Date:	Revised Date:
Campus/Facility:	Client:
(Address):
Building Name(s):	Building Numbers:
Project Title:
Architect/Engineer:
Project No.:	Estimated Project Cost:
Code Enforcement Jurisdiction: DASNY Other: Variance Requested: Yes No
Classification: Single Family Dwelling Two Family Dwelling Townhouse Manufactured Home
NFPA 101 Life Safety Code (for OPWDD & OMH Facilities): (Complete Attachment #3 or #4 as applicable. Use link below)	Life Safety Code Occupancy Chapter (s): Life Safety Code Construction Classification: FSES Utilized: Attach Copy.
Project Type: Check all that apply. Refer to NYS Supplement Appendix J for definitions.	New Building Repair Alteration Level 1 Alteration Level 2	Change of Occupancy Addition Historic Building Relocated Building	Replacement Demolition
Work Involved:	General Construction	Structural	Site Work
Check all that apply.	Roofing	Mechanical	Sprinkler
Asbestos Abatement/Environmental	Plumbing	Elevators
Fire Alarm	Electrical	Other

LEGEND: NA - Not Applicable, NR - Not Required, NP - Not Permitted

No	Topic	Residential Code Section	Required / Allowed	Actual	Comment
1	Building Height	R101.2	More than 3 stories must comply with Building Code.
2	Design Criteria	R301	Provide information in Attachment 1. Use link below.
3	Fire Resistant Construction	R302
Exterior Walls	R302.1
Townhouse Common Walls	R302.2
Townhouse Parapets	R302.2.2
Two-Family Dwelling Wall or Floor	R302.3
Dwelling Unit Rated Penetrations	R302.4
Dwelling-Garage Opening & Penetrations	R302.5
Dwelling-Garage Fire Separation	R302.6, Table R302.6
Flame Spread & Smoke-Developed Index	R302.9, R302.10	Wall: Ceiling: Insulation:
Fire Blocking	R302.11
Draftstopping	R302.12
Fire Protection of Floors	R302.13
Combustible Insulation Clearance	R302.14
4	Light/Ventilation	R303	Light: Natural % Artificial % Vent: Natural % Mechanical %
Mechanical Ventilation	R303.4
Outside Opening Protection	R303.6
Interior Stairway Illumination	R303.7
Exterior Stairway Illumination	R303.8
Required Glazed Openings	R303.9
Required Heating	R303.10
5	Minimum Room Areas	R304
6	Ceiling Heights	R305
7	Sanitation	R306	Provide information in Attachment 1. Use link below.
8	Toilet, Bath & Shower Spaces	R307, Figure R307.1
9	Glazing	R308
Identification	R308.1
Human Impact loads	R308.3
Hazardous Locations	R308.4
Skylights & Sloped Glazing	R308.6
10	Garages/Carports	R309
11	Emergency Escape and Rescue Openings	R310
Minimum Opening Area	R310.2.1
12	Means of Egress	R311
Egress Door	R311.2
Landing at Exterior Doors	R311.3
Hallways	R311.6
Stairways	R311.7
Stairway Width	R311.7.1
Stairway Headroom	R311.7.2
Handrails	R311.7.8
Ramps	R311.8
13	Guards & Window Fall Protection	R312
Guards at Stairways, ramps and Landings	R312.1.1
Window Fall Protection	R312.2
14	Sprinkler System	R313, NYS Supplement R313	Indicate Type of Sprinkler System: NFPA 13 NFPA 13R NFPA 13D
15	Smoke Alarms	R314
Combination Smoke/CO Alarms	R314.5, NYS Supplement IFC 915.2
Power Source	R314.6
Fire Alarm System	R314.7	Indicate Type of Fire Alarm System: Conventional (zoned) Addressable
16	Carbon Monoxide Alarms	R315, NYS Supplement IFC 915.2	Indicate all that apply: CO Alarm Combination CO/Smoke Alarm Hardwired Plug-in Battery Interconnected CO System CO Detector Combination CO/Smoke Detector Connected to FACP
17	Foam Plastic	R316	Locations:
Thermal Barrier Required	R316.4 & R316.5
18	Protection of Wood Against Decay	R317
19	Termite Protection	R318
20	Accessibility	R320
21	Elevator	R321	Indicate Type: Traction, Hydraulic, LULA Platform lift Other:
22	Flood Resistant Construction	R322
Design Flood Elevation	R322.1.4, NYS Supplement R322.1.4
23	Solar Energy Systems	R324, NYS Supplement R324.3	Indicate Type: Solar Thermal System, Photovoltaic System, Location: Rooftop, Ground
24	Mezzanines	R325
25	Swimming Pools, Spas & Hot Tubs	R326, NYS Supplement R326	Indicate Type: Pool, In-Ground, Aboveground, Spa, Hot Tub
Pool Barrier	NYS Supplement R326.5
Pool & Spa Entrapment Protection	NYS Supplement R326.6
Pool & Spa Alarms	NYS Supplement R326.7
26	Foundations	R401
Surface Drainage	R401.3
Soil Tests	R401.4, Table R401.4.1	Geotechnical Evaluation. Presumptive Load-Bearing Values: psf
Foundation Materials	R402	Indicate Type: Wood, Concrete, Precast, Masonry
Footings	R403
Minimum Size Footings	R403.1.1, Table R403.1(1)	Width x Thickness Minimum Depth
Frost Protection	R403.1.4.1
Foundation & Retaining Walls	R404, NYS Supplement R404.2.1
Foundation Drainage	R405
Foundation Waterproofing & Dampproofing	R406
Columns	R407
Under-Floor Space	R408
Ventilation	R408.1
27	Floors	R501
Wood Floor Framing	R502, NYS Supplement R502.1.1
Truss Type, Pre-Engineered Wood or Timber Construction	R502.11, Part 1265	Provide information in Attachment 1. Use link below.
Floor Sheathing	R503 (Table 503.1)
Cold-Formed Steel Floor Framing	R505
Concrete Floors	R506
Exterior Decks	R507
28	Wall Construction	R601
Wood Wall Framing	R602, NYS Supplement R602.1.1
Wall Bracing	R602.10
Wall Anchorage	R602.11
Simplified Wall Bracing	R602.12
Cold-Formed Steel Wall Framing	R603
Wood Structural Panels	R604
Masonry Construction	R606
Glass Unit Masonry	R607
Exterior Concrete Wall	R608	Indicate Type (per 608.3):
Exterior Windows & Doors	R609
Testing & Labeling	R609.3
Structural Insulated Panel Wall	R610
29	Wall Covering	R701
Interior Covering	R702
Vapor Retarder	R702.7	Indicate Class:
Exterior Covering	R703	Combustible Non-Combustible
30	Roof-Ceiling Construction	R801.1
Wood Roof Framing	R802, NYS Supplement R802.1.1	Fire Retardant-Treated: Yes No
Truss Type, Pre-Engineered Wood or Timber Construction	R802.10, Part 1265	Provide information in Attachment 1. Use link below.
Roof Sheathing	R803
Steel Roof Framing	R804
Roof Ventilation	R806
Attic Access	R807
31	Roof Assemblies	R901
Fire Classification	R902
Weather Protection	R903
Roof Covering	R905	Indicate Material:
Roof Insulation	R906
Rooftop-Mounted Photovoltaic Systems	R907 & R909
Reroofing	R908
32	Chimney and Fireplaces	R1001
Masonry Fireplaces	R1001
Masonry Heater	R1002
Masonry Chimneys	R1003
Factory-Built Fireplaces	R1004
Factory-Built Chimneys	R1005
Exterior Air Supply	R1006
33	Energy Efficiency	N1101	Provide information in Attachment 2. Use link below.
34	Mechanical	Chapters 12 - 23
Existing Mechanical Systems	M1202
Type of Fuel for Heating	M1304	Fuel type:
Appliance Access (attic)	M1305.1.3
Clearance from Combustibles	M1306, table M1306.2	Identify inches of clearance (in spaces to the left).
Equipment & Appliance Sizing	M1401.3
Refrigeration Cooling Equipment	M1411	Type of refrigerant:
Auxiliary & Secondary Drain Systems	M1411.3.1
Exhaust Outdoor Discharge	M1501.1
Clothes Dryer Exhaust	M1502
Range Hood Exhaust	M1503	Indicated CFM:
Range Hood Makeup Air	M1503.4
Whole-House Mechanical Ventilation System	M1507.3
Mechanical Exhaust Rates for Kitchens	M1507.4 (Table M1507.4)
Mechanical Exhaust Rates for Bathrooms	M1507.4 (Table M1507.4)
Gage of Metal Ducts	M1601 & Table M1601.1.1)
Duct Insulation Material	M1601.3	Flame spread: Smoke development:
Return Air	M1602
Combustion Air	M1701
Chimney or Gas Vent	M1801, M1804, M1805	Type of Chimney: Type of Vent: Size: Clearance:
Existing Chimney or Vent	M1801.3	Type of Chimney: Type of Vent: Size: Clearance:
Clearance	M1801.3.4
Chimney or Vent Connector	M1803	Size: Gage: Clearance:
Special Appliances, Equipment & Systems	M1901-1904
Boilers & Water Heaters	M2001-2006
Hydronic Piping	M2101 (Table M2101.1)	Material Type:
Ground-Source Heat Pump System Loop Piping	M2105
Oil Tanks	M2201	Location: Size:
Solar Thermal Energy Systems	M2301
35	Fuel Gas	G2401
Appliance Location	G2406.1
Combustion, Ventilation & Dilution Air	G2407	Make-up Air: Combustion Air: (indoor or outside or combination)
Appliance/Equipment Installation	G2408
Clearance Reduction	G2409, Table G2409.2
Electric Bonding	G2411, NYS Supplement G2411.2, G2411.3	Identify if CSST is to be used.
Gas Pipe System	G2412
Pipe Material & Size	G2413, G2414	Material: Size:
Pipe Installation	G2415, NYS Supplement G2415.7
Category of Equipment and Venting	G2427, Table G2427.4
Sizing Category I Appliance Venting System	G2428
Clothes Dryer Exhaust	G2439
Force-Air Warm-Air Furnace	G2442
Unit Heaters	G2444
Cooking Appliances	G2447
Water Heaters	G2448
Boilers	G2452
36	Plumbing	P2501, P2601
Existing Plumbing Systems	P2502
Individual Water Supplies	NYS Supplement P2602.1.1
Individual Sewage Treatment System	NYS Supplement P2602.1.2
Penetrations	P2606
Fixtures	R 306 & P2701	Provide information in Attachment 1. Use link below.
Water Heaters	P2801.1
Solar Water Heating Systems	P2802
Water Supply	P2902/2903
Backflow Protection	NYS Supplement P2902.3
Dwelling Unit Fire Sprinkler System	P2904
Water Supply Piping Materials	P2906
Nonpotable Water Systems	P2910
On-Site Nonpotable Water Reuse System	P2911
Nonpotable Rainwater Collection & Distribution System	P2912
Reclaimed Water System	P2913
Sanitary Drainage	P3001
Drainage System	P3005
Cleanouts	P3005.2
Sumps & Ejectors	P3007
Backwater Valves	P3008
Plumbing Vents	P3101
Island Fixture Venting	P3112
Vent Size	P3113
Air Admittance Valves	P3114
Fixture Traps	P3201
Trap Seals	P3201.2
Strom Drainage	P3301
37	Electrical	E3401
Penetrations	E3402.3
Equipment Location/Clearances	E3405
Service Size and Rating	E3602	Service Load (Table E3602.2): Rating of Service Disconnect: Voltage Rating:
System Grounding	E3607
Bonding	E3609, NYS Supplement E3609.7
Ground-Fault & Arc Fault Circuit Protection	E3902
Emergency Power	N/A
Exit Lights	N/A
Emergency Lighting	N/A

Additional information provided. Open Attachment 1 and enter information:	Energy Conservation information provided. Open Attachment 2 and enter information:

LSC Health Care Facility, Chapters 18/19 for OPWDD & OMH Facilities. Open Attachment 3 and enter information:	LSC Board & Care Chapters 32/33 for OPWDD facilities. Open Attachment 4 and enter information: