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125 Bidwell Road (12)
r - '' FtttG (,21S �c � - CONNECTICUT ENGINEERS IN PRIVATE PRACTICE STRUCTURAL ENGINEERS COALITION STATEMENT OF SPECIAL INSPECTIONS PROJECT: CQa-5 i S 7-/ - 2 LOCATION: i�(w-ed Snke 'so. C r PERMIT APPLICANT: FP5nf(�-hn/�£ APPLICANTS ADDRESS: 10 7 Cy 06jt,J3o C . 124( 810,0,*f ARCHITECT OF RECORD: ,� MN e4 STRUCTURAL ENGINEER OF RECORD: This statement of special inspection is submitted as a condition for permit issuance in accordance with Section 1307.0 of the 1988 Supplement to the 1987 BOCA National Building Code. It includes a Schedule of Special Inspections applicable to this project as well as the name of the Special Inspector, and the identity of other testing laboratories or 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 code official and to the structural engineer or architect of record. All discrepancies shall be brought to the immediate attention of the contractor for correction. If the discrepancies are not corrected,the discrepan- cies shall be brought to the attention of the code official and the structural engineer or architect of record. Interim reports shall be submitted to the code official and to the structural engineer or architect of record monthly, unless more frequent submissions are requested by the code official:- Job site safety is solely the responsibility of the contractor. Materials and activities to be inspected are not to include the contractors equipment and methods used to erect or install the materials listed. Prepared By: i Type or print name 7// Signature Date `s 'y 1 e v�v !W_'x , �0c�aeW„cas ;, Preparer's P.E.Seal Applicant's Authorization: Building Official's Acceptance: c 7 3# Signature Date Signature Date CEPP/SEC FORM SEC 101 •Statement of Special Inspections•CEPP/SEC •C 1990 (See Commentary For Guidance In Gornpleting ThisForm) APPLICABLE TO THIS PROJECT MATERIAL / ACTIVITY SERVICE Y/N EXTENT AGENT* COMPLETED STEEL CONSTRUCTION Verify fabrication/quality control procedures In-plant review (Code Section 1307.3.1) ^ , Note: Open web Joists exempt /v Structural steel Review material identification markings and certified test reports 1307.3.2 U, 1— F661 T Bolts, nuts/,washers Review material identification markings V`'�"AL Tvf-v o and certified test reports (1307.3.2) A)v7 A.4Q rN-op Welb filler material Review,certificate of compliance (1307.3.2) A) V�Sv�C 7'urN o�F � � 31(�4 II review 7 Installation of high strength bolts Field ie (130 .re 3.3.1) � � . Y /)af' M LrH'00 WeldingShop and field review 1307.3.3.2 P ( ) VISUAL F� . Details Field review steel frame 1307.3.3.3 l ) U lS u AL CONCRETE CONSTRUCTION Atvie4J Concrete materials Review certificates of compliance (1307.4.1) M�x ✓��"r� � �^� FC�j �' Installation of reinforcing steel Field review (1307.4.2) �C3 Installation of prestressing In-plant or field review (1307.4.2) A Formwork R view submittals and field review (1307.4.3) Concreting opetations: a. Evaluation of concrete strength Review submittal and field testing (1307.4.4) Y y b. Proper mix proportions and mix techniques Review submittal and field review (1307.4.4) � V•/S 4.,A�_ c. Concrete placement Field review 1307.4.4 — U/`S��►(- /eC� ebo��� P ( ) - l_-- - - — - — — d. Concrete curing Field review (1307.4.4) U/Sa AG FG3 7123/Q4 J/Z 7/� Prestressing In-plant or field review (1307.4.5) w ' Precast concrete manufacturer In-plant review (1307.4.6) Erection of precast concrete Field review (1307.4.7) MASONRY Masonry materials Review submittals (1307.5) //S - Masonry strength testing Review submittal and field testing 1307.5 �s Construction operations Field review (1307.5) WOOD CONSTRUCTION Verify fabrication/quality control procedures In-plant and field review (1307.6) PILE FOUNDATIONS Installation Field review (1307.7) N SPECIAL CASES (Attach B 112 x 11 I1 needed) (t307.8) Pf INSPECTION AGENTS FIRM ADDRESS 1. Special Inspector: FR1riic /°-7 be/cbm ;o/,/C- y C. 00 Z { 2.Testing Laboratory: S ti ��'`�o►�a� nrr,�/1� c ,e<_-_j 3 �R6aa, 3 Z I Llis 5 r�/Lerr..?'' n7e� �y-.h c3T O o.T- 3.Testing Laboratory: r 4. Other: Note: The Qualifications Of The Special Inspector And Testing Laboratories May Be Subject To The Approval Of The Building Official J CEPP/SEC FORM SEC 101 •Statement of Special Inspections CEPP/SEC ©1990