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THE STATE EDUCATION DEPARTMENT / THE UNIVERSITY OF THE STATE OF NEW YORK / Albany, NY 12234
Office of Facilities Planning, Room 1060 Education Building Annex
Tel. (518) 474-3906 Fax (518) 486-5918
www.emsc.nysed.gov/facplan/
General Information PAGES 1, 2, AND 3 ARE REQUIRED FOR ALL PROJECTS SUBMITTED FOR REVIEW.
Note: Fill in every line.
Note: The Excel version of this form has comments embedded for guidance in filling out many areas of the form. Comments are
accessible by placing the cursor over the red triangle, right click and hit edit to read or copy the comment.
Project Description:
SED Project Control Number located on all Contract Documents, forms, and correspondence. Yes
Required Bidding information is located in the contract documents on page or drawing numbers and are paperclipped:
Equivalency Clause Non-Collusion Certification Wage Rates
Required Uniform Safety Standards and TEM information is located on page or drawing numbers and are paperclipped:
C of O statement Exiting Plan Off-Gassing
Safety & Security Ventilation Separation Asbestos Isolation
Separation of Const. Noise Control Testing Lead & Asb.
Cleaning Occupied Area Fume Control TEM & Code Rule 56
Required 155.7 items on the Evaluation of Existing Building Form. Non-conformances are addressed in the documents:
Yes No, District addressing separately No, Addressed in SED project # NA (Big 5 only)
No non-conformances exist list SED project number
Per 155.8 (e) (3) A certificate of Occupancy, a temporary certificate or a building permit may be denied or revoked for violation of health or
safety standards, imposed by law or regulation, which indicate that a building is not suitable for occupancy or intended use.
It is not necessary to provide pages noted as "NA". If the page does apply and is erroneously not provided, the project will
not be reviewed until the page is provided with an addendum.
FP-CCC 12/2006 CODE REVIEW CHECKLIST page 2 of 9
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SED Control Number
SED Project Number
District BEDS Code Building Identification # Project number
0
District Name Building Name
Building Information:
Use and Occupancy Classifications: (check all that apply) E B I-4 S-1 R-2 U
A- M S-2 Other -
For Existing Buildings check all that apply: NA Change of Occupancy Relocation Historic-K10 report required
( * check the definitions in Appendix K) Repair* Renovation* Alteration* Reconstruction* Addition*
* Provide Key Plans demonstrating distinct work areas
list drawing numbers
Type of Construction: (check all that apply)
Existing bldg: I-A I-B II-A II-B III-A III-B IV V-A V-B
New building(s): I-A I-B II-A II-B III-A III-B IV V-A V-B
Building Height and Area for New Buildings and Additions: (If additional space needed, provide on Code Compliance Drawings.) NA
Permitted: Height in feet: Number of stories: Square feet / floor*
Special Features: (check all that apply) Parapet Mezzanine Stage Catwalk Courtyard
Is a Sprinkler System provided? No Yes, full Yes, partial Yes, in new construction only
Accessory Assembly Areas: (If additional space needed, provide on Code Compliance Drawings.) NA
Code requirements:
Gymnasium: area in sq. ft. Occupant load Required E.W. Provided E.W.
Auditorium: area in sq. ft. Occupant load Required E.W. Provided E.W.
Cafeteria: area in sq. ft. Occupant load Required E.W. Provided E.W.
Library: area in sq. ft. Occupant load Required E.W. Provided E.W.
Other: area in sq. ft. Occupant load Required E.W. Provided E.W.
SED (MPS) requirements: Reminder: Exit unit = 22", half units are permitted at 12" per half unit.
Gymnasium: area in sq. ft. / 600 sq. ft added
Req'd exit units Provided exit units
Gymnasium: bleacher sq. ft. / 250 sq. ft equals
Auditorium: area in sq. ft. / 600 sq. ft equals Req'd exit units Provided exit units
Stage/Platform area in sq. ft. / 1200 sq. ft equals Req'd exit units Provided exit units
Cafeteria: area in sq. ft. / 600 sq. ft equals Req'd exit units Provided exit units
Natatorium: bleacher sq. ft / 250 sq. ft added
Req'd exit units Provided exit units
remaining area including / 1500 sq. ft. equals
the pool in sq. ft.
STRUCTURAL RESPONSIBILITY
FP-CCC 12/2006 CHECKLIST and CERTIFICATION page 3 of 9
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SED Control Number
SED Project Number
District BEDS Code Building Identification Number Project number
0
District Name Building Name
The architect/engineer for each project which requires approval by the Commissioner, shall complete and sign this form and submit it together with the final plans
and specifications for the project.
A. STRUCTURAL ELEMENTS
Are there any structural elements involved with this project Yes No
a. If no, go to Section D and sign the Certification.
b. If yes, complete Sections B, C, and D, seal and sign the Certification
B. STRUCTURAL LOADING
Structural loading shall meet at least the requirements of the Uniform Fire Prevention Yes No
and Building Code. Page 5, the Structural Design Checklist, is appropriately filled in and attached
C. STRUCTURAL DESIGN
IMPORTANT: IMPORTANT:
Check who is responsible Check applicable
for the design of each element for each element
ARCH ENGR Present Not Present
STRUCTURAL ELEMENT In Work In Work
1. Foundation
a. Footings
b. Walls
c. Piles (type)
2. Floor Framing Systems
a. Mechanical/Special Framing
3. Columns
4. Walls
a. Exterior Bearing
1. lintels
2. veneer attachment
3. reinforcing
b. Exterior Nonbearing
1. lintels
2. veneer attachment
3. reinforcing
c. Interior Bearing
1. lintels
2. reinforcing
d. Interior Nonbearing
1. lintels
2. reinforcing
5. Roof Framing Systems
a. Mechanical/Special Framing
6. Stairs and Stairways
7. Bridges
8. Catwalks
9. Railings
10. Bleachers/Grandstands
11. Retaining Walls
12. Chimney Stacks
13. Parapet Walls
14. Other
D. CERTIFICATION
Seal of R. A. licensed in New York State Seal of P. E. licensed in New York State
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
SED Control Number
SED Project Number
District BEDS Code Building Identification Number Project number
0
District Name Building Name
LOCATION in Documents
Dead End Corridors less than 1 1/2 times the width, max 20 ft. . Yes not applicable
Smoke Zone Exiting all student spaces over 500 sq. ft. . . . Yes not applicable
Rescue Windows located on Construction Documents . . . Yes not applicable
Rescue Window Clear Opening Size on Construction Document(s) . Yes not applicable
Class A finishes in Corridors and Assembly Spaces . . . Yes not applicable
Assembly Area Maximum Occupancy Sign . . . . . Yes not applicable
Electrically Powered Moveable Partition Sign . . . . . Yes not applicable
Fire Extinguishers . . . . . Yes not applicable
Safety Glazing in Doors, Exterior Corridor Windows, and Stair Windows Yes not applicable
Partition/Wall Fireproofing Design Number of Rated Partitions/Assemblies Yes not applicable
Corridor enclosure . . . . . . . . . Yes not applicable
Rated interior Corridor Windows . . . . . . . . Yes not applicable
Elevator Equipment Room enclosure 2 hour . . . . . Yes not applicable
Stairways, riser and tread sizes are indicated . . . . . Yes not applicable
Classroom Ceiling height 9'-0" . . . . . . . . Yes not applicable
Secure Exam Storage . . . . . . . . . Yes not applicable
Fire Blankets in Laboratory Rooms . . . . . . . Yes not applicable
Door Schedules . . . . . . . . . Yes not applicable
Hardware Schedule . . . . . . . . . Yes not applicable
Window Schedules . . . . . . . . . Yes not applicable
Roof System UL Class A or FM Class 1 . . . . . . Yes not applicable
Carpet, Radiant Floor Panel Test Class 1 . . . . . . Yes not applicable
Assembly Area Seating meets NFPA 701 . . . . . . Yes not applicable
Truss/Joist Identification Signs . . . . . . Yes not applicable
Site and floor plans showing separations during construction . . . Yes not applicable
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
SED Control Number
SED Project Number
District BEDS Code Building Identification Number Project number
0
District Name Building Name
1604.5 Prior to structural design, the District / BOCES has been consulted to determine if this facility is currently or will be
considered for use as an emergency shelter facility? Yes Will this building be used as an emergency Shelter? Yes
The New York State Uniform Fire Prevention and Building Code Section 1603 requires, "The design loads and other information
pertinent to the structural design required by Sections 1603.1.1 through 1603.1.8 shall be clearly indicated on the
construction documents for parts of the building or structure."
Basic wind speed (3-second gust), miles per hour and wind exposure
list drawing numbers
1603.1.6 Flood load Not in flood hazard area per Section 1612.3
Flood certification provided per Section 1612.5 list drawing numbers
1621.2 and 1621.3 have been reviewed and coordinated with architect and engineers Yes
1704 Special Inspection requirements, where are they located in the documents?
list drawing or specification numbers
Print name:
Signature:
Date: Telephone:
Seal of P. E. or R. A. licensed in New York State
FP-CCC 12/2006 ENERGY CONSERVATION CODE CHECKLIST page 6 of 9
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SED Control Number
SED Project Number
District BEDS Code Building Identification Number Project number
0
District Name Building Name
The 2002 Energy Conservation Code of New York State Section 104.2 states "Compliance with specific provisions of this code shall be
determined through the use of computer software, worksheets, compliance manuals and other similar materials when they have met
the intent of this code." (www.eren.doe.gov/buildings/tools_directory/software/comcheckez.htm)
Section 104.3 requires " Construction documents shall be of sufficient clarity to indicate the location, nature and extent of the work
proposed and show in sufficient detail pertinent data and features of the building and the equipment and the systems as herein
governed, including, but not limited to, design criteria, exterior envelope component materials, U-factors of the envelope systems, U-
factors of fenestration products, R-values of insulating materials, size and type of apparatus and equipment, equipment and systems
controls and other pertinent data to indicate conformance with the requirements of this code and relevant laws, ordinances, rules and
regulations."
Glazing percentage: 10% or less between 10% and 25% between 25% and 40% between 40% and 50%
Design Approach: Chapter 7 - Prescriptive Chapter 8 - Acceptable Practice DOE software used
Chapter 7 - System
Chapter 7 - Energy Cost Budget
803 Building Mechanical Systems: 803.2 Applicable 803.3 Applicable Not applicable
Design Load
list drawing number
804 Service Water Heating: Applicable Not applicable
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SED Control Number
SED Project Number
District BEDS Code Building Identification Number Project number
0
District Name Building Name
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
SED Control Number
SED Project Number
District BEDS Code Building Identification Number Project number
0
District Name Building Name
NA = Not Applicable = LOCATION in Construction Documents
GENERAL
Acceptance Testing/Inspection Yes NA Sequence of Operations . Yes NA
Training . . Yes NA Identification Lines/Mtl./Eqpt. Yes NA
Equipment Listed/Labeled . . Yes NA Instruction Manual / Video Yes NA
Fire Stopping . . Yes NA Material/Eqpt Reuse . Yes NA
Equipment Location . . Yes NA Unsafe System Rehab/Rmvl. Yes NA
Access/Clearances . . Yes NA Condensate Disposal . Yes NA
Controls . . Yes NA No Direct Fired Heaters . Yes NA
FP-CCC 12/2006 PLUMBING & GAS REVIEW CHECKLIST page 9 of 9
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SED Control Number
SED Project Number
District BEDS Code Building Identification Number Project number
0
District Name Building Name
NA = Not Applicable = LOCATION in Construction Documents
PLUMBING NA GAS NA
Rodent proofing . . Yes NA Low pressure 1/2 psig or < Yes NA
Protection plumbing systems . Yes NA No gas lines in corridors . Yes NA
Structural Safety . . Yes NA Master Gas Valve for Outlets Yes NA
Piping Support . . Yes NA Pipe Size/Material . . Yes NA
Floodproofing . . Yes NA Valves . . . . Yes NA
Fixtures/Faucets/Fittings NA Enc. of Pressure Regulation Eq. Yes NA
Fixture Adequacy . . Yes NA PSC Distribution Service . Yes NA
Accessible Facilities . . Yes NA Liq. Petroleum Gas NFPA 58 Yes NA
Emergency Shower/Eyewash . Yes NA Vent/Chimney . . . Yes NA
Drinking Fountains . . Yes NA Appliances Shown . . Yes NA
Sink - Bubbler Separated . Yes NA Other ______________ . Yes NA
Lavatories . . Yes NA Other ______________ . Yes NA
Showers . . Yes NA
Sinks . . Yes NA GENERAL - GAS
Urinals . . Yes NA Acceptance Testing/Inspection Yes NA
Water Closets . . Yes NA Training . . . . Yes NA
Water Saving Fixtures . . Yes NA Equipment Listed/Labeled . Yes NA
Water Heaters NA Fire Stopping . . . Yes NA
DHW Heater ASME Tank . Yes NA Equipment Location . . Yes NA
Location . . Yes NA Access/Clearances . . Yes NA
Controls . . Yes NA Controls . . . . Yes NA
Safety Devices . . Yes NA Sequence of Operations . Yes NA
Insulation . . Yes NA Identification Lines/Mtl./Eqpt. Yes NA
Water Supply and Distribution NA Instruction Manual / Video . Yes NA
Protect Water Quality . . Yes NA Material/Eqpt Reuse . . Yes NA
Size/Material Piping . . Yes NA Unsafe System Rehab/Rmvl. Yes NA
No Lead Solder . . Yes NA Condensate Disposal . Yes NA
Disinfection . . Yes NA No Direct Fired Heaters . Yes NA
Sanitary Drainage NA
Sanitary Discharge Permits . Yes NA
Storm - Sanitary Separated . Yes NA
Size/Material Piping . . Yes NA
Sumps/Ejectors . . Yes NA
Indirect/Special Waste . . Yes NA
Vents . . Yes NA
Traps/Interceptors/Separators Yes NA
Storm Drainage . . Yes NA
Swimming Pool . . Yes NA
GENERAL - PLUMBING
Acceptance Testing/Inspection Yes NA Identification Lines/Mtl./Eqpt. Yes NA
Training . . Yes NA Instruction Manual / Video Yes NA
Equipment Listed/Labeled . . Yes NA Material/Eqpt Reuse . . Yes NA
Fire Stopping . . Yes NA Unsafe System Rehab/Rmvl. Yes NA
Equipment Location . . Yes NA Condensate Disposal . Yes NA
Access/Clearances . . Yes NA