Clerk (Original) INSPECTOR'S RECORDS Inspection Date Findings (use code) Applicant Notified I St 211d 3rd 4111 (To Permit Clerk) REMARKS CODE 113 Improper BalTicades IL Improper Lights SI' Sunken Trench or Excavation UTM Unable to Measure(due to backfilling) BL1C Building Under Construction WIP Work In Progress DB Improper Backfill(too high,not sufficient) HFS Inspector Holding for Final Settlement of Excavation RFR Ready for Repair D-39 3 of 3 ,5-) 500/£0010 XVJ £S .6 Ixd DTOz/Oz/90 y GENERAL CONDITIONS OF PERMIT APPLICA'T'ION/PERMIT FOR HIGHWAY EXCAVATION AND REPAIR I, Permittee's Contractors to Comply with Permit Requirements: The Permitlee is responsible for informing its independent contractors, employees,agents and assigns of their responsibility to comply with this permit, including all special/site specific and general conditions imposed by the Highway Superintendent while acting as the permittee's agent with respect to the permitted activities,and such persons shall be required to comply with all permit requirements. 2, No Right to Trespass or Interfere with Private Property Riehts: This permit does not convey to the permittee any right to trespass upon the lands of adjacent property owners in order to perform the permitted work nor does it authorize the impairment of any rights,title, or interest in real or personal property held or vested in a person not a party to the permit. 3. Protection of the Highway and Future Highway Maintenance: If future operations or highway maintenance projects by the Town of Southold require an alteration in the position of the utility, structure or work herein authorized,or if, in the opinion of the Highway Superintendent the work performed under this permit shall cause unreasonable obstruction to required highway maintenance or endanger the health, safety and/or welfare of vehicular or pedestrian traffic,this permit shall be revoked and the utility, structure, fill, excavation,or other modification of the highway hereby authorized shall not be completed. Additionally, the perm it may be revoked if the Highway Superintendent finds that the issuance of the permit was illegal or unauthorized or that the applicant failed to comply with any of the terms and conditions of the permit or Chapter 237 of the Town Code, 4. Revocation of the Permit by the Highway Superintendent: if the Highway Superintendent deems it necessary to revoke this permit and the project hereby authorized has not been completed,the applicant shall,without expense to the Town and to such extent and in such time and manner as the Superintendent may require, remove all or any portion of the uncompleted utility,structure or fill and restore the site to its former condition. 5. Notice of Commencement: At least 24 hours prior to commencement of the project,the permittee and/or contractor shall notify the Town Highway Department in writing that they are fully aware of and understand all terms and project conditions of this permit. Upon completion of the work,the contractor shall provide photographs of the completed work to the Town Highway Department and request a Final inspection. 6. Storage of Equipment& Materials: The storage of construction equipment and/or materials shall be confined within the project work area and/or adjacent areas where permission/legal access has been obtained in a manner that does not interfere with normal highway traffic. 7. Utility Mark-Outs: The Applicant/Contractor shall be responsible for verification of all existing utility mark-outs and shall take all precautions to protect same. Damage to existing utilities shall be the responsibility of the contractor and shall be repaired at the contractor's expense. 8. Road Closures: All scheduled road closures must first receive written permission from the Southold Town Board prior to closing a road. 'Temporary lane closures may be permitted with the approval of the Highway Superintendent. This item will included but not be limited to the installation of appropriate signage and flag men to stop and start traffic to allow for single lane traffic. Road Closures due to unforeseen emergencies require immediate notification of the I-fighway Department and shall be limited to immediate and/or expedited restoration of the Work Zone, 9. Nu Construction Debris in Road Shoulder Area: All Construction Debris shall be removed from the job site on a daily basis. All stockpiled soil as well as all other project materials that will be staged within the Right-of Way must be delineated with reflective signage or other means to meet the minimum requirements of the NYS DOT Construction Standards. S00/v0010 XVd £S -6 I-dal VTOZ/OZ/90 GENERAL CONDITIONS OF PERMIT APPLICATION/PERMIT FOR HIGHWAY EXCAVATION AND REPAIR (Continued) 10. Install,Maintain Erosion Controls: Required Erosion Control Measures(i.e.silt fencing) is to be placed on the downslope edge of any disturbed area. This sediment barrier is to be put in place before any disturbance of the ground occurs and is to be maintained in good functional condition until thick vegetative cover is established. 11. Clean Fill Only: All project back-rill shall consist of clean sand,gravel or soil(NOT asphalt, slag, flyash, broken concrete or demolition debris). All unsuitable soils excavated at the site(i.e. Clay, Bog,etc.)are to be removed from the site and not used to backfill any excavation within a Town Highway. 12. All Areas of Soil Disturbance : All areas of soil disturbance resulting from the approved project shall be stabilized to the satisfaction of the Highway Superintendent immediately following project completion. If the project site remains inactive for more than 48 hours or planting is impractical due to the season,then the area shall be stabilized with straw, hay mulch and/or jute matting until weather conditions flavor germination. 13. Backfill& Compaction of all Excavations: Back Fill shall consist of clean fill or soils which exhibit a well-defined moisture density relationship as determined to be in accordance with ASTMD 698. hill shall be placed in maximum lifts of twelve(12") inches thick and shall be mechanically compacted to a Ninety- rive(95%)percent maxiniu n dry density, Suitable hydraulic compaction by water jetting at three-foot intervals will also be permitted subject to a project specific approval by the Highway Superintendent. 14. Restoration of the Road Shoulder Area: All man-made improvements located within existing road shoulder areas must be protected to the greatest extent practical. Items would include but not be limited to driveway&private road aprons,mail boxes,sprinkler systems,trees and ornamental plantings. Excavations through driveways and private road pavements must be reconstructed to meet all requirements of Southold Town Highway Specifications. All pre-existing road shoulder improvements that have been disturbed daring construction must be replaced or repaired by the contractor to the satisfaction of the Highway Superintendent. 15, Schematic Plans with all Technical information and Scope of Work: To reasonably and adequately describe the proposed work,accurate schematic site plans must be provided to show or indicate all proposed construction activity required under this permit. All Pavement surfaces scheduled for excavation must be saw cut to the full depth of asphalt and/or concrete pavements. Accurate size of bell holes or width of trenching must be indicated by dimension or labeling. This schematic site plan must provide details on al l restoration required to meet the requirements of these General Conditions and requirements found in the Southold"Town Highway Specifications, 16. Pavement Reconstruction: All Pavement sections must be reconstructed in the following manner; (Note: When Concrete Pavements are Present,Please review Restoration requirements with the highway Superintendent) a) Complete all back-fill & soil compaction work as needed to provide a suitable sub-base; b) Over-cut existing asphalt bell hole or trench by twelve(12")inches on all sides; c) Install a compacted lift of 4"thick Stone Blend base(RCA Blend must meet NYS DOT Specification); d) Install a two and one half(2.5") inch compacted lift of Asphalt Base Course; e) Install a one and one half(1.5") inch of Asphalt(Type 6)Wearing Course. (Provide AC at all joints) All work listed herein must meet the minimum requirements of the Southold'Town Highway Specifications. 17. Trenching of Pavement Surfaces Exceeding One Hundred (100')Feet in Length: All trenching of pavement surfaces exceeding 100' in length must first be reconstructed to meet the requirements of Item # 16 as noted above. Once all pavement reconstruction is completed to the satisfaction of the Highway Superintendent,the entire road section and/or width of road over the entire length of trench shall be repaved with a two(2") inch lift of Asphalt('Type 6) Wearing Course(Typical,shoulder to shoulder). s1 ty Soo/So 0ln XVa T? 6 I213 VTOZ/OZ/90 FOREMAN IN CASE WORK CANNOT BE COMPLETED AS SHOWN: VILLAGE CUTCHOGUE N0. T101583838 O.H NOTIFY: HAWKS AT EXT: 4064 NO. 101 —E-30 W.O. T101616775 U.G PERMIT REQUIRED ■ YES ❑NO EASEMENT REQ'D ❑YES ■NO AREA 58/541 'NUMBER 1 300 A OR DIST NO. 8B-7K6 SERVICE OPERATIONS/ACTMTIES PRIMARY OPERATING VOLTAGE ■ 13.2KV ❑4KV REQ'D. BY INSTALL: 6102 SALES OUTRIGHT COMPLETION REMOVE: DDC6302 SLIP NO. CONTRIBUTIONS DATE NSOS ASSOCIATED S.0 T101565425, T.0#149462 EN NGINCO. MAINTAIN: EEER PREPARED BY: AL KALEITA AT ExT, 7036 DATE 6-4-14 JOB NO. DIST. AUTHORIZED C.O. BY: DATE TREE TRIM REQUIRED ❑YES ■NO LETTER SIZES URN SET OWN REM TR RE# REASONS OWN POLE # LOCATION OWN AS DEF. INAD NLR NEW RELOC. L 71 N/S NEW SUFFOLK AV - C/O DEAN DR 35/40'2 L L L LG X �� LONG DISTREBUTION DESIGN m ISLAND 175 E. OLD COUNTRY ROAD ;°'a,E CODY — 630 DEAN DR p•-+� ter- MCKSVMM, NY. 11801 TRA SF. 20or SEC'DY CUSTOMER LOAD REG. 2.1 LOAD 7 KW LEGEND BLUE EXISTING RED INSTALL GREEN REMOVE ORANGE R I NEW HOUSE INSTALLED A 200A U.G SVC PSEG TO REPLACE P#71 AND INSTALL APPROX 750' OF 2/C#2AL XLPE PRIMARY AND A 2" CONDUIT FOR VERIZON PSEG TO INSTALL A 50 KVA GRP#234 TRANSFORMER AND INSTALL AND WIRE THE PRIMARY AND SECONDARY SIDE ROAD STRATA 12' GRASS 26' MAC 12' GRASS o_ • 3/C#2CU 3 CU PVC It I-LBFp14985 B#6197 NEW SUFFOLK AV P#711 R-35'-P(4)LG 5' o 1-40'-P(2)TEL R/I-PTP W/INS. I-100A CUTOUT(10T) I-PHASE LA R/I-(3)DE ASSM'S I-GROUND MATRL. C*4 TEL, CATV o U.G NOTES 1-#2AL POTHEAD N 1-3' UGUARD PRI. RISER m vCNm p DUD U Q 'co co co N c0 cr 5' PL � I-BG#99944 0 1-50 KVA GRP#234 B#7448 CONS OWNED & INSTALLED N CD Lo M n cD O] MARK OUT REQUIRED NO UNDERGROUND ELECTRIC IN AREA AS PER FACILITIES MAPS FOREMAN IN CASE WORK CANNOT BE COMPLETED AS SHOWN: C UTC H OG U E W.O. wL�acE NO. T101583838 O.H Nony: HAWKS AT EXT: 4064 NOD 101 -E-30 NO. T101616775 U.G PERMIT E YES ❑NO FASE EN ❑YES ■NO AREA 58/541 TAX DIST NUMBER* 1 300 NO. 8B-7K6 REQUIRED EASEMENT REQ'D SERVICE OPERATIONS/ACTMTIES PRIMARY OPERATING VOLTAGE ■ 13.2KV ❑4KV REQ'D. BY INSTALL: DC6102 SALES OUTRIGHT COMPLETION REMOVE: DR63O2 SLIP NO. CONTRIBUTION$ DATE NSo#( MAINTAIN: SATED S.00101565425, T.0#149462 ENGINEER PREPARED AL KALEITA AT ExT. 7036 DATE 6-4-14 JOB NO. DIST. AUTHORIZED C.O. BY: DATE TREE TRIM REQUIRED ❑YES ■NO ATTER OWN POLE LOCATION SIZES R SET OWN REM TR RE# REASONS OWN AS DEF. INAD NLR NEW RELOC. L 71 N/S NEW SUFFOLK AV — C/O DEAN DR 35/40'2 L L L LG X ��j(� LANG DISTRIBUTION DESIGN lSl.AND 175 E. OLD COUNTRY ROAD BICKSVIIIZ., NY. 11801 ;� E CODY - 630 DEAN DR A•-+ �-+�-T- TSF. 20% SEC'DY CUSTOMER LOAD REG. 2.1 LOAD 7 KW LEGEND BLUE EXISTING RED INSTALL GREEN REMOVE ORANGE R/I NEW HOUSE INSTALLED A 200A U.G SVC PSEG TO REPLACE P#71 AND INSTALL APPROX 750' OF 2/C#2AL XLPE PRIMARY AND A 2" CONDUIT FOR VERIZON PSEG TO INSTALL A 50 KVA GRP#234 TRANSFORMER AND INSTALL AND WIRE THE PRIMARY AND SECONDARY SIDE ROAD STRATA 12' GRASS 26' MAC I� 12' GRASS • 3/C#2CU 3 CU PVC ITT7-- I-LBF#14985 B#6197 NEW SUFFOLK AV P#71 R-35'-P(4)LG 5' o 1-40'-P(2)TEL R/I-PTP W/INS. I-100A CUTOUT(10T) I-PHASE LA a R/I- 3 DE ASSM'S a I-GR UND MATRL. cl, TEL, CATV o U.G NOTES I-#2AL POTHEAD N 1-3" UGUARD PRI. RISER �8r- � �� in OC_)E U t0<O co C14 5' PL I-BG#99944 0 1-50 KVA GRP#234 CONS OWNED B#7448 & INSTALLED CV O tf� m MARK OUT REQUIRED NO UNDERGROUND ELECTRIC IN AREA AS PER FACILITIES MAPS