NYC 9/11 Public Portal Document
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f' ew York Qty APPLTCA771W FOR CONTRA CT PF)RMTT
mt of lrinsportaton
of P Tit Ma t and Consoattion Conu of Lal (REV.8-98)FROST
PERMIT NUMBER:
PEI(laT=(1) : CONTRACT #: ROC - REM3
BOROIIGH: ®M ❑B ❑Q Ox ❑s ❑MEC ❑BNEC ❑QEC ❑B}~C ❑REC OCMC#
SPONSORING AGCY: ]DEP ❑DDC ❑DOT ❑NYSDEC ❑NYSEDC DHPD ❑PARKS ❑SCA ❑HM OPA of NrLNJ
PROTECT ENGINEER NAME: R.RACeiAKRt$i, 4AId P. F.. TELEPHONE #: (7 IS') SOWS- 2'7 (t3
NAME OF CONTRACTOR: TRto ASOESTos 2L .MDVAL LoP-P. TEI~PHONE R: (?I `a ) Qbl - y)OO
BUSL?iESS ADDRESS: 14-20 t2 5T'2EE'r COL,L F( c Pot - T N ' I t 3 ,S
RESIDENT ENGINEER NAME: TELEPHONE 8: ( )
PROJECT DESCRIPTION:%6U%t.01X14 e1hTERtoR CLEPN
CONTRACT START DATE: 51 2 8 f0 2 CONTRACT CO IETION DATE: `7 / Z 5 /02
TYPE OF PAVEI~tTf: ROADWAY: SIDEWALK:
\PTYPE OF PTR!!IT(S) REQUESTED (Check All Applicable) :
0111-MAJOR INS LTATEON-SEryzM 0126-TEST PITS, CORES OR BORING CRANE/SHOVEL ON STREET
0112 -RAPID TRANSIT CONSTRUCTION 0132 -INSTALL FENCE 0205-PLACE SHANTY/TRAf_ER ON
0113-REPAIR WATER ❑135-£IHAL RESTORATION STREET
0114-REPAIR SEWER ❑136-DEP-MAJOR INSTALL TIONS- O208-TEMPORARY PEDESTRIAN WALE
0115-REPAIR WATER/SEWER WATER 0211-TEMPORARY ROADWAY CLOSING
0116 -FUEL OIL LINE ❑137-DEP-29+JOR INSTAT.L 2'Iol S- 0214-PLACE CONT.A32MR ON STREET
❑118-RESET,REPAIR OR Rrm.ACE SERER 0215 -TEMPORARY SIDEWALK CLOSING
41 CURB D201-PLACE NATEETAL ON STREET 0401 -REPAIR SIDEWALK
0119 -PAVE STREET 0202 -CROSSING SIDEWALK 0402 -CONSTRUCT NEW SIDEWALK
0120-TREE PIT 0203-PLACE CRANE/SHOVEL ON 0403 -REPLACE SIDEWALK
0121-CONSTRucT OR ALTER EANHOLE STREET VENTILATORS
AND/OR CASTING 0204-PLACE EQUIPMENT OTEZR THAN
OTHER TYPE OF PERMIT:
Ot STRUT FS STREET Lruc.A ROBE WORK
TO SSREeT FEET STBRT E~
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OCHC APPROVAL BY: DATE: ' ❑MORE LOCATIONS ON REVERSE
THE PERICT TO BE GRANTED SUBJECT TO THE FOLLORING CONDITIONS:
THE APPLICANT A/9ES TO COST WITH ALL LAPS AND ROLES OF TEE DEPART} NT AND OT
HE[2 APPLICABLI,LAFS AIR) RULES.
NO PE T SHALL BE ISSUED UNLESS THE APPLICANT BAS ON FILE ALL INSURANCE(BONDS). ..
APPROVED FOR THE COEMISSIONER BY: SUBMITTED BY: DATE:
DATE• SIGNID BY: c-t~ TE,L • p (
AUTHORIZE] REPRESENTATIVE OF APPLICANT
NYC-WTC 000111854
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