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Building Permit # 11/12/2015
t%O R'i H BUILDING P IT �Q-®�Rgf��o TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION _ Permit No#: Date Receivedy A�ARTEO �SSAcwus"�� Date Issued: i '' 9 IMPORTANT: Applicant must complete all items on this page l Ii1i � �//� , BLOC �I,O / I / 1 r / P'Gm Irl V rl rsk. IIfID ",rf J;,Y !. 1 / �rnn✓ ,rr rror.,uttiaar rI /r I / D / � MI TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family ❑Addition ❑ Two or more family ❑ Industrial [Alteration No. of units: kCommercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: W-Demolition ❑ Other // ai ,,, ,,, „,/ , o /❑, e ds ,,. /r/ ,„/�, Watershed Dtstnct / / We r r � ,, , r,,,❑.Flo d Ialn W tlan r / �i � / /. / r/ ✓ r r J r,ii y L r DESCRIPTION OF WORK TO BE PERFORMED: c� M d,�� .�✓,� iyo e e- e-oA2> Ze5 A k-1et,�A e.te, A^TL> a e,v,0^r�ru Identification- Please Type or Print Clearly OWNER: Name: C-6eA Al 114 oz, Phone: Address: y2. E,.011C. A'; g- "0r`Z. ,,. e r, ,, r r rrr,/�r�//r/„ ,.:, ,„ r/fart/„r a/ ,, i o ,✓r /,,. ✓ ,, � � �/l, /i //i it / /CQ,fraGtQr / r r / r, r J / I �i%dliiffi�6�%/lir!{�i/ii�Nlmf,ITr.Tr%iirfr�//rn/r/I it Yr�irAr/iriY/irllGr��/ri,acrlJrryir rorJ ola .�r'c,/7/,i� �.m///,;.yb//r7; �i�, ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BULDI //ERMIT:$92.00 PER$9000.00 OF THE TOTAL ESTIMATED COST�BAS ELZON$125.00 PER S.F. Total Project Cost: $ /(,eFEE: $ ”[ Check No.: q3a :A0,:), Receipt No.: ' _ DOTE: "Persons contracting with unregistered contractors do not have access to the uaranty fund ;Signature of Agent/Owner Signature of contractor, Dimension Number of Stories: Total square feet of floor area, based on Exterior dimensions. Total land area, sq. ft.: ELECTRICAL: Movement of Meter location, mast or service drop requires approval of Electrical Inspector Yes No DANGER ZONE LITERATURE: Yes No MGL Chapter 166 Section 21A—F and G min.$100-$1000 fine NOTES and DATA— (For department use) -1, ® Notified for pickup Call Email Date Time Contact Name Doe.Building Permit Revised 2014 1 tkO R TH Town of Andover . 2A((* ver, Mass, o IC1. COCNIC"I Ne WI CK �•Q AD�'ATED PPP•�,`� a� U BOARD OF HEALTH rx MMM T LD Food/Kitchen P E Septic System THIS CERTIFIES THAT ,.,,�„ ....... BUILDING INSPECTOR ........ has permission to erect .......................... buildings on .t...... ... ......... Foundation ough 40 to be occupied as !. .. .... ........ ... M .... ..... ... ........I=..,. .......... ....loohd.. ... .. .�,004ihimney.. provided that the rson accepting this ermit shall in every respect conform to the terms of the ap ation Final on file in this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. PLUMBING INSPECTOR Rough VIOLATION of the Zoning or Building Regulations Voids this Permit. Final doop PERMIT EXPIRES I 6 MONTIi� ELECTRICAL INSPECTOR UNLESS CONSTRUCTIO Rough Service ................. .... .... ...... ........................................... Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required t® Occupy Building Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approvedthe Building Inspector. Burner Street No. Smoke Det. cwffgC Clean Harbors—Remediation Technologies 3300 US-131 North P.O.Box 968 Kalkaska,MI 49646-0968 231.258.8014 office 231.258.6993 fax www.cleanharbors.com September 29, 2015 B. Geoffrey Jones VP, Remediation &Discontinued Operations Clean Harbors Environmental Services 40o Arbor Lake Drive, Suite B-goo Columbia, SC 29223 RE: Clean Harbors-Service Chemical,Andover, MA Proposal to Decommission Existing GWTS and SVE Systems The Construct and Install Replacement Systems Hi Geoff: We appreciate the opportunity to submit this proposal. Here is a summary of the components and services we intend to provide, along with pricing for each category. This is based on our discussions, and on AECOM's 6o%System Design. _Complete Svstem Design $3,527.00 The 6o%design will be finalized with adjustments for constructability and specifications for components that are not specified in the 6o%design. Decommission Existing System $ 21,051.00 This includes costs to remove all existing components of both systems located inside the treatment building. Removal of the Pack Tower Air Stripper will involve insulating nearby power lines and setting up a crane to lift the tower up and out of the building. Spent media will be placed in appropriate containers for characterization and disposal. Includes transportation and disposal of up to 5 tons of construction debris at $1oo.00 per ton. Other materials will be segregated for recycling as appropriate. Remove Wall in Building $7,834.00 The existing interior walls will be demolished and placed in a rolloff container for disposal. Includes transportation and disposal of up to 5 tons of construction debris at$1oo.00 per ton. "People and Technology Creating a Better-Environnnent" O Mr. Geoff Jones September 29, 2015 Page 2 Cost of All GWT&SVE System Components $ 69,827.00 This is the purchase cost of all materials required to construct the system per the specifications (not including electrical). It covers all interior components, such as tanks, air stripper, pumps blowers, GAC vessels, initial load of vapor phase GAC, piping and valves, etc. System Construction Labor $ 13,527.00 Labor for Clean Harbors employees to construct and test the system at the site in Andover, MA. Cost of All System Electrical $36,765.00 This is the cost all of materials and labor to provide the complete electrical system per the specifications. This includes all building interior electrical, including labor and materials to install a light, heater, PLC, etc. on-site. Our electrician will perform a full system test at the site to assist in the system startup. System-Startup&Training $3,889.00 This item includes 3 days to startup and test the new systems and train the designated O&M staff on the systems. O &M Manual $5,605.00 All manufacturer-specific literature/manuals will be provided upon delivery of the system. The completed O&M manual will be provided within 3o days of system delivery. Things not included in this project: • Any required permits for any parts of the system • Containers or transportation for any materials to be recycled • Insulating overhead power lines. A$1,000.00 allowance has been added for this item. • Transportation and disposal of any waste classified has hazardous • O &M of the system • Initial drum of chelating agent Sincerely, Senior Field Project Manager Attachments: Cost Proposal cc: Tony Fisher, C1eanHarbors Mike Leahy, C1eanHarbors Joe Green, C1eanHarbors Bob Cornwell, CleanHarbors Cost Proposal d Item Estimated Description Unit Unit Price Subtotal No. Quantity 1 System Design Ea. 1 $3,527.00 3,527.00 ---------- --------------------------------------------------------------- --------------- ------------------------------------------------------------ 2 Decommission Existing System Ea. 1 $ $ 21,051.00 21,051.00 ---------- --------------------------------------------------------------- ---------------------------------------------------------------------------- 3 Remove Wall in Building Ea. 1 7,834.00 7,---$--834.00 ---------- ------------------------------------------------------------------------------- ------------------------$------------------- -------- 4 System Components Ea. 1 69,827.0069,827.00 -------------------------------------------------------------------------- --------------------------------------------------------------------------- 5 System Construction Labor Ea. 1 $ $ 13,527.00 13,527.00 ---------- ------------------------------------------------------------------------------- ------------------------------------------------------------ 6 System Electrical Ea. 1 $ $ 36,765.00 36,765.00 ---------- --------------------------------------------------------------- --------------- ----------------------------------------------------- ------ System Startup &Training Ea. 1 3,889.00 3,889.00 ---------- --------------------------------------------------------------- --------------- -------------------- - - - ------------------------------ 8 System O&M Manual Ea. 1 $ $ ---------- --------------------------------------------------------------- --------------- --------------------5,605.00--------------5,605.00------ 9 Pay Item 9 Ea. 1 $ $ ---------- --------------------------------------------------------------- --------------- ------------------------------- --------------------------- 10 Pay Item 10 Ea. 1 $ $ TOTAL: 162,025.00 editions, Clarifications and or Assurritions: 1 2 3 4 5 "People and Technology Creating a Better Environment DIYM Au `fIFI A OF LIABILITY IN U NCE page 1 of 2 F�ATE Imm10/28/20 51 ) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(les)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement.Astatement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Willis of Massachusetts, Inc. PHONE 877-945-7378 FAx 888-467-2378 c/o 26 Century Blvd. E-MAIL P. 0. Box 305191 certificatesC�willis.com Nashville, TN 37230-5191 INSURER(S)AFFORDING COVERAGE NAIC# INSURERA:ACE American Insurance Company 22667-001 INSURED Clean Harbors Environmental Services, Inc. INSURERB:American Guarantee and Liability Insuranc 26247-003 and its affiliates INSURER C:ACE American Insurance Company 22667-076 42 Longwater Drive Norwell, MA 02061 INSURERD: Indemnity Insurance Company of North Amer 43575-003 INSURERE: Illinois Union Insurance Company 27960-002 INSURER F. COVERAGES CERTIFICATE NUMBER:23763562 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN.THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPEOFINSURANCE DDL SUB POLICY EFF POLICYEXP LTR pOLICYNUMBER LIMITS A X COMMERCIAL GENERAL LIABILITY HDOG2740067A 11/1/2015 11/1/2016 EACH OCCURRENCE $ 2,000,000 CLAIMS-MADE X OCCUR ppRMGGE77QENTED occuren ce) $ 500,000 X XCU MED EXP(Any one person) $ 51000 X Contractual X PERSONAL$ADVINJURY $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERALAGGREGATE $ 4,000,000 POLICYPRO ❑ LOC PRODUCTS-COMP/OPAGG $ 4 000 000 JECT OTHER:rxi $ A AUTOMOBILE LIABILITY ISAH08860889 11/1/2015 11/1/2016 COMBINED SINGLE LIMIT (Ea accident) $ 5,000,000 XANYAUTO BODILY INJURY(Per person) $ X AUTOSALLOWNED SCHEDULED X BODILY INJURY(Per accident) $ UTOS X HIREDAUTOS X NON-OWNED PROPERTYDAMAGE AUTOS (Peraccident) $ X MCS-90 $ B X UMBRELLALIABX OCCUR AUC-4275262-11 11/1/2015 11/1/2016 EACH OCCURRENCE $ 10,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $ 10,000,000 DED I RETENTION$ $ C WORKERS COMPENSATION WLRC48592715 11/1/2015 11/1/2016 X I PER STATITTF OTH- PP AND EMPLOYERS'LIABILITY D ANY PROPRIETOR/PARTNER/EXECUTIVE� N/A WLRC48592739 11/1/2015 11/1/2016 E.L.EACH ACCIDENT $ 2,000,000 OFFICER/MEMBER EXCLUDED? IMandatory.inNH) E.L.DISEASE-EA EMPLOYEE $ 2,000,000 f yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 2,000,000 E COO G27416603 001 CPL 11/1/2015 11/1/2016 Contractors Pollution $10,000,000 Each Claim Liability $10,000,000 All Claims $250,000 SIR DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additonal Remarks Schedule,may be attached if more space is required) See Attached: CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE For Reference Only Co11:4794023 Tpl:2005632 Cert:23763562 ©1988-2014ACORD CORPORATION.All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: 076900 LOC#: A ADDITIONAL REMARKS SCHEDULE Page-2-of 2 AGENCY NAMED INSURED Clean Harbors Environmental Services, Inc. Willis of Massachusetts, Inc. and its affiliates POLICY NUMBER 42 Longwater Drive Norwell, MA 02061 See First Page CARRIER NAIC CODE See First Page EFFECTIVEDATE: See First Page ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: CERTIFICATE OF LIABILITY INSURANCE Pollution Leal Liability Carrier: Indian Harbor Insurance Company Policy Number: PECO042039-02 Policy Term: 11/1/2015 - 11/1/2016 Limits: $10,000,000 Each Claim/Aggregate ACORD 101 (2008/01) Coll:4794023 Tpl:2005632 Cert:23763562 ©2008ACORD CORPORATION.All rights reserved. The ACORD name and logo are registered marks of ACORD Unrestricted-Buildings of any use group which contain less than 35,000 cubic feet(991m3) of enclosed space. Failure to possess a current edition of the Massachusetts State Building Code is cause for revocation of this license. For DPS Licensing information visit: www.Mass.Gov/DP5 )IM J3 Massachusetts - Department of Public Safety Uv Board of Building Regulations and Standards Construction Supervisor License: CS-107440 DINOISEPPI - 5 BLACKBERRY Framingham iVW 17b Expiration Commissioner 09/19/2017