CC-0729-2021 Office Use Only
� r ` ADDITION/ALTERATION PERMIT Permit#: CC —0 :- 202
APPLICATION Permit Fee:$ �5
Town of Qae ne sbury
742 Bay Road,Queensbury, NY 12804
Invoice #: �v
P:518-761-8256 www.queensbury.net
Flood Zone? Y N eyiewed
Project LocationXCarey Road Bldg. 2 Basement
Tax Map ID #: 309.13-2-31.2 Subdivisior I E. C E O V E
OCT 0 4 2021
PROJECT INFORMATION: TOWN OF QUEENSBURY
BUILDING& CODES
TYPE: Residential x Commercial, Proposed Use:
Single-Family Two-Family Multi-Family (#ofunits_ Townhouse
Business Office Retail Industrial/Warehouse Garage (#of cars )
x Other(describe)—Health Care Facility Expansion
ADDITION SQUARE FOOTAGE: ALTERATION SQUARE FOOTAGE:
1st floor: 1st
2ndfloor: floor:
31d floor: 2ndfloor:
Basement (habitable 31d floor:
space): Basement (habitable space):
Total sq ft: 1,300
Total sq ft:
Scope of work to be done:
Renovation of approximately 1,300 s.f. of existing storage areas within the basement level of HHHN Building#2, located at the
161 Carey Road.The project's program is inclusive of examination and office space to be added to the existing Saratoga Hospital
Pulmonary Clinic.
Addition/Alteration Application Revised January2021
ADDITIONAL PROJECT INFORMATION:
1. Estimated Cost of Construction: $260,000.00
2. Source of Heat(circle one): x Gas Oil Propane Solar Other
Fireplaces/inserts need a separate Fuel Burning Appliances & Chimney Application
3. Are there any structures not shown on the plot plan? YES x NO Explain:
4. Are there any easements on the property? YES x NO
SITE INFORMATION:
• Is this a corner lot? YES NO
• Will the grade be changed as a result of the construction? YES NO
• What is the water source? x PUBLIC PRIVATE WELL
• What type of wastewater system is on the parcel? x SEWER PRIVATE
SEPTIC
DEC RATIOM:
I. 1 acknowledge that no construction shall be commenced prior to the issuance of a valid permit and will be
completed within a 12 month period.Any changes to the approved plans priorto/during construction will require
the submittal of amended plans, additional reviews and re-approval.
2. If,foranyreason,the building permit application iswithdrawn,30%ofthefee is retained bytheTownof
Queensbury. After 1 year from the initial application date, 100%of the fee is retained.
3. If the work is not completed by the 1 year expiration date the permit may be renewed, subject to fees
and department approval.
4. 1 certifythatthe application,plans and supporting materials areatrueand a complete statement and/or description
of the work proposed,thatall workwill be performed in accordance withthe NYS Building Codes,local building laws
and ordinances, and in conformance with local zoning regulations.
5. 1 acknowledge that prior to occupying the facilities proposed I, or my agents, will obtain a certificate of
occupancy.
6. 1 also understand that I/we are required to provide an as-built survey by a licensed land surveyor of all newly
constructed facilities prior to issuance ofa certificate of occupancy.
I have read and agree to the above:
PRINT NAME:
SIGNATURE: DATE:
100/1
Addition/Alteration Application Revised January2021
CONTACT INFORMATION: PLEASE PRINT LEGIBLY OR TYPE, PLEASE INCLUDE AN EMAIL
• Applicant:
Name(s): Hudson Headwaters Health Network
Address, C/S/Z: 9 Carey Road Queensburv, NY 12804
Cell Phone: (518) 857-3408 Land Line: � )
Email:-dvalentini@hhhn.org.
Primary Owner(s):
Name(s): Hudson Headwaters Health Network
Mailing Address, C/S/Z: 9 Carey Road Queensburv, NY 12804
Cell Phone: (518) 857-3408 Land Line:
Email: dvalentini@hhhn.org
C Check if all work will be performed by property owner on_yl
• Contractor(s): (List all additional contractors on the back of thisform)
Contact Name(s): AOW Construction
Contractor Trade: General Contractor
Mailing Address, C/S/Z: 30 Essex St Albany, NY 12206
Cell Phone:) Land Line: (518) 482-3400
Email: apelfrev@aowconstruction.com
**Workers' Comp documentation must be submitted with this alplication**
• Arch itect(s)/Engi nee r(s):
Business Name: The Architectural Collaborative
Contact Name(s): Jon P r i m e a u
Mailing Address, C/S/Z: 33 Church Street Saratoga Springs, NY 12866
Cell Phone:) Land Line: (518) 796-6236
Email: ion@the archcollaborative.com
Contact Person for Compliance in regards to this project: Jon Primeau
Cell Phone:) Land Line:
Email: ion@the archcollaborative.com
Addition/Alteration Application Revised January2021
• Contractor(s): Workers' Comp documentation must be submitted with this application
Contractor Name(s): Absolute Fire Protection LLC
Contractor Trade: Fire Suppression
Mailing Address, C/S/Z: 1182 US Route 9W (PO Box 10) Selkirk, NY 12158
Cell Phone: Land Line: (518) 767-3700
Email:
• Contractor(s): Workers' Comp documentation must be submitted with this application
Contractor Name(s): Tri Valley Plumbing & Heating, Inc
Contractor Trade: Plumber
Mailing Address, C/S/Z: 2617 Hamburg St. Schenectady, NY 12303
Cell Phone: Land Line: (518) 355-8039
Email:
• Contractor(s): Workers' Comp documentation must be submitted with this application
Contractor Name(s): JDJ Comfort Systems
Contractor Trade: HVAC
Mailing Address, C/S/Z: 44 Brickyard Rd. Mechanicville, NY 12118
Cell Phone: Land Line: (518) 857-6131
Email:
• Contractor(s): Workers' Comp documentation must be submitted with this application
Contractor Name(s): Prediletto Electric
Contractor Trade: Electrician
Mailing Address, C/S/Z: 56 Clifton Country Rd. Suite 108 Clifton Park, NY 12065
Cell Phone: Land Line: (518) 371-2511
• Contractor(s): Workers' Comp documentation must be submitted with this application
Contractor Name(s): Jimco Painting
Contractor Trade: Painter
Mailing Address, C/S/Z: 14 Cliff View Lane Voorheesville, NY 12186
Cell Phone: Land Line: (518) 368-2932
Email:
Addition/Alteration Application Revised January2021
FIRE MARSHAL'S OFFICE
Town of Queensbury
742 Bay Road, Queensbury, NY 12804
"Home of Natural Beauty ... A Good Place to Live "
LAN RE iE `
HHHN / Saratoga Hospital
151 Carey Road B-100
CC-0729-2021
10/7/21
I have reviewed the submitted drawings for the above project; and offer the
following comments:
1) Verify Fire extinguisher Inspection & locations per plan.
2) Locks / latches shall comply with 2020 NYSFC.
3) Exit-emergency light plan appears adequate. Fire Marshal to witness a
function test prior to CO.
4) Verify Knox Box keys.
5) Verify aisles & storage.
6) Provide NFPA 72 letter for fire alarm modifications.
7) Provide NFPA 13 letter for sprinkler modifications.
8) Carbon Monoxide detection required.
4n,
Deputy Fire Marshal
Gary K. Stillman
742 Bay Road
Queensbury NY 12804
518 761 8205
garys@queensbury.net
Fire Marshal 's Office • Phone: 518-761-8206 Fax: 518-745-4437
Crenuirslual@queensbuni.net • WWW.queensbun .net
COMcheck Software Version 4.1.5.3
Interior Lighting Compliance Certificate
OF Epy
Project Information COS°
Energy Code: 2018 IECC `�� z
Project Title: 2
Project Type: New Construction 07788-rA
� ssfoNP�'
Construction Site: Owner/Agent: Designer/Contractor:
Additional Efficiency Package(s) REVIEWED FOR
Credits: 1.0 Required 1.0 Proposed
Reduced Lighting Power,1.0 credit ENERGY CODE COMPLIANCE
Allowed Interior Lighting Power
A B C D
Area Category Floor Area Allowed Allowed Watts
(ft2) Watts/ft2 (B X C)
1-Health Care-Clinic 1250 0.74 922
Total Allowed Watts= 923
Proposed Interior Lighting Power
A B C D E
Fixture ID: Description/Lamp/Wattage Per Lamp/Ballast Lamps/ #of Fixture (C X D)
Fixture Fixtures Watt.
1-Health Care-Clinic
LED 1:Al:Other: 1 10 33 331
LED 2:131:Other: 1 7 38 269
LED 3:Cl:Other: 1 6 10 62
LED 4:D1:Other: 1 5 8 40
Total Proposed Watts= 702
Interior Lighting PASSES: Design better than code
Interior Lighting Compliance Statement
Compliance Statement. The proposed interior lighting design represented in this document is consistent with the building plans,
specifications, and other calculations submitted with this permit application.The proposed interior lighting systems have been
designed to meet the 2018 IECC requirements in COMcheck Version 4.1.5.3 and to comply with any applicable mandatory
requirements listed in the Inspection Checklist.
Name-Title Signature Date
Project Title: Report date: 10/11/21
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COMcheck Software Version 4.1.5.3
Mechanical Compliance Certificate
OF e
Project Information
Energy Code: 2018 IECC z
Project Title: 2
Location: Glens Falls, New York
Climate Zone: 6a 'sjpNP+
Project Type: New Construction
Construction Site: Owner/Agent: Designer/Contractor:
Additional Efficiency Package(s)
Credits: 1.0 Required 1.0 Proposed
Reduced Lighting Power,1.0 credit
Mechanical Systems List
Quantity System Type&Description
1 GF-2(Single Zone):
Heating:1 each-Duct Furnace,Gas,Capacity=38 kBtu/h
Proposed Efficiency=95.00%Ec,Required Efficiency: 80.00%Ec
Cooling:1 each-Split System,Capacity=25 kBtu/h,Air-Cooled Condenser,No Economizer,Economizer exception:None
Proposed Efficiency=14.00 SEER,Required Efficiency: 13.00 SEER
Fan System: FAN SYSTEM 1—Compliance(Motor nameplate HP method):Passes
Fans:
FAN 1 Supply,Constant Volume,984 CFM,0.5 motor nameplate hp,0.0 fan efficiency grade
Mechanical Compliance Statement
Compliance Statement. The proposed mechanical design represented in this document is consistent with the building plans,
specifications, and other calculations submitted with this permit application.The proposed mechanical systems have been
designed to meet the 2018 IECC requirements in COMcheck Version 4.1.5.3 and to comply with any applicable mandatory
requirements listed in the Inspection Checklist.
Name-Title Signature Date
Project Title: Report date: 10/11/21
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COMcheck Software Version 4.1.5.3
Inspection- Checklist
Energy Code: 2018 IECC
Requirements: 100.0% were addressed directly in the COMcheck software
Text in the "Comments/Assumptions" column is provided by the user in the COMcheck Requirements screen. For each
requirement,the user certifies that a code requirement will be met and how that is documented, or that an exception
is being claimed.Where compliance is itemized in a separate table, a reference to that table is provided.
Section
# Plan Review Complies? Comments/Assumptions
& Req.ID
C103.2 ;,Plans, specifications, and/or ;❑Complies ;Requirement will be met.
[PR2]1 calculations provide all information :❑Does Not
;with which compliance can be ; ;Location on plans/spec: Drawings
determined for the mechanical ❑Not Observable
systems and equipment and ,❑Not Applicable
;document where exceptions to the
standard are claimed. Load
calculations per acceptable
engineering standards and ;
handbooks. I
C103.2 ;,Plans,specifications, and/or ;❑Complies ;Requirement will be met.
[PR4]1 :calculations provide all information :❑Does Not
;with which compliance can be
determined for the interior lighting ;❑Not Observable
and electrical systems and equipment :❑Not Applicable
;and document where exceptions to
;the standard are claimed. Information
provided should include interior
I lighting power calculations,wattage of; ;
bulbs and ballasts,transformers and
control devices.
C406 ;Plans,specifications, and/or ;❑Complies ;Requirement will be met.
[PR9]1 calculations provide all information :❑Does Not
with which compliance can be i
determined for the additional energy ![]Not Observable
efficiency package options. ;❑Not Applicable ;
Additional Comments/Assumptions:
11 High Impact(Tier 1) 1 2 1 Medium Impact(Tier 2) 3 Low Impact(Tier 3)
Project Title: Report date: 10/11/21
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Section
# Footing/Foundation Inspection Complies? Comments/Assumptions
& Req.ID
C403.12.2;Snow/ice melting system and freeze ;[ Complies ;Exception: Requirement does not apply.
i protection systems have sensors and :❑Does Not
C403.12.3;controls configured to limit service for ;❑Not Observable
[F09]3 ;pavement temperature and outdoor ;
#temperature.future connection to ;❑Not Applicable
controls.
Additional Comments/Assumptions:
1 High Impact(Tier 1) 2 Medium Impact(Tier 2) 3, Low Impact(Tier 3)
Project Title: Report date: 10/11/21
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Section
# Plumbing Rough-in Inspection Complies? Comments/Assumptions
& Req.ID
C404.5, ;Heated water supply piping conforms ;❑Complies 1 Exception: Requirement does not apply.
C404.5.1, to pipe length and volume :❑Does Not
C404.5.2 i requirements. Refer to section details.
[PL6]3 ; :❑Not Observable
i :❑Not Applicable
C404.6.3 Pumps that circulate water between a ;❑Complies ;Exception: Requirement does not apply.
[PL7]3 j heater and storage tank have controls :❑Does Not
that limit operation from startup to I 1❑Not Observable<= 5 minutes after end of heating
cycle. ;❑Not Applicable
C404.7 !Demand recirculation water systems ;❑Complies ;Exception: Requirement does not apply.
[PL8]3 have controls that start the pump ;❑Does Not
i upon receiving a signal from the
i action of a user of a fixture or 1,❑Not Observable
3 appliance and limits the temperature ❑Not Applicable
of the water entering the cold-water ;
piping to 104°F. 1
Additional Comments/Assumptions:
1 High Impact(Tier 1) 2 Medium Impact(Tier 2) 3 Low Impact(Tier 3)
Project Title: Report date: 10/11/21
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Section
# Mechanical Rough-In Inspection Complies? Comments/Assumptions
& Req.ID
C402.2.6 Thermally ineffective panel surfaces of;❑Complies Requirement will be met.
[ME41]3 sensible heating panels have :❑Does Not
insulation >= R-3.5. :[]Not Observable;Location on plans/spec:Schedule
;❑Not Applicable
C403.11.3;HVAC piping insulation insulated in ;❑Complies ;Requirement will be met.
[ME61]2 ;accordance with Table C403.11.3. PDoes Not
;Insulation exposed to weather is ;❑Not Observable;
on plans/spec: Drawings
protected from damage and is ,
!provided with shielding from solar .❑Not Applicable
radiation.
C403.8.4 !Motors for fans that are not less than ;❑Complies !Requirement will be met.
[ME142]2 �1/12 hp and less than 1 hp are ' ;❑Does Not
electronically commutated motors or 1 ;Location on plans/spec: Schedules
',have a minimum motor efficiency of ;❑Not Observable 1
70 percent.These motors have the ;❑Not Applicable
means to adjust motor speed. ;
C403.8.5 'Each DX cooling system >65 kBtu ;❑Complies ;Requirement will be met.
[ME143]2 and chiller water/evaporative cooling E❑Does Not
system with fans> 1/4 hp are ;❑Not Observable;Location on plans/spec: Schedules
,designed to vary the indoor fan airflow,
as a function of load and comply with �❑Not Applicable
;detailed requirements of this section. ;
C403.12.1!,Systems that heat outside the building;❑Complies ;Exception: Requirement does not apply.
[ME71]2 envelope are radiant heat systems ;❑Does Not
;controlled by an occupancy sensing ;
device or timer switch. ❑Not Observable
;❑Not Applicable
C403.2.3 ;HVAC equipment efficiency verified. ;❑Complies ;See the Mechanical systems list for values.
[ME55]2 ;❑Does Not
I.❑Not Observable;
;❑Not Applicable
C403.2.2 Natural or mechanical ventilation is ;❑Complies :Requirement will be met.
[ME59]1 :provided in accordance with ;❑Does Not
International Mechanical Code :Location on plans/spec: Drawings
;Chapter 4. Mechanical ventilation has ![]Not Observable
capability to reduce outdoor air supply!❑Not Applicable
;to minimum per IMC Chapter 4. ;
C403.7.1 {Demand control ventilation provided ;,[]Complies ;Exception: Requirement does not apply.
[ME59]1 :for spaces>500 ft2 and >25 ;❑Does Not
people/1000 ft2 occupant density and ; ;
served by systems with air side []Not Observable
economizer, auto modulating outside ;❑Not Applicable ;
air damper control,or design airflow
>3,000 cfm.
C403.7.2 'Enclosed parking garage ventilation ;❑Complies ;Exception: Requirement does not apply.
[ME115]3 has automatic contaminant detection :❑Does Not
3 and capacity to stage or modulate
fans to 50%or less of design capacity.;❑Not Observable
;❑Not Applicable
C403.7.6 (HVAC systems serving guestrooms in ;❑Complies ;Exception: Requirement does not apply.
[ME141]3 Group R-1 buildings with >50 ;❑Does Not
guestrooms: Each guestroom is
provided with controls that ;❑Not Observable;
automatically manage temperature ;❑Not Applicable
setpoint and ventilation (see sections
C403.7.6.1 and C403.7.6.2). ;
C403.7.4 ;Exhaust air energy recovery on ;❑Complies ;Requirement will be met.
[ME57]1 systems meeting Table C403.7.4(1) T❑Does Not
;and C403.7.4(2). ;❑Not Observable;
;❑Not Applicable
1 I High Impact(Tier 1) 2 1 Medium Impact(Tier 2) 3 1 Low Impact(Tier 3)
Project Title: Report date: 10/11/21
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Section
# Mechanical Rough-In Inspection Complies? Comments/Assumptions
& Req.ID
C403.7.5 ;Kitchen exhaust systems comply with ;❑Complies ;Exception: Requirement does not apply.
[ME116]3 !replacement air and conditioned E❑Does Not
}supply air limitations, and satisfy hood ❑Not Observable
rating requirements and maximum
;exhaust rate criteria. ;❑Not Applicable
C403.11.1HVAC ducts and plenums insulated in :[]Complies ;Requirement will be met.
accordance with C403.11.1 and ;❑Does Not
C403.11.2;constructed in accordance with ❑Not Observable!Location on plans/spec:Specs
[ME60]2 ;C403.11.2,verification may need to ;
occur during Foundation Inspection. ❑Not Applicable
C403.4.1. ;Heating for vestibules and air curtains ;❑Complies ;Exception: Requirement does not apply.
4 with integral heating include ;❑Does Not
[ME63]2 automatic controls that shut off the
heating system when outdoor air [--]Not Observable
temperatures>45F.Vestibule ;❑Not Applicable
heating and cooling systems
controlled by a thermostat in the ;
vestibule with heating setpoint<_
1.60F and cooling setpoint>=80F.
C403.3.3 :Hot gas bypass limited to: <=240 ;❑Complies ;Requirement will be met.
[ME35]1 kBtu/h-50%>240 kBtu/h-25% :❑Does Not
❑Not Observable:Location on plans/spec:Schedule
❑Not Applicable
C408.2.2. Air outlets and zone terminal devices ;❑Complies ;Requirement will be met.
1 have means for air balancing. T❑Does Not
[ME53]3 Location on plans/spec: Drawings
$ ,❑Not Observable
❑Not Applicable
C403.5, Refrigerated display cases,walk-in ;❑Complies ;Exception: Requirement does not apply.
C403.5.1, coolers.or walk-in freezers served by T❑Does Not
C403.5.2 3 remote compressors and remote
[ME123]3 condensers not located in a UNot Observable;
r condensing unit, have fan-powered ,❑Not Applicable
condensers that comply with Sections
C403.5.1 and refrigeration compressor;
systems that comply with C403.5.2..
Additional.Comments/Assumptions:
1 High Impact(Tier 1) 2 Medium Impact(Tier 2) 3, Low Impact(Tier 3)
Project Title: Report date: 10/11/21
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Section
# Rough-In Electrical Inspection Complies? Comments/Assumptions
& Reci.ID
C405.2.2. ;Spaces required to have light- ;❑Complies ;Requirement will be met.
2 :reduction controls have a manual ;❑Does Not
[EL22]1 ;control that allows the occupant to
reduce the connected lighting load in ;❑Not Observable
a reasonably uniform illumination ;❑Not Applicable
pattern >=50 percent. ;
C405.2.1, ;Occupancy sensors installed in ;❑Complies ;Requirement will be met.
C405.2.1. classrooms/lecture/training rooms, ;,❑Does Not
1 ;conference/meeting/multipurpose
[EL18]1 !rooms, copy/print rooms, :❑Not Observable
lounges/breakrooms, enclosed offices, 1❑Not Applicable
;open plan office areas, restrooms,
;storage rooms, locker rooms, ;
warehouse storage areas,and other
;spaces<=300 sqft that are enclosed
by floor-to-ceiling height partitions.
;Reference section language
C405.2.1.2 for control function in ;
warehouses and section C405.2.1.3 ;
:for open plan office spaces.
C405.2.1. :Occupancy sensors control function in ;❑Complies ;Exception: Requirement does not apply.
2 :warehouses: In warehouses,the ! Does Not
[EL19]1 :lighting in aisleways and open areas i ❑
s
controlled with occupant sensors that ;❑Not Observable
automatically reduce lighting power �❑Not Applicable
by 50%or more when the areas are ;
unoccupied.The occupant sensors
control lighting in each aisleway
independently and do not control ;
:lighting beyond the aisleway being ;
!controlled by the sensor.
C405.2.1. !Occupant sensor control function in ;❑Complies ;Exception: Requirement does not apply.
3 :open plan office areas: Occupant :❑Does Not
[EL20]1 ;sensor controls in open office spaces ❑Not Observable
>= 300 sq.ft. have controls 1)
configured so that general lighting can�❑Not Applicable
be controlled separately in control ;
zones with floor areas<=600 sq.ft.
within the space, 2)automatically turn:
off general lighting in all control zones
within 20 minutes after all occupants
have left the space,3) are configured
so that general lighting power in each ;
control zone is reduced by>=80%of. ;
;the full zone general lighting power
;within 20 minutes of all occupants ;
leaving that control zone, and 4) are
configured such that any daylight
responsive control will activate space ;
general lighting or control zone
general lighting only when occupancy
for the same area is detected. ;
C405.2.2, ;Each area not served by occupancy ;❑Complies ;Requirement will be met.
C405.2.2. :sensors(per C405.2.1)have time- :❑Does Not
1, ;switch controls and functions detailed ;
C405.2.2. ;in sections C405.2.2.1 and C405.2.2.2.;❑Not Observable
2 ;❑Not Applicable
[EL21]z
;
1 I High Impact(Tier 1) 2 1 Medium Impact(Tier 2) 3 Low Impact(Tier 3)
Project Title: Report date: 10/11/21
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Section
# Rough-In Electrical Inspection Complies? Comments/Assumptions
& Req.ID
C405.2.3, ;Daylight zones provided with ;❑Complies ;Exception: Requirement does not apply.
C405.2.3. individual controls that control the PDoes Not
1, ;lights independent of general area
C405.2.3. ;lighting.See code section C405.2.3 1❑Not Observable
2 Daylight-responsive controls for ;❑Not Applicable
[EL23]2 ;applicable spaces,C405.2.3.1 Daylight;
;responsive control function and ;
section C405.2.3.2 Sidelit zone.
C405.2.4 ;Separate lighting control devices for ;❑Complies :Requirement will be met.
[EL26]1 :specific uses installed per approved :❑Does Not
`lighting plans. UNot Observable;
❑Not Applicable
C405.2.4 ;Additional interior lighting power ;❑Complies ;Requirement will be met.
[EL27]1 :allowed for special functions per the :❑Does Not
;approved lighting plans and is
;automatically controlled and ❑Not Observable;
separated from general lighting. :❑Not Applicable
C405.3 ;Exit signs do not exceed 5 watts per ;❑Complies ;Requirement will be met.
[EL6]1 ;face. ;❑Does Not
❑Not Observable;
;❑Not Applicable
C405.6 ;Low-voltage dry-type distribution ;❑Complies ;Exception: Requirement does not apply.
[EL26]2 ;electric transformers meet the ;❑Does Not
minimum efficiency requirements of
;Table C405.6. :, Not Observable;
;❑Not Applicable
C405.7 ;,Electric motors meet the minimum . ;❑Complies ;Requirement will be met.
[EL27]2 !efficiency requirements of Tables :❑Does Not
C405.7(1)through C405.7(4).
Efficiency verified through certification;❑Not Observable
under an approved certification :❑Not Applicable
program or the equipment efficiency ; ;
ratings shall be provided by motor ;
!manufacturer(where certification ;
programs do not exist).
C405.8.2, :Escalators and moving walks comply ;❑Complies ;Exception: Requirement does not apply.
C405.8.2. iwith ASME A17.1/CSA B44 and have T❑Does Not
1 ;automatic controls configured to ;
[EL28]2 ;reduce speed to the minimum ;❑Not Observable
permitted speed in accordance with ,❑Not Applicable
;ASME A17.1/CSA B44 or applicable ;
)local code when not conveying
passengers.
C405.9 ;Total voltage drop across the ;❑Complies ;Requirement will be met.
[EL29]2 �combination of feeders and branch ;❑Does Not
;circuits <=5%. :❑Not Observable;
:1--]Not Applicable
Additional Comments/Assumptions:
111 High Impact(Tier 1) 2 1 Medium Impact(Tier 2) 3 1 Low Impact(Tier 3)
Project Title: Report date: 10/11/21
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Section
# Final Inspection Complies? Comments/Assumptions
& Req.ID
C303.3, IFurnished O&M instructions for I❑Complies ;Requirement will be met.
C408.2.5. ;systems and equipment to the ;❑Does Not
2 ;building owner or designated
[FI17]3 representative. �❑Not Observable
;❑Not Applicable
C303.3, Furnished O&M manuals for HVAC ;❑Complies ;Requirement will be met.
C408.2.5. systems within 90 days of system E❑Does Not
3 acceptance.
[F18]3 ;❑Not Observable;
I i
❑Not Applicable
C403.2.2 HVAC systems and equipment ;❑Complies !Requirement will be met.
[F127]3 capacity does not exceed calculated ;❑Does Not
loads. :Location on plans/spec: Schedule
;[-]Not Observable
❑Not Applicable
C403.2.4, s Heating and cooling to each zone is ;[]Complies ;Requirement will be met.
1 controlled by a thermostat control. ;❑Does Not
[F147]3 Minimum one humidity control device ❑Not Observable;Location on plans/spec: M1.0
per installed
humidification/dehumidification �❑Not Applicable
system.
C403.4.1. Thermostatic controls have a 5 °F ;❑Complies ;Requirement will be met.
2 deadband. ;❑Does Not
[F138]3 ;Location on plans/spec: Specs
❑Not Observable
❑Not Applicable
C403.2.4. (Temperature controls have setpoint I❑Complies ;Requirement will be met.
1.3 overlap restrictions. ;❑Does Not
[F120]3 ; :Location on plans/spec: Specs
❑Not Observable
❑Not Applicable
C403.2.4. !Each zone equipped with setback X❑Complies !Exception: Requirement does not apply.
2 controls using automatic time clock or ❑Does Not
[FI39]3 ;programmable control system.
1 ;❑Not Observable
R ;❑Not Applicable
C403.2.4. jAutomatic Controls: Setback to 557 I❑Complies :Requirement will be met.
2.1, (heat)and 85°F (cool); 7-day clock, 2- ;❑Does Not
C403.2.4. hour occupant override, 10-hour Location on plans/spec: Specs
2.2 lbackup ;❑Not Observable;
[F140]3 ;❑Not Applicable
C403.2.4. I Systems include optimum start ;❑Complies ;,Exception: Requirement does not apply.
2.3 controls. ;❑Does Not
[F141]3
;❑Not Observable;
❑Not Applicable
C405.4.1 i Interior installed lamp and fixture ;❑Complies ;See the Interior Lighting fixture schedule for values.
[F[18]1 :lighting power is consistent with what :❑Does Not
is shown on the approved lighting ;
!plans, demonstrating proposed watts ;❑Not Observable
are less than or equal to allowed :❑Not Applicable
watts.
C408.1.1 i Building operations and maintenance ;❑Complies ;Requirement will be met.
[FI57]1 �documents will be provided to the I❑Does Not
;owner. Documents will cover
manufacturers' information, :❑Not Observable
:specifications, programming ;❑Not Applicable
procedures and means of illustrating ;
I to owner how building,equipment and;
systems are intended to be installed,
maintained, and operated.
1 I High Impact(Tier 1) 2 1 Medium Impact(Tier 2) 3 Low Impact(Tier 3)
Project Title: Report date: 10/11/21
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Section
# Final Inspection Complies? Comments/Assumptions
&Req.ID
C408.2.1 ;Commissioning plan developed by ;❑Complies ;Requirement will be met.
[FI28]1 :registered design professional or T❑Does Not
approved agency. :Location on plans/spec: Specs
❑Not Observable
j ;❑Not Applicable
C408.2.3. ;HVAC equipment has been tested to ;❑Complies ;Requirement will be met.
1 censure proper operation. ;❑Does Not
[F131]1 !Location on plans/spec: Specs
❑Not Observable
❑Not Applicable
C408.2.3. ;HVAC control systems have been ;❑Complies ;Requirement will be met.
2 tested to ensure proper operation, ;❑Does Not
[FI10]1 :calibration and adjustment of controls.:❑Not Observable on plans/spec: Specs
❑Not Applicable
C408.2.4 ;Preliminary commissioning report ;❑Complies ;Requirement will be met.
[F129]1 completed and certified by registered :❑Does Not
;design professional or approved ;Location on plans/spec:Specs
agency. :❑Not Observable
;❑Not Applicable ;
C408.2.5. 1 Furnished HVAC as-built drawings ;❑Complies ;Requirement will be met.
1 submitted within 90 days of system ;❑Does Not
[FI7]3 acceptance.
![:]Not Observable
❑Not Applicable ;
C408.2.5. Furnished as-built drawings for ;❑Complies ;Requirement will be met.
1 ;electric power systems within 90 days ;❑Does Not
[FI16]3 of system acceptance.
❑Not Observable;
❑Not Applicable
C408.2.5. An air and/or hydronic system ;❑Complies ;Requirement will be met.
3 balancing report is provided for HVAC �,❑Does Not
[F]43]1 ;systems. I Location on plans/spec:Specs
❑Not Observable;
❑Not Applicable
C408.2.5. ;Final commissioning report due to ;❑Complies ;Requirement will be met.
4 building owner within 90 days of ;❑Does Not
[F130]1 receipt of certificate of occupancy. I❑Not Observable:Location on plans/spec:Specs
❑Not Applicable
C408.3 ;Lighting systems have been tested to ;❑Complies :Requirement will be met.
[F133]1 :ensure proper calibration,adjustment,QDoes Not
I programming,and operation. ;
❑Not Observable;
El Not Applicable
Additional Comments/Assumptions:
11 High Impact(Tier 1) 2 1 Medium Impact(Tier 2) 3 1 Low Impact(Tier 3)
Project Title: Report date: 10/11/21
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Project Title: Report date: 10/11/21
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