FP-AU 10/2013 page 1 of 2
THE STATE EDUCATION DEPARTMENT / THE UNIVERSITY OF THE STATE OF NEW YORK
Office of Facilities Planning, 89 Washington Avenue, Room 1060 Education Building Annex, Albany, NY 12234
Tel. (518) 474-3906
Fax. (518) 486-5918
www.p12.nysed.gov/facplan/
REQUEST FOR APPROVAL OF USE OF A FACILITY
SED Project #:
8 digit district BEDS Code 4 digit building number 3 digit project number
INSTRUCTIONS
- No space shall be used by a School District, BOCES or Charter School until a valid CERTIFICATE OF OCCUPANCY (CO)
is issued by the Commissioner of Education. To obtain a CO for a facility that does not have a CO pursuant to the annual
fire/safety inspection, execute and submit two copies of this form, together with other required exhibits detailed on page two
to the Office of Facilities Planning. Telephone: (518) 474-3906.
- Subsequent to the initial approval, annual approval of use is required in the form of a CO issued pursuant to
the annual fire inspection required by Section 807-a of the Education Law.
Name of Disctict/BOCES/Charter School: SED Project Manager: Date Submitted:
1. Building Name:
2. Building Address:
3. Project Contact Person: Telephone No.: ( )
4. Type of Facility: (Check appropriate type)
Leased space for educational use, acquired pursuant to Education Law, Section 1709.7 (church rooms, grange halls, etc.)
Leased space for other than educational use, acquired pursuant to Education Law, Section 1709.7 (administration/office, storage,
etc.)
Mobile Instructional Unit (MIU) – acquired pursuant to Department guidelines issued January 27, 1986.
Enter New York State Vehicle Identification No.:
Discovered Building, Other (Describe):
5. Space Utilization: For each room being used, complete the following: Use one line for each room, attaching separate sheets as
necessary. Correlate space designations with required plan information, using exactly the same designations on both.
Grade Maximum Number of Net Floor Area
Room No. Subject Taught or Activity
Housed Occupants (square feet)
Signature:
School Superintendent Date
FOR FACILITIES PLANNING OFFICE USE ONLY
Date Reviewed: Authorized Signature: Date CO Issued:
6. EXHIBITS AND PLAN INFORMATION REQUIRED WITH EACH REQUEST FOR APPROVAL OF USE OF A FACILITY. page 2 of 2
A. EXHIBITS REQUIRED (Check box for each required exhibit that is included in the submission)
1. LEASED EDUCATIONAL SPACE, LEASED SPACE, DISCOVERED BUILDING, OTHER:
Request for Approval of Use, Form FP-AU, two copies.
A completed Fire Safety Report of the fire safety inspection of the facility, one copy. Download the Fire Safety
Report form from Facilities Planning website and conduct the inspection prior to submitting the form FP-AU. Correct
all nonconformances prior to submission of form FP-AU.
A copy of the current Certificate of Occupancy issued by the local code enforcement agency. If owned by a public
school district, certification by a licensed architect or engineer that the whole building, as well as the space being
used, complies with applicable provisions of the Codes of New York State, one copy.
Floor Plans and Elevations, one copy. See B.1 below.
Site Plan, one copy. See B.2 below.
A completed Management Plan pursuant to AHERA, 40 CFR, Part 763.93. Submit one copy of AHERA form #5, or
other substantiation.
2. MOBILE INSTRUCTIONAL UNIT (MIU):
Request for Approval of Use, Form FP-AU, two copies.
A completed Fire Safety Report of the fire safety inspection of the facility, one copy. Download the Fire Safety
Report form from Facilities Planning website and conduct the inspection prior to submitting the form FP-AU. Correct
all nonconformances prior to submission of form FP-AU.
Certification by the manufacturer of the MIU, or in the case of a converted existing vehicle, by the Superintendent of
Schools and a licensed architect or engineer, that the vehicle conforms to the Department’s January 27, 1986
Guidelines for the Acquisition and Use of Mobile Instructional Units.
Floor Plan, one copy. See B.1 below.
A completed Management Plan pursuant to AHERA, 40 CFR, Part 763.93. Submit one copy of AHERA form #5, or
other substantiation.
B. PLAN INFORMATON REQUIRED
1. FLOOR PLAN(S) and ELEVATIONS – Architectural-quality, scaled drawing(s) (1/8 in = 1 ft. minimum) which
indicates corridors, stairs, walls, door openings and swings, windows and room uses. Include each floor of the entire
building and designate the spaces being used. The designation shall be exactly as indicated at Part 5 of this
form. For MIUs, indicate furniture, including pupil stations, and ceiling height(s). Floor plan(s) must indicate any
renovations or alterations which will take place for the proposed use of the area(s).
2. SITE PLAN – Architectural-quality, scaled drawing(s) (11” x 17” minimum sheet size) of the total property which
indicates the relative location of buildings, streets, roads, parking areas and walks. NOTE: typical minimum
building separation is 15’, except 30’ where classroom windows are involved.
7. DESCRIPTION OF BUILDING – complete this section for all facilities, except an MIU. Mark box(s) and complete blanks where necessary.
1. Building Height: 5. Floor Structure: 9. Roof Deck: 13. Windows:
a. No. of stories (not incl. concrete concrete casement
basement): steel steel double hung
b. Is there a basement? wood wood sliding
Yes No other: other: other:
2. Construction Type: 6. Flooring: 10. Roofing: 14. Sewer:
I A B concrete metal on-site
II A B steel shingle municipal
III A B wood built-up other:
IV other: single-ply
V A B other:
3. Interior Partitions: 7. Ceilings: 11. Type of Heat: 15. Water:
masonry a. Describe: hot air well
metal hot water municipal
wood b. Height: steam other:
other: other:
4. Interior Partition Finish: 8. Roof Struct. Framing: 12. Type of Fuel: 16. Electric:
masonry concrete oil Yes No
metal steel gas - LP
wood wood gas - Natural 17. Exit Door Hardware:
other: other: electric panic
other: classroom function
other:
