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Home My WebLink About159 Burgess Road (3) 1 STRUCTURAL i' �1GINEERS Statement of Special Inspections COALITION CONNECTICIL7 ENGINEERS IN PRIVATE PRACTICE Project: v�lGIL��`� Location: ` p Owner: (� �/Ci1�iNi�01o�. G7• Owner's Ad ress: !�" �,�G��I 7 Architect of Record: Jiry K • Structural Engineer of Record: This Statement of Special Inspections is submitted as a condition for permit issuance in accordance with the 1 Special Inspection requirements of the BCCA National Building Code It includes a Schedule of Special Inspection Services applicable to this project as well as the name of the Special Inspector and the identity of other aooroved agencies intended to be retained for conducting these inspections The Special Inspector shall keep records of all inspections and shall furnish inspection reports to the Building Official, Structural Engineer and Architect of Recora Discovered discrepancies shall be brought to the immediate attention of the Contractor for correction If such discrepancies are not corrected, the discrepancies shall be brought to the attention of the Building Official. Structural Engineer and Architect of Record. The Soecial Inspection program does not relieve the Contractor of his or her responsibilities Interim reports shall be submitted to the Building Official, Owner, Structural Engineer and Architect of Record A Final Report of Special Inspections documenting completion of all required Special Inspections and' correction of any discrepancies noted in the inspections shall be submitted prior to issuance of a Certificate of ',.'se arc Cccuparcf ico site safety and means and methods of construction are solely the responsibility of the Contractor Interim Report Frequency or❑ per attached schedule Prepared by * ;tyre or printfame) -Ij Q39s *� Q� `sr S at a Da Des'on� nall Sea! Gtiv ,er s Authorization Building Official's Acceptance. Sgna!ure Date Signature Date SEC/CT Form 101R • Statement of Special Inspections • .9 SEC/CT 1999 Sheet 2 of f 0 Project: 4W W/ � ��. Schedule of Special Inspection Services The following sheets comprise the required schedule of special inspections for this project. The ccnstrucnon divisions which require special inspections for this project are as follows, Soils and Foundations ❑ Cold-Formed Steel Framing Cast-in-Place Concrete ❑ Spray Fire Resistant Material Precast Concrete Wood Construction [] Masonry Exterior Insulation and Finisn System ❑ Structural Steel ❑ Special Cases Inspection Agents Firm Address 1 Special Inspector r, PAy7 MA ,0. �)( 745 Tr%.,,W A%AH" A 2 Testing Laboratory r�0� MRr- . • &y 7&5 � 7 D /r 7" ,ern GA$. I N VI OF C7, 3 Testing Laooratory Cis -pi O"Nff4-- 14A7• • 0• -&Ox tv 7 � 4 Other Note The qualifications of all personnel per`o,ming Spectral Inspection activities are subject to the approval of the Building Official The inspection and testing agent snall be engaged by the Owner or the Owner's Agent, and not by the Contractor or Subcontractor whose work is to be inspected or tested Any conflict of interest must be disclosed to the Building Official, prior to commencing work r The credentials of all Insoectors and testing techn►c;ans shall be provided if requested It is recommended that the person administering the Special Inspections program be a Professional Engineer experienced in the design of buildings Kev for Minimum Qualifications of Inseection Agents where indicated on Schedules) Pc I Professional Engineer EIT I Engineering in Trainor ACI I American Concrete Institute Certified Concrete Field Testing Technician AWS I American Welaing Society Certified Welding Inspector ASN T I American Society of Non-Destructive Testing - Level II or III Qualifications of mspection agents may be indicated on the Schedule in instances where the Structural Engineer ceerns sucn requirements are appropriate SECICT Form 101R • Statement of Special Inspections • SEC/CT 1999 t Schedule of Special Inspection Services Sheet ?J of Soils and Foundations Project: fir' O'Wf FAIL - GOUTo WJAqwP Cl• Item Agent No. Scope (Qualit.) 1 Shailow Foundations 1 2 Controlled Structural Fill 17057 `vNfO t*RIC ON 7 AA)o CVMPICTIOAJ 3 Deep►=ouncyat:cns 1705 8 1705 9. 1816 13 i 4 Cther SECICT Form 101111 Statement of Special Inspections q!•SECICT 1999 Schedule of Special Inspection Services heet of l0 j Proect: �n�� f�L ' Cast-in-Place Concrete 95LCTti N NOW- Clo Item Agent No. Scope (Qualif.) A'► /�,,1u 1 Mix Design' Hly, 17054 1 q 1 2 Material Certification' , J 6� 1A64%fopo 17054 1 Y lAj.e �G ll�N �J`�JIV•off 1N✓J�• 3 Reinforcement Installation` 170542 4 Post-Tensioning Operations 170545 5 Batching Plant 17#054 a C T 1705 a 3 /* DNS � b0�aN , 1Ht &9 Concrete Placement;' GJ j j(f�•f��-�1l� �j� 170544 d Evaluation of Concrete S:re^y;h6 iC UAVA< Al 74 1705 4 4 9 Curing and Protection'1705 C -1 4 GU /q" 10 Other SEC/CT Form 101R • Statement of Special Inspections • !SEC CT 1999 1 Schedule of Special Inspection Services y of 1� Precast Concrete Project: �� 6% 1�llNG"�� Item Agent No. Scope (Qualif.) l 1 Plant Certification/Quality Control Procedures 1705 2: 1705 4 6 2. Mix Design' 1705.4 1 3 Material Certification' 1705.4 1 4 Reinforcement installation` It 17054.4 5 Prestress OGeraucrts 170545 6 Connections /Embeddea Items 1 7 Formwork Geometry C' 170543 8 Concrete Placement' 1705 4 4 9 Evaluation of Concrete Strength6 170544 1 G Curing and Protection' „GS44 11 Erec:ec Precast E-:ernents 1705 4 7 12 Cther SECICT F rm 101R Statement of Soec.ai Inspections C SEVCT 1999 Schedule of Special Inspection Services Sheet of 1D Masonry Project: lvn�,,i^'�i� L • 50-Orbi WIN&.4e,G • Item Agent No. Scope (Qualif.) 1 Material Certification 17055 2. Mixing of Mortar and Grout 17055 3 Installation of Masonry 17055 4 Remforcemerit lnstallat;cn 17055 5 Grouting Gperations ` 11705 b Weather protection' 17G55 7 Evaluation or Masonry Strength" 17055 8 Ancncrs and Ties 1705 5 9 Cther SEC/CT Form 101R • Statement of Soecial Inspections • f SECICT 1999 Schedule of Special Inspection Services Sheet of Structural Steel Project: G b gva,( • C , Item Agent No. Scope (Qualif.) 1 Fabricator Certification/ Quality Control Procedures 1705 2. 1705.3 1 2. Material Certification 19. 1705.32 3. Open Web Steel Joists Bolting` 1705331 X 5 weiarng- ' 05332 6 Shear Connectors" i Structural Details 1705333 C kletai Deck 1 9 Drier SECICT Form 101R Statement or Soec.al Inspections •d SEC/CT 1999 Schedule of Special Inspection Services Sheet of Cold-Formed Steel Framing Project: �� N C • Item Agent No. Scope (Quallf.) 1 Member Sees 2. Material Thickness 3 Material Properties 4 Mecnanical Connections 5 We!dirg 6 Framing Details 1 ,r Wither SECICT F rm 101R Statement of Soec;al Inspections SE,--"CT 1999 Schedule of Special Inspection Services Sheet of !a Spray plied Fire Resist t Nlaberial Project: SANDSOUJ k�/'��L• Item Agent No. Scope (Qualif.) 1 Material Specifications 2. Laboratory Tested Fire Resistance Design 3 Schedule of Thickness 4 Surface Preparation 1705 121 5 Application 1705 12.2 6 Cunng and Ambient Conchbon 1705 12 2 7 Thickness 1705 123 1 8 Density 1705 124 9 Bond Strength 1705 12 5 10 Cther SECICT F rm 1101111 Statement of Special Inspections • f SEA./CT 1999 t Schedule of Special Inspection Services Sheet (0 of/0 Wood Construction Project: 5ANOSPAVI L a Item Agent No. Scope (Qualif.) 1 Fabricator Certification/ Quality Control Procedures 1705 2: 1705 6 t ? ,Material Grading 3 Connect;ons , ,17056 _ a framing ana Details pow T�O Cther SECICT F rm 101R Statement of Special Inspections ?SE::./CT 1999 1