HomeMy WebLinkAbout20250507 624 N Broadway Site Plan New Water Connection Service Agreement and Application FormProperty Owner's Name
CITY OF SARATOGA SPRINGS
UTILITIES DEPARTMENT
Department of Public Works
474 Broadway-RM is
Saratoga Springs, New York 12866
Telephone 518-58 7-3550
Email: utilities@saratoga-springs.org
www.s arato ga-springs. org
NEW WATER SERVICE CONNECTION
AGREEMENT & APPLICATION FORM
Unitarian Congregation
JASON GOLUB
COMMISSIONER
1OSEPH nNE1LL, III
DEPUTY COMMISSIONER
MICHAEL VEITCH
BUSINESS MANAGER
of Saratoga Springs Project Name (if applicable) 624 North Broadway
Property Address 624 North Broadway
Size of Tap (check one below)
Number of Dwellings: 4
Tax Map #:
165.44-1-22
1" X Greater than1"
A unit of water shall be defined as 14,000 (fourteen
thousand) cubic feet of water per year.
Contact the Utilities Department for assistance with
water use estimation and meter specifications
before signing below.
Estimated Cubic Feet of Water per Year75,147 cf/year
To be completed in full without any contingencies or protest, on or before the Building Inspector approval of
the rough plumbing, including the installation of the water meter, or at the time of the issuance of a tapping
permit.
The undersigned represents to the City that they have full and complete authority to execute this document
and find and commit the developer to abide by the City Water Ordinance. This agreement shall be binding on
all of the undersigned transferees.
The undersigned acknowled at a copy of this document will be delivered to appropriate and necessary
governmental entities.
Authorized Signature i Print Name Artem Golynkin / applicant under contract
Company Name & Address 624 N Broadway Development LLC, 2201 Neptune Ave, Brooklyn, NY 11224
Company Phone Number 718-265-9358 EMAIL artem.omnibuiId@yahoo.com Date
OFFICE USE ONLY.
Department of Public Works Approval Date:
UPDATED 6/8/23