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Oxoboxo Lofts 42 Pink Row Uncasville, CT
ASI-04 – Revised Statement of Special Inspections
Issue Date: December 09, 2019 Changes to the Drawings Following the Construction Set dated 6/11/19:
Statement of Special Inspections dated 11/11/19, revised to include inspections for helical piles.
END OF ASI-04
Statement of Special Inspections
Project:Oxoboxo Lofts
Location:Pink Row, Uncasville, Connecticut
Owner:Ox Owner, LLC
Design Professional in Responsible Charge:
Daniel J. Morrissey P.E., Morrissey Engineering
LLC
This Statement of Special Inspections is submitted as a condition for permit issuance in accordance with the
Special Inspection and Structural Testing requirements of the Building Code. It includes a schedule of
Special Inspection services applicable to this project as well as the name of the Special Inspection
Coordinator and the identity of other approved agencies to be retained for conducting these inspections and
tests. This Statement of Special Inspections encompass the following disciplines:
Structural Mechanical/Electrical/Plumbing
Architectural Other:
The Special Inspection Coordinator shall keep records of all inspections and shall furnish inspection reports
to the Building Official and the Registered Design Professional in Responsible Charge. 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
and the Registered Design Professional in Responsible Charge. The Special Inspection program does not
relieve the Contractor of his or her responsibilities.
Interim reports shall be submitted to the Building Official and the Registered Design Professional in
Responsible Charge.
A Final Report of Special Inspections documenting completion of all required Special Inspections, testing and
correction of any discrepancies noted in the inspections shall be submitted prior to issuance of a Certificate of
Use and Occupancy.
Job site safety and means and methods of construction are solely the responsibility of the Contractor.
Interim Report
Frequency:monthly
or per attached schedule.
Prepared by:
Design Professional Seal
Daniel J. Morrissey
(type or print name)
11/11/19
Signature Date
Owner’s Authorization: Building Official’s Acceptance:
Signature Date Signature Date
Page 2 of 8
Schedule of Inspection and Testing Agencies
This Statement of Special Inspections / Quality Assurance Plan includes the following building systems:
Soils and Foundations Spray Fire Resistant Material
Cast-in-Place Concrete Wood Construction
Precast Concrete Exterior Insulation and Finish System
Masonry Mechanical & Electrical Systems
Structural Steel Architectural Systems
Cold-Formed Steel Framing Special Cases
Special Inspection Agencies Firm Address, Telephone, e-mail
1. Special Inspection
Coordinator
To Be Determined
2. Inspector Geotechnical Engineer if required
3. Inspector
4. Testing Agency Testing Laboratory
To Be Determined
5. Testing Agency
6. Other
Note: The inspectors and testing agencies shall 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.
CASE Form 101 Statement of Special Inspections CASE 2004
Page 3 of 8
Qualifications of Inspectors and Testing Technicians
The qualifications of all personnel performing Special Inspection and testing activities are subject to the
approval of the Building Official. The credentials of all Inspectors and testing technicians shall be provided if
requested.
Key for Minimum Qualifications of Inspection Agents:
When the Registered Design Professional in Responsible Charge deems it appropriate that the individual
performing a stipulated test or inspection have a specific certification or license as indicated below, such
designation shall appear below the Agency Number on the Schedule.
PE/SE Structural Engineer – a licensed SE or PE specializing in the design of building structures
PE/GE Geotechnical Engineer – a licensed PE specializing in soil mechanics and foundations
EIT Engineer-In-Training – a graduate engineer who has passed the Fundamentals of
Engineering examination
American Concrete Institute (ACI) Certification
ACI-CFTT Concrete Field Testing Technician – Grade 1
ACI-CCI Concrete Construction Inspector
ACI-LTT Laboratory Testing Technician – Grade 1&2
ACI-STT Strength Testing Technician
American Welding Society (AWS) Certification
AWS-CWI Certified Welding Inspector
AWS/AISC-SSI Certified Structural Steel Inspector
American Society of Non-Destructive Testing (ASNT) Certification
ASNT Non-Destructive Testing Technician – Level II or III.
International Code Council (ICC) Certification
ICC-SMSI Structural Masonry Special Inspector
ICC-SWSI Structural Steel and Welding Special Inspector
ICC-SFSI Spray-Applied Fireproofing Special Inspector
ICC-PCSI Prestressed Concrete Special Inspector
ICC-RCSI Reinforced Concrete Special Inspector
National Institute for Certification in Engineering Technologies (NICET)
NICET-CT Concrete Technician – Levels I, II, III & IV
NICET-ST Soils Technician - Levels I, II, III & IV
NICET-GET Geotechnical Engineering Technician - Levels I, II, III & IV
Exterior Design Institute (EDI) Certification
EDI-EIFS EIFS Third Party Inspector
Other
CASE Form 101 Statement of Special Inspections CASE 2004
Soils and Foundations Page 4 of 10
Item Agency #
(Qualif.)
Scope
1. Shallow Foundations
2 or 4
PE/GE
Inspect soils below footings for adequate bearing capacity and
consistency with geotechnical report.
Inspect removal of unsuitable material and preparation of subgrade
prior to placement of controlled fill
Inspect 100% of bearing surfaces.
2. Controlled Structural Fill
2/4
PE/GE
Perform sieve tests (ASTM D422 & D1140) and modified Proctor
tests (ASTM D1557) of each source of fill material.
Inspect placement, lift thickness and compaction of controlled fill.
Test density of each lift of fill by nuclear methods (ASTM D2922)
Verify extent and slope of fill placement.
Full time inspection is required for fill under footings. Inspect 50 to
100% of fill under slabs on grade depending on results.
3. Deep Foundations
(Helical Piles)
2/4 Inspect, locations and sizes for compliance with contract documents.
Review boring logs for compliance with specifications and approved
submittals. Inspect installation of hardware, brackets, etc. for
compliance with contract documents, approved submittals and
manufacturer’s specifications.
4. Load Testing
4. Other:
CASE Form 101 Statement of Special Inspections CASE 2004
Cast-in-Place Concrete Page 5 of 10
Item Agency #
(Qualif.)
Scope
1. Mix Design
1/4
ACI-CCI
ICC-RCSI
Review concrete batch tickets and verify compliance with approved
mix design. Verify that water added at the site does not exceed that
allowed by the mix design.
2. Material Certification
3. Reinforcement Installation
1/4
ACI-CCI
ICC-RCSI
Inspect size, spacing, cover, positioning and grade of reinforcing
steel. Verify that reinforcing bars are free of form oil or other
deleterious materials. Inspect bar laps and mechanical splices.
Verify that bars are adequately tied and supported on chairs or
bolsters. Inspect 75 to 100% of bars.
4. Post-Tensioning Operations N/A
5. Welding of Reinforcing N/A
6. Anchor Rods 1/4 Inspect size, positioning and embedment of anchor rods. Inspect
concrete placement and consolidation around anchors. Inspect 75 to
100% of rods.
7. Concrete Placement
1/4
ACI-CCI
ICC-RCSI
Inspect placement of concrete. Verify that concrete conveyance and
depositing avoids segregation or contamination. Verify that concrete
is properly consolidated.
8. Sampling and Testing of
Concrete 4
ACI-CFTT
ACI-STT
Test concrete compressive strength (ASTM C31 & C39), slump
(ASTM C143), air-content (ASTM C231 or C173) and temperature
(ASTM C1064). Take samples for each day of placement operations
and for each 150 cubic yards and each 5000 square feet of wall or
slab surface.
9. Curing and Protection
1/4
ACI-CCI
ICC-RCSI
Inspect curing, cold weather protection and hot weather protection
procedures.
10. Other:
CASE Form 101 Statement of Special Inspections CASE 2004
Masonry Required Inspection Level: 1 2 Page 6 of 10
Item Agency #
(Qualif.)
Scope
1. Material Certification
2. Mixing of Mortar and Grout
ICC-SMSI
Inspect proportioning, mixing and retempering of mortar and grout.
3. Installation of Masonry
ICC-SMSI
Inspect size, layout, bonding and placement of masonry units.
4. Mortar Joints
ICC-SMSI
Inspect construction of mortar joints including tooling and filling of
head joints.
5. Reinforcement Installation
ICC-SMSI
AWS-CWI
Inspect placement, positioning and lapping of reinforcing steel.
6. Prestressed Masonry
ICC-SMSI
N/A
7. Grouting Operations
ICC-SMSI
Inspect placement and consolidation of grout. Inspect masonry
clean-outs for high-lift grouting.
7. Weather Protection
ICC-SMSI
Inspect cold weather protection and hot weather protection
procedures. Verify that wall cavities are protected against
precipitation.
9. Evaluation of Masonry
Strength
ICC-SMSI
Test compressive strength of mortar and grout cube samples (ASTM
C780).
Test compressive strength of masonry prisms (ASTM C1314).
10. Anchors and Ties
ICC-SMSI
Inspect size, location, spacing and embedment of dowels, anchors
and ties.
11. Other:
CASE Form 101 Statement of Special Inspections CASE 2004
Structural Steel Page 7 of 10
Item Agency #
(Qualif.)
Scope
1. Fabricator Certification/
Quality Control Procedures
4
AWS/
AISC-SSI
ICC-SWSI
Review shop fabrication and quality control procedures.
2. Material Certification
4
AWS/
AISC-SSI
ICC-SWSI
Review certified mill test reports and identification markings on
wide-flange shapes, high-strength bolts, nuts and welding electrodes
3. Open Web Steel Joists N/A
4. Bolting
4
AWS/
AISC-SSI
ICC-SWSI
Inspect installation and tightening of high-strength bolts. Verify that
splines have separated from tension control bolts. Verify proper
tightening sequence. Continuous inspection of bolts in slip-critical
connections.
5. Welding
4
AWS-CWI
ASNT
Visually inspect all welds. Inspect pre-heat, post-heat and surface
preparation between passes. Verify size and length of fillet welds.
Ultrasonic testing of all full-penetration welds.
6. Shear Connectors
4
AWS/
AISC-SSI
ICC-SWSI
Inspect size, number, positioning and welding of shear connectors.
Inspect suds for full 360 degree flash. Ring test all shear connectors
with a 3 lb hammer. Bend test all questionable studs to 15 degrees.
7. Structural Details
1/4
PE/SE
Inspect steel frame for compliance with structural drawings,
including bracing, member configuration and connection details.
8. Metal Deck
4
AWS-CWI
Inspect welding and side-lap fastening of metal floor deck.
9. Other:
CASE Form 101 Statement of Special Inspections CASE 2004
Cold-Formed Steel Framing Page 8 of 10
Item Agency #
(Qualif.)
Scope
1. Member Sizes 1/4 Inspect materials used for compliance with contract documents.
Inspect 50 to 100% of members.
2. Material Thickness 1/4 Inspect materials used for compliance with contract documents.
Inspect 50 to 100% of members.
3. Material Properties 1/4 Inspect materials used for compliance with contract documents.
Inspect 50 to 100% of members.
4. Mechanical Connections 1/4 Inspect connections for compliance with contract documents,
including member sizes, geometry, hardware, number and size of
fasteners, etc.
5. Welding 1/4 Inspect connections for compliance with contract documents,
including member sizes, geometry, hardware, number and size of
fasteners, etc.
6. Framing Details 1/4 Inspect connections for compliance with contract documents,
including member sizes, geometry, hardware, number and size of
fasteners, etc.
7. Trusses N/A
8. Permanent Truss Bracing N/A
9. Other:
N/A
CASE Form 101 Statement of Special Inspections CASE 2004
Spray-Applied Fire Resistant Material Page 9 of 10
Item Agency #
(Qualif.)
Scope
1. Material Specifications
2. Laboratory Tested Fire
Resistance Design 3/4
ICC-SFSI
Review UL fire resistive design for each rated beam, column, or
assembly.
3. Schedule of Thickness
3/4
ICC-SFSI
Review approved thickness schedule.
4. Surface Preparation
4
ICC-SFSI
Inspect surface preparation of steel prior to application of
fireproofing
5. Application
4
ICC-SFSI
Inspect application of fireproofing.
6. Curing and Ambient Condition
4
ICC-SFSI
Verify ambient air temperature and ventilation is suitable for
application and curing of fireproofing.
7. Thickness
4
ICC-SFSI
Test thickness of fireproofing (ASTM E605). Perform a set of
thickness measurements for every 1,000 SF of floor and roof
assemblies and on not less than 25% of rated beams and columns.
8. Density
4
ICC-SFSI
Test the density of fireproofing material (ASTM E605).
9. Bond Strength
4
ICC-SFSI
Test the cohesive/adhesive bond strength of fireproofing ASTM
E736). Perform not less than one test for each 10,000 SF.
10. Other:
CASE Form 101 Statement of Special Inspections CASE 2004
Wood Construction Page 10 of 10
Item Agency #
(Qualif.)
Scope
1. Fabricator Certification/
Quality Control Procedures
Fabricator Exempt
1/4 Review shop fabrication and quality control procedures for wood
truss plant.
2. Material Grading 1/4 Inspect materials used for compliance with contract documents.
Inspect 50 to 100% of members.
3. Connections 1/4 Inspect connections for compliance with contract documents,
including geometry, hardware, number and size of fasteners, etc.
Inspect 50 to 100% of connections.
4. Framing and Details 1/4 Inspect connections for compliance with contract documents,
including member sizes, geometry, hardware, number and size of
fasteners, etc.
5. Diaphragms and Shearwalls 1/4 Inspect size, configuration, blocking and fastening of shearwalls and
diaphragms. Verify panel grade and thickness.
6. Prefabricated Wood Trusses 1/4 Inspect the fabrication of wood trusses. Inspect placement, spacing
and connections.
7. Permanent Truss Bracing 1/4 For floor faming, inspect size, placement and connections of
strongbacks.
For roof framing, inspect size, placement and connections of all
permanent bracing including truss bracing and member bracing if
required.
8. Other:
CASE Form 101 Statement of Special Inspections CASE 2004