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50 FORT AVE - BUILDING INSPECTION City of Salem \ Weal S 1 �J APPLICATION FOR PERMIT TO BUILD ADDITION, MAKE ALTERATIONS OR NEW CONSTRUCTION IMPORTANT-ApplIcard to Compote"Rom/in aectlons. 1 Il, lit IV,and IX. L AT 0.0CATIOM �+� FO• ' /7-Fj1�'t' c�9K`11 M 0 Moll / 770 LOCATION OF WT EEN NBr}{I Icw.� �F' k7 /uy SihfET A� 54��bn �II�ewS Vk BUILDING "�8� 10A0d STRM 1 SusoNL910N LOT_SL= Siff i II. TYPE AND COST OF BUILDING-AN appNcants complete Parts.A-D - 3 A. TYPE OF IMPROVEMENT D. PROPOSED USE.-FOR"DEMOLITION"USE MOST RECENT USE I Q Now building Ratlesrleal NMn99tlftnto t 2 Q AddMon rd nspenwil enMnunWvdnw, 12 Q Orr1MW 15 Q A MAMOM nuameY nouauq wins adeso.d any.n Oen O,131 19 Q CMtJt orm leb9 rY 1J ❑ Two or non 4nieY-Enter rwmbr 3 ® A11en4n/see 2 abort/ of uiir 20 Q IMtwend 4 Reoar nPlsCMlns�f p+'ccGis efV/�/hr 14 Q TMro" nEn.rt I 'Wdmn pry- T7 Q � OO�aP F.nesrrrnes.a/Mw - 22 ❑ service action, pas,praw 5 Q vnaaMerp ro nnderrrosy reeierert erwrrMarrer 2313 tloepeel,baetrlbrrl al lines in buddnp In PM D. 13) 15 Q Graph 240 Oaw,bark araleeswr c S Q Mwnp 1rNotmonl Ip Q C w" 25 IM Pubpe utility 6 7 Q Fou annex aniy 17 Q 00W-SPseb - 20 ❑ sa�no4l&--Y.cow atluulorr 1 B.OWNERSNIP 27 Q 51cm reefs ZO Q Trer4lDYnra 5 Q Privwuwir"cownewn,nunbim n ij atiMrborr.e1c.l 29 Q Our-spo'ty I 9 IM PublicrFleelr.$taK or IofJl 9WrMmi1 i 1 C.COST ICYnitarw/ Norawbrn w Describe n delete orooaneo u e of bud&*k a9-food owasssip olrd. I/'' (� mrsrsr Nm hammy bueoeq at Irosbw4 elerriarnerY eeliaa4 aeaonotW sIJiab4 abYpR 10. Copal mpraamre 5 77,3 /0� pI�JMr School.a{ri 911ra1 ICI AMrarM pre,nrMp aeit a bueolrrp.oMee buedm 3 p nauxmr plan.A use of eff:strp bueoir g r bwv Cbrlpeo,a olaooMC aeL 'c In meAND"cop no/neertl�d ore 414fer 1'a 'IVI(061 (Jh+01 F447Ill+y k like du llarep rrcorwtloNp SQt 000 i a OOrr Nlseasor.61 11. TOTAL COST OF IMPROVEMENT s 6s� 99.3 III. SELECTED CHARACMUSTICS OF BUILDING -For new buildings and additions, complete Parts E-L;dwirwi wn, complete on1v Parts J& V.aN others Skip to IV E PRINWAL TYPE OF FRAME F. PRNCM TYPE OF HEATING FUEL G. TYPE OF SEWAGE DISPOSAL L TYPE OF M ECl1AWAL 30 Mleva v Map, 01 35 M GM 40 0 Plree a<orrlw am New v wa em be CM AV 1 32 ® Sblm+r Mile37 Q E1411t>Yy {t Q PIMaNs laaple tans alGl M 13 45 IM No 33 ® Renbras0 abrc ew 35 Q col N. TYPE OF WATER SUPPLY wa rrre beM eiview 34 Q Other-Sasryr 39 Q Otter-SpNY 42 JS P#Ak or paella mrroarlr 46 ❑ 11a 47 ® No 43 Q PrMsss lnae.eiernil J.ONENs10NS M. DEMOLITION OF STRUCTURES: Ja N.e M e1eMS ..._....... _.._................_..._...._.._.. 49 Tsai ware IM a non a ea Has Approval from Historical Commission been received a:moo b oaaea an e.twae 9 YPS_ NO_ for any structure over fifty(50)Y�• I -p 50. TOM u w anx an it_._-- y Dig Sale Number 1C NUMBER OF OFF-STREET PAIIKWO SPACES Post COnitrot51 :{) HAVE-THE FOLLOWING UTILITIES BEEN DISCONNECTED? 52. ouwwm._ -- Yes No L RESIDENTIAL SURDINGS OW' : ,"'a ,: -r g ss. F1do•o _ ,_ -. . w SavRe' 5k Numto of - j oaueoar ` DOCUMENTATION FOR THE ABOVE MUST BE ATTACHED wmr BEFORE A PERMIT CAN BE ISSUED N. COMPLETE THE FOLLOWING: Historic District? Yes_ No4 (K yes,please enclose documentation f m Hist.Com.) Conservation Area? Yes Ido Iti Yes.Please enclose Order of Conditions) d Has Fire Prevention approved and stamped Plans or apPlicatioits? Yek4 No-- is progeny bated in the SRA district? Yes_ No- Comply with Zoning? -Yea-X No_ (If no,enclose Board of Appeal decision) Is grandfathered? Yes= No-X (If yes,submit documentationfd no,submit Board of Appeal decision) �. If new coraUvction,has tfte proper Routing Slip been enclosed?. Yes_ No_ )VIA Is Architectural Access Board approval required? Yes_ NoX (If yes,submit doamentabon) Massachusetts State Contractor License# Salem License# Home,Improvernent Contractor# Homeowners Exempt form(if applicable) Yes_ No— CONSTRUCTION TO BE COMMENCED WITHIN SIX(B)MONTHS OF ISSUANCE OF BUILDING PERMIT CONSTRUCTION IS TO BE COMPLETED BY: V i$ 1(90 6 Han extension i necessary,please submit in writing to the Inspectpnof Buddutgs. V. IDENTIFICATION- To be completed by all applicants _ Name _ MWV aCCno•mmw..LnM.eaF,antl sow ZIP cow Tal.No. 6� Es Se�errP 0. Box W fgkA WOO 971 Y— OM.or, z. 40 Low Ill taq 9F 030 q �tg ca nu er C4j . c e h LOMNM ' e tB® � T c. 53 Soui= q iA aq qrs a— ArcWa or Enprrw - I hereby car*that the proposed work is authoraed by the owner of record and that I have been authorized by the owner to make this appGcatron as his aumonzea Spent ano we agree to conform to all applicable laws of this A jurisdiction. G�, date te cv.�xz� �v/a J1 k& D S— �orI M ov1' 0V1 DO NOT WRITE BELOW THIS LINE VI. VALIDATION Building FOR DEPARTMENT USE OIriY Permit number Building Use crow Permit issued 19_ Fire Gndirq Building _._ _ LM l oadmg Permit Fee $ 00=112M LOW Certificate of Occupancy S Approved by. Drain TiM Plan Review Fee Y $ NOTES AND Data•(For department use) _ . ._ r PERMIT TO BE MAILED TO: 0 DATE MAILED: E Construction to be started by: Completed by fi VI ZONING PLAN EXAMINERS NOTES DISTRICT USE FRONT YARD SIDE YARD SIDE YARD REAR YARD NOTES OR PLOT PLAN-For nt Use SITE Applrca O N I I a v���ONDIL(� CITY OF SALEM, MASSACHUSETTS �4 PUBLIC PROPERTY DEPARTMENT 0 ' 120 WASHINGTON STREET, 3Ro FLOOR INV WH SALEM. MASSACHUSETTS 01970 STANLEY J. USOVICZ. JR. TELEPHONE: 978-745-9595 EXT. 380 MAYOR FAX: 978-740-9846 April S, '_005 AIan Taubcrt, Jr., P.E. Project tilanager i0 For Avenue PO Box 9S9 Salem, MA 01970 Dear Mr. Tauber: We have reviewed your permit application and have determined the required permit amount to be $16,524.93. Upon receipt of permit fee, we will issue your Building Permit. If you have any question please feel tree to call me at 978-745-9595 ext. 380. Sincerely, phomas St. Pierre Building Commissioncr Vendor Code: 5-A1,&M Date $Amt. Go ABC#: �_v I lOo - OD . gLQf2 .4 Purchaser /� Confirmation : to / 7 4 1�o Dept. Head Approval : t i 77 OP ID D DATE(MMIDDIYYYY) ACGRQ CERTIFICATE OF LIABILITY INSURANCE METHU-1 02 07 05 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE . eSanetis Insurance Agey, Inc. HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR D ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 36 Cummings Park Woburn MA 01801 NAIC# - Phone: 781-935-8480 Fax:781-933-5645 INSURERS AFFORDING COVERAGE INSURED INSURERA CNA Insurance Co anies 20443 INSURERS: Aeeriaan International croup INSURER C: xravalere property Geoalty 01899 Methuen Construction Co Inc Salem NH Road P`uY INSURERD: Cb INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED .ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. POLICY NUMBER DATE MMID DATE MMIDDIYY LIMITS LTR NSR TYPE OF INSURANCE EACH OCCURRENCE S1,0001000 GENERAL LIABILITY $100,000 A X X COMMERCIAL GENERAL LIABILITY C207757.3167 07/Ol/04 07/Ol/05 MEDEXPREMISES(Eaonepa e) CLAIMSMADE K OCCUR - MED ON (Any DV pawn) $ 10,00O X Blkt Contractual PENERAL AGGREGATE s1,000,000 GENERAL AGGREGATE $2,000,000 X XCU Hazards PRODUCTS-COMP/OP AGG S2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER'. POLICY X JEC LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 A X X ANY AUTO NH C2049381064 07/01/04 07/0l/05 (Ea accident) ALL OWNED AUTOS BODILY INJURY �$ (Per pawn) SCHEDULED AUTOS X HIREDAUTOS - BODILY INJURY 6 (Per accident) X NON-OWNEDAUTOS PROPERTY DAMAGE $ (Per accident) AUTO ONLY-EA ACCIDENT S GARAGE LIABILITY EA ACC S ANY AUTO OTHER THAN AUTO ONLY: AGG E EACH OCCURRENCE $25,000,000 EXCESSIUMBRELLA LIABILITY B X X OCCUR �CLAIMSMADE BE5684444 07/01/04 07/Ol/05 AGGREGATE $25,000,000 8 DEDUCTIBLE. $ RETENTION $ - - X TORV LIMBS ER WORKERS COMPENSATION AND EMPLOYERS'LIABILITY - W 174023092 07/01/04 07/01/05 E.L.EACH ACCIDENT A $1,000,000 ANY PROPRIETOPIPARTNER/EXECUTNE - t:�L„rnMA NH, E.L.DISEASE-EA EMPLOYEE $1,000,000 OFFICER/MEMBER EXCLUDED? I(yes,descrbe under E.L.DISEASE-POLICY LIMIT $1,000,000 SPECIAL PROVISIONS be]= OTHER A Builders Risk TBA 02/02/05 09/02/06 Limits $6,937,079 ' Deduct $5,000 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT SPECIAL PROVISIONS "Addll Ins limits are no greater than those required by written contract." RE: Contract No. 04-1, Upgrade of Wastewater Treatment Plant, Residuals Management and Odor Controls Facilities. South Essex Sewerage District and Tighe s Bond, Inc, and their officers, directors, and employees. .Continued. . CERTIFICATE HOLDER - °CANCELLATION SOUTH-E SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL EMAIL 30 DAVSWRITTEN South Essex Sewerage District NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, PO Box 989 50 Fort Avenue Kffi Salem MA 01970 AUTHORIZEDREPRESENTATIVE ©ACORD CORPORATION 988 ACORD 25(2001/08) ^ AL Additional insured as respects to the GL, Auto, and Um- Waiver of subrogation applies to all. umbrella policy covers ng underlying policies: GL, Auto, WC S EL. The South Essex Sewerage District and Tighe 6 Bond, Inc. will be notified in writing of cancellation or restrictive amendment of the above policies at least thirty (30) days prior to the effective date of such All on or endorsementssent. All required by the policies are primary and noncontributory.tort'. (Revised Certificate of Insurance issued Contract documents are in effect. on 2/2/05.) acoRv CERTIFICATE OF LIABILITY INSURANCE CSR PR DATE(MMBTDZO5 ANNES-1 Ol 27 05 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION MF&T Ins. Construction Div. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Construction Division HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR - 77 Accord Park Drive Unit B-1 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Norwell MA 02061 Phone: 781-261-2000 INSURERS AFFORDING COVERAGE NAIC# INSURED - INSURER A: one Beeaon Ineuranoe Caagpeny INSURER B: Ohio Casualty Group Annese Electrical Services Inc INSURERC 1119 Washington Street INSURER D: Weymouth.MA 02189 - INSURER E: i COVERAGES 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 MAYBE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH - POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. IRSR LTR NSR TYPE OF INSURANCE POLICY NUMBER DATE MM/DD/YY DATE MMIDD/YY LIMITS - EACH OCCURRENCE $ $1,OOO,DOD GENERAL LIABILITY - A X COMMERCIAL GENERAL LIABILITY CBR823359 05/01/04 05/01/05 PREMISES(Ea occurence) $ $500,000 CLAIMS MADE X❑ OCCUR MED EXP(Any one person) $ $5,000 PERSONAL B ADV INJURY $ $1,000,000 GENERAL AGGREGATE $ $2,000,000 GENT AGGREGATE LIMIT APPLIES PER: _ PRODUCTS-COMP/OP AGG $ $2,000,000 POLICY lil JECT LOC AUTOMOBILE LIASIUTY - COMBINED SINGLE LIMB S 1,000,000 A ANY AUTO - CBXE48709 05/01/04 05/01/05 (Ea accident ALL OWNED AUTOS BODILY INJURY $ (Per Person) X SCHEDULED AUTOS _ X. HIRED AUTOS BODILY INJURY $ (Per accibenp X NON-OWNED AUTOS X Coll $500 Ded. PROPERTY DAMAGE $ X Cc $500Ded. (Par accident) GARAGE LIABILITY- AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ $10,000,000 B X OCCUR � CLAIMSMADE BX053080803 05/01/04 05/01/05 AGGREGATE $ $10,000,000 'DEDUCTIBLE RETENTION $ _ $ WORKERS COMPENSATION AND X TORY LIMITS ER A EMPLOYERS'LIABILITY I'QB4 4387O 05/01/04 05/01/05 E.L.EACH ACCIDENT $ $500;000 ANY PROPRIETOR)PARTNER/EXECUTIVE OFFICERIMEMBER EXCLUDED? E.L DISEASE-EA EMPLOYEE a $500,000 Vyes,oesmide antler E.L.DISEASE-POLICY LIMIT $ $500 000 ' SPECIAL PROVISIONS below OTHER A Property CBR823359 05/01/04 05/01/05 Limit $60,000 ALL RISK REPLACEMENT COST Dednetlbl $1,DDD DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT SPECIAL PROVISIONS South Essex WWTP Upgrade - - Methuen Construction Co. Inc. is named as Additional Insured on a primary, non-contributory basis. CERTIFICATE HOLDER CANCELLATION METHUEN SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL Methuen Construction Co.Inc. IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER ITS AGENTS OR 40 Dowell Rd. REPRESENTATIVES. Salem NH 03079 ALI ED REP S TAT%1 � ACORD 25(2001108) � ©ACORD CORPORATION 1988 ACORD. CERTIFICATE OF LIABILITY INSURANCE oiiis%z o) PRODUCER (781)681-66S6 - FAX (781)681-6686 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION J Barry Driscoll Ins Agcy, Inc ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 600 Longwater Drive ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. P.O. Box 9120 Norwell, MA 02061 INSURERS AFFORDING COVERAGE NAIC# INSURED Enterprise Equipment Co. , Inc. INSURER A: West American Insurance Co. _ 276 Libbey Parkway INSURERS: Ohio Casualty Insurance Co." East Weymouth, MA 02189 INSURER C: \ INSURER D: INSURER E: If t, 75PR; C<>. COVERAGES - 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.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR DD' TYPE OF IN POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS GENERAL LIASILT' BKW52522623(05) 08/01/2004 09/01/2005 EACH OCCURRENCE $ 1,000,00 X COMMERCIAL GENERAL LIABILITY - DAMAGE TO RENTED S 500,00 CLAIMS MADE FRI OCCUR MED EXP(Any one Person) $ .10,00( A PERSONAL SADVINJURY $ 1,000,00 GENERAL AGGREGATE $ 2,060,00 GEWL AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,00 X POLICY X ECT LOC AUTOMOBILE LIABILITY - BAO(OS)S2522623 08/01/2004 08/01/2005 COMBINED SINGLE LIMIT $ANY AUTO . - (Eaactlaent) 1,000,00 ALL OW NED AUTOS BODILY INJURY X SCHEDULED AUTOS (Per person) $ B X HIRED AUTOS BODILY INJURY X NON-OWNEDAULOS - (Per accident) S -- -- PROPERT'CAMAGE - $ -- (Peraoddent) DARAGE LIABILITY - AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESSNMBRELLA LIABILITY BX052522623 05 09/01/2004 08/01/2005 EACH OCCURRENCE $ 10,000,00 X OCCUR CLAIMS MADE AGGREGATE $ 10,000,0001 B $ DEDUCTIBLE - $ RETENTION $ $ WORKERS COMPENSATION AND IXWO(OS)52522623/08/O1/2004 OS/O1/2005 X wesraruTA- FR EMPLOYERS'LIABILITYE.L.EACH ACCIDENT $ Soo,OO B ANVPROPRIETORIPXCLUDEIEXECUTIVE OFFICERIMEMBER EXCLUDED'! E.L.DISEASE-EA EMPLOYEE $ SOO,OO 'If yes,describe under - - _ ' _.... ". SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $ 500,00 . OTHER BKW52522623(OS) 08/01/2004 08/01/2005 Install. Floater:$SOO,000 A ontractors Equipment Leased/rented equip: $50,000 q P� Unsched. Equip: $20,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS E: South Essex Sewarage District WWiP Improvements, Salem MA Job #1798 '"SEE ATTACHED ADDENDUM" Evidence of Insurance for work performed within the Insureds scope of normal business operations. otice of Cancellation provision is 30 days except 10 days applies for non-payment of premium. CERTIFICATE SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, Methuen Construction CO. , Inc. BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY 40 Lowell Road OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. Salem, NH 03079 AUTHORIZED REPRESENTATIVE } /N/B. Driscoll/KCS V R""" ACORD 25(2001/08) CACORD CORPORATION 1988 Methuen Construction Co. , Inc. Certificate issued to Methuen Construction Co. , Inc. 01/18/2005 J Barry Driscoll Ins Agcy, Inc 01/18/2005 Methuen Construction Co. , Inc. is included as an Additional Insureds for General Liability and Excess (Umbrella) Liability as required by a signed written contract or agreement with the Named Insured. Methuen Construction Co. , Inc. is included as an Insured for Automobile Liability on a Primary Basis for the conduct of the Named Insured, but only to the extent of that liability. 0�5iw� �1 �.. ' 1 t The Commonwealth of Massachusetts _ 7 Department of Industrial Accidents � `- =- O1flCA0//dYbStlyBtlB�S 600 Washington Street, 7`h Ffoor ' S Boston,Mass. 02111 xA . Workers•Com ensation Insurance Affidavit Buildip lumbin lectrical Contractors name: Methuen Construction Co. Inc. address: 40 Lowell Road city Salem stale: NH ZiP 03T079 Phone N 603-328-2222 o t §'sek Sewerage Is r c AWTF work site location(null address) SO Essex Avenue Salem MA 01970 ❑ I am a homeowner performing all work myself. Project Type: ❑New Construction®Remodel ❑ 1 am a sole proprietor and have no one working in any capacity. ❑Building Addition - -Jf-I-am an.employerproviding workers'-compensation for my-employees working on thisjob tj C9 c n C ''sID.0 rf addract 40 Lowell Road,_ `.% i .�,f rr j ' £ + �Y, t � city: Salem. NH 03079 in CNA Insurance Companies � `WC174023092 I am a sole proprietor, neral contractor r homeowner(circle one)and have hired the contractors listed below who-have the following workers' compensa ion po i es.- company name: Annese Electrical Services Inc address: 1119 Washington St�� city: We outh, mA 02189 - 78&337 6462 < t S Y. it � e "'+t in ran One Beacon Insurance company name: Enterprise Eauinm nCo.- Tn 4"" " °�`�•`' �'....,'; 4 276. Libbe Parkwa of,+ x $ " <r x > 4 4 t kh address: 9- { CRY, East .Weymouth, MA 02189 . CONT.Pg2) Failure to secure coverage as required under Section 74' of MOL 157 cap lead to the impwitlon of criminal penahia ora fine up to 51,500.00 and/or one years'imprisonment u well as civil penalties in the form of a STOP WORK ORDER nod a fine of$100.00 a day against me. I understand that a copy of this statement may be forwarded to the Office of investigations of the DIA for coverage verification. do herebMcerd der a pai and penalties of perjury that the information provided above is true and correct Signature � Date b Print name Rnry Man]f- t` Phone H 603_a7R_7777 official use only do not write in this area to be completed by city or town official city or town: permitflicense p 7IDepartmeat rtment d ❑check if immediate response is required Office contact person: hone a; eatsro�.±aolP Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employees. As quoted from the"law",an employee is defined as every person in the service of another under any contract of hire,express or implied,oral or written. An employer is defined as an individual, partnership,association,corporation or other legal entity,or any two or more of in the legal representatives of a deceased employer,or the receiver in engaged in a'oint enterprise,and including g p the foregoing rP g g1 or trustee of an individual, partnership, association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer. MGL chapter 152 section 25 also states that every state oral licensing agency shallwithhold-the-issuance or--- -- — - renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required. Additionally,neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority. Applicants Please fill in the workers' compensation affidavit completely,by checking the box that applies to your situation. Please name,address and hone numbers along with a certificate of insurance as all affidavits may be supply company a p pP Y P submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of Industrial Accidents. Should you have any questions regarding the`law"or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. City or Towns Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference'riutimber. The affidavits may be returned to the Department by mail or FAX unless other arrangements have been made. The Office of Investigations would like to thank you in advance for you cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth Of Massachusetts Department of Industrial Accidents ON@ of Imesdeadens 600 Washington Street,7'"Floor Boston, Ms. 02111 fax#: (617)727-7749 phone#: (617) 727-4900 ext. 406 Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employees. As quoted from the`law",an employee is defined as every person in the service of another under any contract of hire,express or implied,oral or written. An employer is defined as an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer. MGL chapter 152 section 25 also states that every state or local licensing agency shat[withhold-the-issuance or- - -- - renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required. Additionally,neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority. Applicants Please fill in the workers' compensation affidavit completely,by checking the box that applies to your situation. Please supply company name,address and phone numbers along with a certificate of insurance as all affidavits may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of Industrial Accidents. Should you have any questions regarding the`law"or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. r � f City or Towns Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office.of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number: The affidavits may be returned to the Department by mail or FAX unless other arrangements have been made. The Office of Investigations would like to thank you in advance for you cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number. The Commonwealth Of Massachusetts Department of Industrial Accidents ortice of Inlles adeae 600 Washington Street,7'"Floor Boston, Ma. 02111 fax#: (617)727-7749 phone#: (617) 727-4900 ext. 406 Page 2 The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street, 7`h Floor Boston, Mass. 02111 Workers' Compensation Insurance Affidavit: Building/Plumbing/Electrical Contractors ® I am a sole proprietor, general contractor, or homeowner(circle one) and have hired the contractors listed below who have the following workers' compensation policies: company name: John W. Egan Co., Inc. address: 3 Border Street city: Newton, MA 02465-2005 phone#: 617-244-6390 insurance co. Liberty Mutual olicy#: WC1-111-252969-015 m4�.-a. _ -e d __. _.... .,,.taseAAP�RR..c ..Yi;:+i .i'aga+9�� ",�'•,.:. � e _ r°� -'low, .I.. .<xa= company name: Rockwell Roofing, Inc. address: P.O. Box 479, 44 Pond Street city: Leominster, MA 01453-0479 phone#: 978-537-7825 insurance co. American Interstate Insurance Co. policy#: AVWCMA1274412004 Failure to secure coverage as required order Section 25A ofMGL 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of$100.00 a day against me.I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. I do hereby certify under the pains and penalties ofperjury that the information provided above is true and correct. Signature: Date 3 Print name Rory Moulton Phone# 603-328-2222 CONTRACT 04-1 SOUTH ESSEX SEWERAGE DISTRICT 6Ll Idl h� Pe VPw1 11- CYY WASTEWATER TREATMENT PLANT UPGRADE Dy SECTION 01370-SCHEDULE OF VALUES 3/3//0 S Part 1 2 Primary Residual Sludge Pump System Upgrade (M-3B) Replacement otprimary sludge pumps, grinders and related work Mobilization De-mobilization $58,000 Bond and insurance $2,300 Site administration $17,690 Demo pumps,grinders,controls,and associated piping and valves $31,450 PP 9 467 Modify concrete pad $102, _ Install new pumps and grinders-labor $25,496 Install new pumps and grinders-material $44,746 Install associated piping i in and valves - $503,975 o&m manuals $158,502 Certifications and testing $10,062 Training $10,062 Lubricants and spare parts $10,062 Closeout Documentation $10,062 Instrumentations $10,062 r+reyewasb - $75,900 Sample systems 1•1/2"pvc $935 Seal water 1/2"copper $29,935 Painting $20,636 QjunSrys $3,000 Conduit/Supports/Boxes-Labor $15,000 E�e�fvli Conduit/Supports/Boxes-Material $11,000 fl-e�f0 Demolition-Labor/Material $6,000 Conductors and Cables-Labor $11,000 ileolv�� Conductors and Cables-Material $12,000 �l2 o I i Fuses/Breakers/Disconnects-Labor $12,000 Fuses/Breakers/Disconnects-Material 12,0010 rt.It c�"c Subtotal-Item 2 $1,199,838 To+ii � 2i, 5-� 1 ao��, la1/Il� ;kq g73, 903 4l2 �IL �gs0o kUkL J SS2-10O0 � �(oSl�ga3 Page 1 of 14 CONTRACT 04-1 SOUTH ESSEX SEWERAGE DISTRICT WASTEWATER TREATMENT PLANT UPGRADE SECTION 01370-SCHEDULE OF VALUES Part 1 3 Blended Residual Scum Pump System Upgrade Replacement or scum pumps, grinders and related work Mobilization De-mobilization $17,000 Bond and insurance $2,300 Site administration $4,162 demo pumps,gnnders,controls,and associated piping and valves $7,400 r+r concrete pump pads - $26,803 install new pumps and grinders-labor $9,186 install new pumps and grinders-material $27,133 install associated and valves $111,473 o&m manuals $20,873 Certifications and testing $2,229 Training $2,229 I Lubricants and spare parts $2,229 Closeout Documentation $2,229 painting $2,229 Instrumentations $2,000 $27,600 Conduit/Supports/Boxes-Labor $15,000 0.tJvtt Conduit/Supports/Boxes-Material Demolition-Labor/Material $8,000 (Iec L,000 ' Conductors and Cables-Labor $$5$5,000 Conductors and Cables-Material $13,000 Fuses/Breakers/Disconnects-Labor $8,000 �(,C c(yIL Fuses/Breakers/Disconnects-Material $6,000 Qt,c(Al Subtotal-Item 3 $335,078 Ole-ciAi ft63/000 Page 2 of 14 CONTRACT 04-1 SOUTH ESSEX SEWERAGE DISTRICT WASTEWATER TREATMENT PLANT UPGRADE SECTION 01370-SCHEDULE OF VALUES Odor Control Duct Work Upgrade - Grit Residuals Building Part 1 5 (H-16B) Replacement of odor control ductwork in the Grit Building and related Mobilization De-mobilization $42,000 Band and insurance $2,300 Site administration $11,446 infill wall to match existing $20,350 Grit Room-Preparation $25,690 QUr$81,000 Grit Room Demolition $76,000 Grit Room FRP Product $135,350 Grit Room FRP Installation $80,000 Testing 8 Balancing $8,000 Primary Influent Building Demolition $60,000 Primary Influent Building FRP Product $206,000 Primary Influent Building FRP Install $102,000 Conduit/Supports/Boxes-Labor $500 £lent, Conduit/Supports/Boxes-Material $500 Demolition-Labor/Material $750 Conductors and Cables-Labor $1,000 Conductors and Cables-Material - - $1,000 CuAn.- Fuses/Breakers/Disconnects-Labor $1,000 �G,t.At, Fuses/Breakers/Disconnects-Material $500 (l.! kk: Subtotal-Item 5 $855,386 6vi) dI4 7Sb9D ✓ Page 3 of 14 CONTRACT 04-1 SOUTH ESSEX SEWERAGE DISTRICT WASTEWATER TREATMENT PLANT UPGRADE SECTION 01370-SCHEDULE OF VALUES Part 1 g Replace Primary Residuals MCC's 38,4 Replacement of the existing MCC's 303 and 304 and related work Mobilization De-mobilization $7,000 Bond and insurance $2,300 Site administration $3,122 $5,550 Conduit/Supports/Boxes-Labor $17,000 4�,,W Conduit/Supports/Boxes-Material $11,000 Elt ckt Demolition-Labor/Material $8,000 Conductors and Cables-Labor $15,000 QV,avt. Conductors and Cables-Material $14,000 Q4 t,hu Motor Control Centers-Labor $41,000 (,lV it Motor Control Centers-Material $70,000 (,(tt,�•t. o&m manuals Certifications and testing $500$1,500 Training Lubricants and spare parts $500 Closeout Documentation $200 $200 Subtotal-Item 9 $196,872 4LW I /00D Page 4 of 14 CONTRACT 04A SOUTH ESSEX SEWERAGE DISTRICT WASTEWATER TREATMENT PLANT UPGRADE SECTION 01370-SCHEDULE OF VALUES Part 1 10 Primary Influent, Effluent and Grit Building Roofs installation of new roofing systems on the Primary Influent Building, Primary Effluent Building and Grit Building and related work Mobilization 000 De-mobilization $31, - Bond and insurance $2,300 Si[e administration $8,324 $14,800 Primary Influent Asbestos Removal $12,800 r� Vapor Retarder Roofing Insulation Material $18,680 Roof Membrane&Accessories $14,900 Ballast $2 200 (( Wood Blocking Material $3,160 l: Sheet Metal Material - $7,920 R Roof Drain Replacement $6,000 Roof Demo&Installation $48,890 I'{L Wood Blocking Installation $2,100 R Sheet Metal Installation $4,800 Rein alumn railing certify/warranties $2,562 $2,500 Primary Ef0uen Asbestos Removal $24 880 Vapor Retarder Roofing Insulation Material $35,220 V oti; Roof Membrane&Accessories $28,100 1, Ballast $4,200 R Wood Blocking Material $6,000 Sheet Metal Material $14,900 (l Roof Drain Replacement $16,000 PlVnbttiS Roof Demo&Installation $94 380 tlL -Wood Blocking Installation $3,960 R Sheet Metal Installation $9,060 (Z OUT Roof Hatch $600 alumn railing $2,562 certify/warranties $2,500 Grit Building Asbestos Removal - $20,000 roof vent demo and infill $8,000 Vapor Retarder Roofing Insulation Material $28,810 •Rpo� Roof Membrane&Accessories $23,000 Q Ballast $3,400 IZ -Wood Blocking Material $4,910 R - Sheet Metal Material $12,190 R I Roof Drain Replacement $10,000 �IvMt+lk, Roof Demo&Installation $75,625 '1, -Wood Blocking Installation $3,240 k Sheet Metal Installation $7,400 (Z 0 Roof Hatch - $600 p Z��bbr5 -alumn railing $2,562 certify/warranties _ $2,500 Scum Buildings Conduit/Supports/Boxes-Labor $500 (t, t,t�nol - Conduit/Supports/Boxes-Material $500 - Demolition-Labor/Material $750 I CONTRACT 04-1 SOUTH ESSEX SEWERAGE DISTRICT WASTEWATER TREATMENT PLANT UPGRADE SECTION 01370-SCHEDULE OF VALUES Conductors and Cables-Labor __$1,000Ms� Conductors and Cables-Material $750 ( kA Fuses/Breakers/Disconnects-Labor $500 ry"L,j Fuses/Breakers/Disconnects-Material $500 Subtotal-Item 10 $632,035 Q��hS1�5 3Lnoo %/ sq7, S6 JAL, 311 Sa ✓ Page 6 of 14 CONTRACT 04-1 SOUTH ESSEX SEWERAGE DISTRICT WASTEWATER TREATMENT PLANT UPGRADE SECTION 01370-SCHEDULE OF VALUES Part 1 11 Primary Influent and Effluent Building HeatiVent Upgrade Replacement of air handling units,steam piping,heat exchangers and controls with a glycol system and related work in the Primary Influent Building,Primary Effluent Building, two Scum Buildings and Operations Building Mobilization De-mobilization $49,000 Bond and insurance $2,300 Site administration $13,527 :E:: Painting $24,050 Demolition Pipe/Equip in Basement Level 9 $1,180 $38,000 Demo Pipe/Equip in Pipe Galle 1 &2 $3889641 jq$48,000 000 Demo Pipe/Equip in Influent/Effluent Bldgs. Install Pipe/Equip in Basement Level 9 �}1/y�{ Install Pipe/Equip in Pipe Gallery 1 &2 {1/ Install Pipe/Equip in Influent/EHluent Bldgs. (1V y7r-L Install AHUs in Influent/Effluent Bldgs. - RV<Q'L FRP Product µ(/y�LInstall FRP&SS Duct $ , 00 µ V L Install Hydronics in Boiler Room $72,000 J�/ik( Insulation(Duct&Pipe) $35,000 N VOr, Automatic Temperature Controls $160,000 5,_/670p Iesting&Balancing $10,000 &m manualsertifications and testing $5,500 raining ubricants and spare parts Closeout Documentation - Conduit/Supports/Boxes-Labor 4-LLc.� Conduit/Supports/Boxes-Material [ACLk,knk Demolition-Labor/Material $24.000 Conductors and Cables-Labor $13,000 l It if i Conductors and Cables-Material $10,000 Fuses/Breakers/Disconnects-Labor $12,000 4,�Nl,- Fuses/Breakers/Disconnects-Material $6,000 Subtotal-Item 11 $1,101,398 RV►4C 5761 .200 ,i Oec{Ytc (�8� 000 Page 7 of 14 CONTRACT 04-1 SOUTH ESSEX SEWERAGE DISTRICT WASTEWATER TREATMENT PLANT UPGRADE SECTION 01370-SCHEDULE OF VALUES Part 1 13 Primary and Secondary Construction Clean-up items Exterior painting of influent Pump Station,Primary Influent Building, Primary Effluent Building, Grit Building and two Scum Buildings,lead paint abatement in the Operations Building,insulation replacement on existing piping systems in the Operations Building,demolition of EF-10, demolition of gas piping in pipe galleries, demolition of existing abandoned HVAC controls in Operations Building and installation of exit lighting in Influent Pump Station, Grit Building and two Scum Buildings. Mobilization . De-mobilization $7,000 Bond and insurance $2,300 Site administration $8,324 remove and install new dock bumpers $14,800 Existin pipe insulation,6"-Unit Price(90 LF) $10,000 9P Existing pipe insulation,3-4"-Unit Price(200 LF) $4,680 Existing pipe insulation, 1-2"-Unit Price(500 LF) $8,200 Painting-Pumping Station $15,000 Painting-Influent bid $20,006 Painting-effluent bld $20,006 Painting-grid bid $20,006 Painting-scum bids $20,006 Painting-operation bid $20,006 Conduit/Supports/Boxes-Labor $20,006 $1,000 tj� U4 Conduit/Supports/Bozes-Material 4 Demolition-Labor/Material $750 (, r�k.a w($750 Conductors and Cables-Labor $1,000 Conductors and Cables-Material $1,000 1 Fuses/Breakers/Disconnects-Labor $1,000 S Lt('�n�,t Fuses/Breakers/Disconnects-Material �i 0 (cE,nU(� Light Fixtures-Labor $$75$750 L � i't rl Light Fixtures-Material $12,000 Subtotal-Item 13 $214,589 Subtotal-Part 1 $4,535,196 � (eti��gl 11zISoo Page 8 of 14 CONTRACT 04-1 SOUTH ESSEX SEWERAGE DISTRICT WASTEWATER TREATMENT PLANT UPGRADE SECTION 01370-SCHEDULE OF VALUES Part 2 1 Blended Residual Mixer Upgrade (M-1A) Replacement of existing mixers in the Thickened Waste Activated Sludge and Blended Sludge Storage tanks and related work Mobilization De-mobilization $7,000 Bond and insurance $2,300 Site administration $4,162 install mixers-labor $7,400 install mixers-material $20,377 ohm manuals - $146,660 Certifications and testing $3,203 Training $3,203 Lubricants and spare parts $3,203 Closeout Documentation $3,203 Conduit/Supports/Boxes-Labor $3,203 Conduit/Supports/Boxes-Material $7,000 CULu.t Demolition-Labor/Material $3 000 4,Lt jtA$2,000 Conductors and Cables-Labor $7,000 CI��M e I Conductors and Cables-Material ,000 �ic� lh ' Fuses/Breakers/Disconnects-Labor $$1,000 j • " 1 FusesBreakers/Disconnects-Material painting $1,500 l t,Lt.1 $8,500 Subtotal-Item1 $235,912 Page 9 of 14 CONTRACT 04-1 SOUTH ESSEX SEWERAGE DISTRICT WASTEWATER TREATMENT PLANT UPGRADE SECTION 01370-SCHEDULE OF VALUES Odor Control Duct Work Upgrade- Residuals Process Bid Part 2 4 Replacement of existing odor control ductwork with FRP ductwork in the Operations Building and related work Mobilization De-mobilization $34,000 Bond and insurance $2,300 Site administration $12,487 $22,200 System Preparation $64,500 Demo Duct $25,000 Install Fan EF-8903) $15,000 FRP Product $197,000 Install FRP $104,000 System Preparation $30,000 Demo Duct $30,000 Install Fan(EF-8902) $15,000 FRP Product $75,000 Install FRP " $65,000 Scrubber No.3 FRP Damper $20,000 o&m manuals Certifications and testing - $750$300 Training Lubricants and spare parts $150$150 Closeout Documentation $150 A Conduit/Supports/Boxes-Labor $1,000 ((-tJ�t�nL Conduit/Supports/Boxes-Material $750 Demolition-Labor/Material $1,000 Conductors and Cables-Labor $1,000 (LL, ( VL Conductors and Cables-Material $1,000 L.LWL Fuses/Breakers/Disconnects-Labor $1,0o0 (,LCtA L Fuses/Breakers/Disconnects-Material $750 t Subtotal-Item 41 719,487 ��,t,tthL �sSDO� Page 10 of 14 CONTRACT 04-1 SOUTH ESSEX SEWERAGE DISTRICT WASTEWATER TREATMENT PLANT UPGRADE SECTION 01370-SCHEDULE OF VALUES Part 2 6 Odor Control System Upgrade- Residuals Building (1-1-1A) Installation and modification of odor control systems in the Operations Building,including addition of roof mounted carbon filters and new exhaust fans for the ventilation air from the lower pump and mechanical rooms and Mechanical Room No.3 that currently houses the hot water heaters, a separate enclosure around the gas-fired units,increasing ventilation air in the compressor room,additional of an isolation valve in Odor Control Facility G and related work. Mobilization De-mobilization $7,000 Bond and insurance $2,300 Site administration $7,284 Replace Fan(EF-8910) $12,950$15,000 Install Carbon Filter&Roof Duct $42,000 System Balancing $5,000 Replace Fan(EF-8911) $15,000 Install Carbon Filter&Roof Duct $15,000 FRP Product Install FRP $40,000 System Balancing $38,000 MAU-8908 balancing - $5,000 $11,500 MAU-8904 balancing $11,500 o&m manuals Certifications and testing $750 Training $300 Lubricants and spare parts $150 Closeout Documentation $150 $150 ConduiVSupports/Boxes-Labor $1,000 Clwa�°I ConduiUSupports/Boxes-Material - $500 (u,t�hAMll Demolition-Labor/Material $1,500 Conductors and Cables-Labor $2,000 ��r.L"r".l�n"µ" Conductors and Cables-Material $1,500 fWhw• =akeDkers/Disconnects-Labor $1,000 C I.t,:&Lt kers/Disconnects-Material $800 fl,�t,IwU� al steel columns,beams and framing $25,114 QVi 614j nd ceiling $7,248 kojjd114) cking $7,599 gur�ptl� alant C/S-4A $515 EN I o r tJ f+i hm door and frame $4,156 ®N painting $25,500 sprinkler system $7,760 Subtotal-Item 6 $342,227 r� P�vilL�iti� � S-Zl3 � Z✓ LLeJt( L1I p oo f Page 11 of 14 CONTRACT 04.1 SOUTH ESSEX SEWERAGE DISTRICT WASTEWATER TREATMENT PLANT UPGRADE SECTION 01370-SCHEDULE OF VALUES Part 2 7 Residuals Management System improvements (M-5A to M-10A) Installation of conveyor modifications,weigh scales,second lime system and high and low roof access stairways and related work Mobilization De-mobilization $44,000 Bond and insurance $2,300 Site administration $12,487 install belt scales $22,200 install lime storage day bin and activator and volumetric feeder& i in $95,782 install pugmill mixer no. 1 piping $101,629 inline conveyor no.1,incld modification and plow no.5&6 $122,611 inline conveyor no.2,InGd modification and plow no.7 8 8 $87,036 install by-pass screw conveyor no:1 &no.2 $87,036 o&m manuals $93,572 Certifications and testing $5,960 Training - $5,960 Lubricants and spare parts $5,960 Closeout Documentation $5,960 cut and patch slabs $5,960 relocate 4"Cl drain $4,403 compress air 1"carbon steel $1,469 P1vr ltt) painting $6,546 $4,500 r+d exterior wall $470 ealdt\� f+i steel stair and cold formed framing(fsb) $$470 BN Idt J Ainfill masonry gwb $5,570$1,463 au 11r4� d nailer $594 a,,, I lr4te roof deck $14,053 t }dtil�i�� nailer at exisfing roof $2,850 Q,d I t j metal wall and roof $7,851 ev,1��`.1 wall-gwb - $2,089 f+i alumn door,frame&hardware(D-601) $4,134 Instrumentations - Aa �dty $69,000 Conduit/Supports/Boxes-Labor $35,000 ConduiUSupports/Boxes-Material $22,000 Demolition-Labor/Material $6,000 Conductors and Cables-Labor $18 000 fp„} i Conductors and Cables-Material $13,000 Fuses/Breakers/Disconnects-Labor $10,000 Fuses/Breakers/Disconnects-Material $7,000 L Subic tal-Item 7 $943,595 Pl"IIy i 1yb9 ✓ g��ial�, � �guy aecivi, 4 10S- 000 Page 12 of 14 CONTRACT 04-1 SOUTH ESSEX SEWERAGE DISTRICT WASTEWATER TREATMENT PLANT UPGRADE SECTION 01370-SCHEDULE OF VALUES Part 2 8 Thickened Residual Tank Aeration System (M-3A) installation of diffused air equipment and piping connected to existing compressors in the waste activated sludge wetwells and related work Mobilization De-mobilization $7,000 Bond and insurance $2,300 Site administration $2,081 painUng $3,700 3"ss diffused systems and associated piping,valves-labor $2,000 3"as diffused systems and associated piping,valves-material $55,000 ot:m manuals $15,000 Certifications and testing $750 Training $1,700 Lubricants and spare parts $1,500 Closeout Documentation $2,500 $550 Subtotal-Item 8 $94,081 Page 13 of 14 CONTRACT 04-1 SOUTH ESSEX SEWERAGE DISTRICT WASTEWATER TREATMENT PLANT UPGRADE SECTION 01370-SCHEDULE OF VALUES Part 2 12 Administration Building HVAC Modifications Modification of the dry cooler on the roof of the Administration Building and related work Mobilization De-mobilization $7,000 Bond and insurance $2,300 Site administration $2,081 - ,700 modify dry cooler unit(H-11A) $$3$3,000 sound Attenuators $12,000 administration Building HVAC Modifications $5,300 o&m manuals $4,000 Closeout Documentation $4,000 Conduit/Supports/Boxes-Labor $500 Conduit/Supports/Boxes-Matedal $500 Demolition-Labor/Material $200 Conductors and Cables-Labor $200 Conductors and Cables-Material $500 Fuses/Breakers/Disconnects-Labor $200 Fuses/Breakers/Disconnects-Material $100 Subtotal-Item 12 $66,581 Subtotal-Part 2 $2,401,883 GRAND TOTALS $6,937,079 �C� v(v►�,I Z� 060 Page 14 of 14