The heart and science of medicine. UVMHealth.org/MedCenter
February 2, 2017
University of Vermont Medical Center Approach and Strategy for Sustainable Design
and Construction
• Dave Keelty, BS, CEM, CHFM, CHC – Director Facilities Planning and Development, University of Vermont Medical Center – Owner
• William Repichowskyj – Partner, E4H - MorrisSwitzer Environments for Health – Planning & Architecture
• Michael Pulaski, Ph.D., LEED AP BD+C – Senior Associate, Weidlinger and Thornton Tomasetti – LEED & Sustainability Consultant
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Presenters
Project Overview Our Commitment to Sustainable Design and Construction
Master Plan Guiding Principles
Sustainability Approach Start Early in the Planning Process…before Programming and Design Assemble a Team that Represents all Constituencies Use Industry Standard Benchmarks Clearly Communicate Expectations Set Measurable Targets Include a rigorous Commissioning Process
Analysis & Implementation
Agenda
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Just a Thought
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Project Overview
Triple Aim: Ensure and Improve Patient Safety and Quality of Care
Enhance the Patient Experience
More Efficient Cost of Care
Four Project Objectives:
Improve Quality
Bed Need: Ensure appropriate bed capacity and care environment
Financial Feasibility: Accomplish objectives within available resources
Affordability: Minimize the impact on patients and payers
Project Objectives
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Overhead Campus View
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Overhead Campus View
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Seven-story inpatient building above existing Emergency Department parking area
180,000 Square Feet
Four inpatient floors of 32-single-occupancy medical-surgical, telemetry-capable rooms: 128 Beds
Increase single-rooms from 30% to 90%
Replacement of oldest inpatient rooms
Project cost is $187M (of which $12.35M is capitalized interest)
Project Overview
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Conceptual Floor Plan
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Conceptual Floor Plan
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Perspective Looking South East
Perspective Looking North East
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Our Commitment to Sustainable
Design and Construction
Master Facility Planning Guiding Principles
Be informed by and strive to reinforce the strategy of the organization
Promote a safe, healing and pleasing environment for patients, families, visitors and staff
Strive for LEED certification
Seek input from our key constituents including patients and the communities we serve
Be sensitive to the neighborhoods within which our facilities are located and responsive to the concerns of our neighbors
Ensure that all planning is fiscally responsible
Preserve our heritage, promote a sense of community ownership and reinforce our brand promise
Minimize the disruption of the environment
Master Facility Planning
Guiding Principle
The master facility plan will strive for LEED certification (Leadership in Energy and Environmental Design) that recognizes performance in five key areas of human and environmental health:
Sustainable Site Development Water Savings Energy Efficiency Materials Selection Indoor Environmental Quality
Practice Greenhealth Top 25 for Environmental Excellence and 6 Circles of Excellence awards:
Leadership Waste Reduction Chemical Reduction Greening the OR Sustainable Food Services Green Building
LEED Projects: Inpatient Bed Building Goal: Silver -Healthcare Radiation Oncology Garden Pavilion: Gold- New Construction Clinical Research Center: Gold- Interiors Renovation Mother-Baby Unit: Gold- Interiors Renovation Hinesburg Family Practice: Certified- New Construction Other Projects Pending Certification
Shelburne Road- Core and Shell and Interiors Garden Atrium- Interiors Renovation
LEED Projects and Recognition
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Sustainability Approach
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Establish Sustainability Goals Early in the Planning Process
Project Conceptual Planning
Programming
Schematic Design
Design Development
Construction Documents
Bidding
Construction
Occupancy
Post Occupancy Evaluation
Planning Design and Construction Define Sustainability Goals Early in the Planning
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Set Sustainability Goals Here
Meet 2010 FGI Guideline for Commissioning*
Achieve LEED Certification
Design to meet Energystar rating of 75
Meet CON Standards 1.9 and 1.10
Meet Act 250 Criteria 9 (F) Energy Conservation
Starting Assumptions
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*Currently following 2014 FGI Guidelines.
Facility Master Planning Steering Committee - Project Oversight
Sustainability Council - Established Overarching Sustainability Goals for the Project
Internal Departments – Developed Owner’s Project Requirements Facilities Management Infectious Disease Environmental Services Environmental Health and Safety Supply Chain Community Health Improvement Patient Safety Nutrition Services
Design User Groups
Patients and Families Design User Group
Utility Partners Burlington Electric Department Vermont Gas
Project Design, Engineering, Sustainability and Commissioning Consultants MorrisSwitzer~Environments for Health - Architect Bard, Rao + Athanas Consulting Engineers (BR+A) Thornton Tomasetti - LEED and Sustainability Consultant CxAssociates – Commissioning Agent Whiting-Turner Contracting Company
Sustainability Team and Roles You Need Everyone's Input
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Sustainability Council
A multi-disciplinary steering committee charged with oversight of all elements of sustainability programming.
M I S S I O N S TAT E M E N T Our mission and vision are built on a foundation of values that include a longstanding commitment to being prudent stewards of limited natural resources. We continue to look for new ways to build on our long tradition of environmental responsibility. We will continue our efforts to reduce energy consumption, waste stream and carbon footprint, and to increase the use of health, locally produced foods.
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Areas of Focus
Leadership Waste
Chemicals Greening the OR Healthier Food
Smarter Purchasing Leaner Energy
Water Climate
Green Buildings
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Members
Dawn LeBaron - Vice President Hospital Services & Council Leader
John Berino - Occupational/Environmental Program Coordinator
Matt Bushlow – Communications Specialist
Janet Carroll – Administrative Director of Nursing
Jack Conry – Director, Security/Safety/Parking
Sidney Hamilton – Manager Purchasing, Contract & Value Analysis
Diane Imrie – Director, Nutrition Services
Dave Keelty – Director, Facilities Planning & Development
Karen McBride – Director, Pharmacy
Maria McClellan – Sr. Community Relations Strategist
Wes Pooler – Director, Facilities Management
Paul Rosenau, MD – Pediatrics
Lori Ann Roy – Manager, Radiation Oncology
Brooke Stahle – Director, Peri-Operative Services
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Industry Standard Benchmarks
LEED is an internationally recognized green building certification system: providing third-party verification that a building or community was designed and built using strategies aimed at improving performance across all the metrics that matter most:
Energy Savings
Water Efficiency
CO2 Emissions Reduction
Improved Indoor Environmental Quality
Stewardship of Resources and Sensitivity to their Impacts
Source: USGBC Web Site
Leadership in Energy & Environmental Design (LEED)
LEED Checklist
Energy Star Score
Energy Star Score
EUI Defined
EUI is defined as energy consumed per square foot per year
It’s calculated by dividing the total energy consumed by the building in one year by the total gross floor area of the building
Typically expressed as kBtu per square foot
Energy Star
Energy Star: EUI
Why EUI ?-It’s an increasingly important metric
It has become the common currency for measuring and reporting energy consumption in buildings
It is now the universal measurement for energy performance
It can measure energy performance “apples to apples” overtime and building to building providing management and decision making information
Emerging as the standard for performance reporting and benchmarking by Healthcare Executives
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EPA Energy Star Target Finder
EPA Energy Star Target Finder
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Metric Design Project
Design Target*
Median Property*
ENERGY STAR score (1-100) Not Available 75 50
Source EUI (kBtu/ft²) Not Available 378.1 436.5
Site EUI (kBtu/ft²) Not Available 201.7 232.9
Source Energy Use (kBtu) Not Available 68,060,143.2 78,578,758.1
Site Energy Use (kBtu) Not Available 36,303,410.0 41,914,060.0
Energy Cost ($) Not Available 787,954.85 909,732.36
Total GHG Emissions (Metric Tons CO2e) 0.0 2,553.3 2,947.9
EPA Energy Star Target Finder
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272
204
161
143
100
-
50
100
150
200
250
300
MCHV Existing Base (VAV system) Alt 1 (ACB in core) Alt 2 (ACB in core+floor 6) Target
KBTU
/SF
Total EUI Use and Value as a decision making tool
What’s the best investment
What system will be the most sustainable and afford the lowest operating costs
EUI as a Tool
Chilled Beam vs. Variable Air Volume System
Active Chilled Beam
Variable Air Volume
Exterior Design Options Reviewed
Building Exterior and Window Studies
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Clearly Communicate Expectations
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Owner’s Project Requirements: o A written document that details the functional requirements of a project
and the expectations of how it will be used and operated. These include project goals, measurable performance criteria, cost considerations, benchmarks, success criteria, and supporting information.
The Owner’s Project Requirements should include the following: Energy efficiency goals Environmental and sustainability goals Community requirements Adaptability for future facility changes and expansion Systems integration requirements, especially across disciplines
Expectation Setting Owners Operating Requirements (OPR)
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Setting Measurable Targets
Reflect UVM Medical Center’s commitment to ongoing environmental stewardship in order to minimize our environmental footprint by utilizing design and building practices that to the extent possible minimize the consumption of energy and natural resources.
Achieve LEED Silver Certification
Achieve a site EUI of 143,000 BTU/sf/year Enhanced Commissioning Requirement
Complete Utility Metering Capability
To Support Post Occupancy Measurement and Verification
Patient Room Energy Consumption Research
Water Metering by Floor
LED Lighting
Innovative HVAC Chilled Beams While meeting FGI requirements
Building Envelop
Air Tightness
Thermal Insulation
Setting Measureable Targets Owners Operating Requirements (OPR)
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Commissioning
ASHRAE definition: Commissioning is the process of ensuring that systems are designed, installed, functionally tested, and capable of being operated
and maintained to perform in conformity with the design intent.
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Owners Operating Requirements (OPR)
• Enhanced Commissioning with Measurement and Verification $ 2.50/SF • LEED Consulting with Full Sustainability Consulting Services $ .75/SF • Additional General Conditions and General Requirements $ 1.00/SF • Additional Hard Construction Costs (if sustainability efforts begin early) $ 0.00/SF Total $ 4.25/SF As a Percent of Project Cost .05 % Simple Payback 4.9 Years
Estimated Costs
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Potential Value Management Impacts
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Analysis & Implementation:
Sustainable Design & The Inpatient Building
Where we are now?
Currently, hospitals consume 5% of all energy consumed in the United States. Healthcare energy consumption continues to rise up to 5.5% of the commercial building energy, from 4.3% in 2004.
Although energy represents a small portion of a hospitals overall operating costs, reducing utility expenditures can provide low risk high yield, and stable investment for the future.
Targeting 100! Getting to 100 EUI
Targeting 100! Is a research project completed by the University of Washington’s College of Built Environments. The project examined the efficiency of two massing options for six regions across the United States to determine the best strategies for getting to an EUI of 100.
Reserved.
Copyright ©2012 University of Washington
Background
The research team met with over 200 stakeholders in each of six study regions, collecting data with respect to regions specific approaches for deep energy savings and a balanced capital investment.
The Targeting 100! Case studies did not include Region 6 so we have provided data for Chicago’s climate which most closely relates to Vermont’s Climate.
Targeting 100 Studies
Typical Hospital Energy Demands
Reheat energy: A good place to Start!
Keys for Success in High Performance Healthcare Design
1. Reduce Internal Loads (Equipment, Lighting)
2. Reduce Peak Heating and Cooling Loads
3. Decouple Heating and Cooling from Ventilation
4. Optimize the Central Plant Equipment
Reduce Peak Loads with Good Architectural Design
Heating and Cooling Load Reduction
Example Loads – Patient Rooms (WEST)
Mechanical Systems
• Decouple Heating and Cooling from Ventilation – Significantly reduces re-heat energy
• Displacement Ventilation • Low side-wall radiant heating panels • Ceiling cooling panels
Plant Options
Energy - Savings
2010-2015 = 60% Reduction from code energy use 2030 = Net Zero annual energy demand
• Major reductions in heating energy use (reheat).
• Heating savings 73%-97%
• Load reductions & maximized efficiency in equipment
• A4 & B4 = ground coupled heat pumps Most Energy Efficient!
Cost – Per Square Foot
Project Analysis
Keys for Success:
1. Reduce Internal Loads (Equipment, Lighting)
2. Reduce Peak Heating and Cooling Loads
3. Decouple Heating and Cooling from Ventilation
4. Optimize the Central Plant Equipment
Patient Room Estimated Equipment Load Intensity
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HVAC Options: 1. VAV at 6ACH 2. VAV at 4ACH 3. VAV at 4ACH + Chilled Panels 4. Chilled Beams at 2 ACH 5. DV at 4 ACH 6. DV at 4 ACH with Chilled Panels
• Envelope Options Patient Room Glazing
West Patient Room Envelope and HVAC Systems Analysis
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195 21
1
179
149
201
203
175
221
138
135 14
6
189
146
208
211
157
233
0
50
100
150
200
250
Opt
ion
1A
Opt
ion
1B
Opt
ion
1C
Opt
ion
2A
Opt
ion
2B
Opt
ion
2C
Opt
ion
3A
Opt
ion
3B
Opt
ion
3C
Opt
ion
4A
Opt
ion
4B
Opt
ion
4C
Opt
ion
5A
Opt
ion
5B
Opt
ion
5C
Opt
ion
6A
Opt
ion
6B
Opt
ion
6C
KBTU
/SF
Total EUI
A B C
70% Glazing 40% Glazing 90% Glazing
-$200,000 $0 $200,000 $400,000 $600,000 $800,000 $1,000,000 $1,200,000 $1,400,000
VAV 6ACH, Opt 1A
Opt 1B
Opt 1C
VAV 4 ACH Opt 2A
Opt 2B
Opt 2C
VAV 4 ACH + CH Panels, Opt 3A
Opt 3B
Opt 3C
Chilled Beams 2 ACH, Opt 4A
Opt 4B
Opt 4C
Disp Vent 4 ACH, Opt 5A
Opt 5B
Opt 5C
Disp Vent 4 ACH CH Panels, Opt 6A
Opt 6B
Opt 6C
First Cost
Ten Year Energy Savings
Patient Room HVAC Systems Cost Analysis
Whole Building Modeling Process Managing and Analyzing ECMS
B. ECMs Included in Base Building Scope
2 Interior Light Power Density Reduction using LED lights
11 Triple glazing with high performance curtain wall frame14 Fan Array technology for AHU supply and return fans
18 Envelope insulation upgrade R20 (effective)
22 Chilled water delta T - 18F23 Heat-recovery bypass dampers open during air-side economizer mode24 Partial heat recovery glycol run around on dedicated exhaust26 Pressure-independent control valves (PICVs) at chil led water coils28 Comprehensive air sealing and Façade Cx (0.25 cfm/sf 75Pa)34 Chilled beams with DOAS for core spaces and 6th floor patient rooms35 Low static pressure and low velocity across coils and fi lters at AHU
B. ECMs for Future Consideration1 Occ sensors in patient rooms - Reduce ACH to X unoccupied
2 Supply low dew point at higher air temp
3 Daylighting controls in Patient rooms
4 Condition MER (penthouse) with relief air
C. ECMs Reviewed but not included1 External shades at (7.5'ht 3' wide)
2 Reduced glazing (si l l ht at 24")3 Reduced glazing (si l l ht at 36")
4 Nursing stations - low occupancy mode demand control ventilation
Energy Use Intensity Profile Comparison
-2 0 2 4 6 8 10
$(5,000) $- $5,000 $10,000 $15,000 $20,000 $25,000
Envelope insulation upgrade R30
Roof Insulation R40
Roof insulation R50
SHGC 0.2
SHGC 0.3
Double Pane Dynamic glass
Automated interior blinds
Regen (traction) elevators
DHW drain water heat recovery on showers
Chilled water delta T - 20 F
Heat-recovery bypass dampers open during air-side economizer mode
Partial heat recovery glycol run around on dedicated exhaust
Wrap around heat pipe for chilled beam exhaust
Energy Valves at main CHW coils (AHUs)
Pressure-independent control valves (PICVs) at chilled water coils
Change in EUI (kBTU/sf/year)
Annual Operationsal Savings ($)
ECM EUI vs. Annual Savings
Whole Building Energy Use Intensity Breakdown
EUI (kBtu/sf)
End Uses
Baseline - 90.1 ASHRAE
2007 Compliance Design Case
Percent Savings
Heating 100.37 23.86 76% Cooling 45.65 44.77 2% Interior Lighting 21.74 10.66 51% Interior Equipment 37.94 37.74 1% Fans 18.89 20.49 -8% Pumps 2.68 2.67 0% Heat Rejection - - 0% DHW 4.49 1.35 70% Total 231.76 141.53 39% -
20.00
40.00
60.00
80.00
100.00
120.00
Heating Cooling Interior Lighting
Interior Equipment
Fans Pumps Heat Rejection
DHW
Energy Use Intensity Comparison (kbtu/sf/yr)
Baseline - 90.1 ASHRAE 2007 Compliance Design Case
$-
$20,000
$40,000
$60,000
$80,000
$100,000
$120,000
$140,000
$160,000
Heating Cooling Interior Lighting
Interior Equipment
Fans Pumps DHW Heat Rejection
Energy Cost Savings Comparison
Baseline - 90.1 ASHRAE 2007 Compliance Design Case
TOTAL ENERGY COST
End Uses
Baseline - 90.1 ASHRAE
2007 Compliance Design Case
Percent Savings
Heating $ 77,315 $ 18,380 76%Cooling $ 40,188 $ 39,410 2%Interior Lighting $ 78,980 $ 38,208 52%Interior Equipment $ 137,877 $ 135,297 2%Fans $ 68,657 $ 73,448 -7%Pumps $ 9,726 $ 9,585 1% DHW $ 3,458 $ 1,037 70%Heat Rejection $ - $ - Total End Uses $ 416,201 $ 315,366 24%
Whole Building Annual Energy Cost Breakdown
• 24% better than ASHRAE • 38% energy savings • EUI: 142 kbtu/sf/yr • Targeting LEED Silver
Whole Building Energy Modeling Results
Key Architectural Design Decisions
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Building Location Determined by campus
master planning Building Orientation Maintain existing
Emergency Department and Ambulance drop-off
Maximize Views Respectful of existing
campus architecture Existing site conditions
Key Architectural Design Decisions
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Façade design Curtain wall design driven by
patient & family environment, aesthetics, & energy efficiency
Balancing size of window with energy efficiency
Solar Considerations
o Reducing Solar Gains
o Electro Chromatic Film
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Bathroom Inboard vs. Outboard
Key Architectural Design Decisions
Impacts: Increased patient safety by maximizing Nurses’ view from corridor to headwall Increased energy efficiency due to reduced window size
Key Architectural Design Decisions
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Wall System Overview
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UVMMC OPR – Envelope Goals: Energy Performance
Thermal Performance
Durability
Air Tightness: whole
building/assembly tightness .25CFM
West Wall Section
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Air Tightness & Durability High-performance AVB
transition assembly at window opening
Detailing at offsets in plane at insulation, cladding, and window.
Ensurs performance between adjacent assemblies
Tighter detailing at corners Maintains continuity of AVB
Cavity closure at wall assemblies maintains continuity of AVB transition at curtainwall /window frame
East Wall Section
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Metal Panel Assembly Pressure-equalized rain screen mitigates
wind driven rain Pressure and drainage composed of
compartmentalized ventilation cavities that allow pressure inside to match outside air pressure, preventing moisture from being driven toward the inner wall assembly
Ultra-Thermal Window System
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Metal Panel Assembly Use of EAI Thermal Clip
System to drastically reduce thermal bridging
Thermal Performance
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Slotted Stainless Steel Masonry Tie Minimize conductivity, minimal
thermal degradation of continuous insulation
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Key Architectural Design Decisions
Sustainable finishes to meet LEED Checklist : Recycled materials Natural materials Low VOC materials
Interior Design
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Appendix
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Tools and Resources
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www.sustainabilityroadmap.org
The 2015 Vermont Commercial Building Energy Standard http://codes.iccsafe.org/Vermont.html#2015
Act 250 Criterion 9F (Energy Conservation) Must Use Best Available Technology https://energycode.pnl.gov/COMcheckWeb 2014 FGI Guidelines
ASHE Health Facility Commissioning Handbook Health Facility Commissioning Handbook Health Facility Commissioning Guidelines
EPA Energystar Program Portfolio Manager/Target Finder
http://www.energystar.gov/buildings/service-providers/design/step-step-process/evaluate-target/epa’s-target-finder-calculator
CON STANDARD 1.9: Applicants proposing construction projects shall show that costs and methods of the proposed construction are necessary and reasonable. Applicants shall show that the project is cost-effective and that reasonable energy conservation measures have been taken.
CON STANDARD 1.10: Applicants proposing new health care projects requiring construction shall show such projects are energy efficient. As appropriate, applicants shall show that Efficiency Vermont, or an organization with similar expertise, has been consulted on the proposal.
CON Standards
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Criterion 9(F) -- Energy Conservation: All projects must incorporate the best available technology for energy efficiency and reflect principles of energy conservation, including reduction of greenhouse gas emissions from the use of energy. All projects must also provide evidence that the project complies with the applicable building energy standards under 30 V.S.A. § 51 or 53.
Commercial buildings (all buildings which are not residential buildings three stories or less) are subject to Vermont’s Commercial Building Energy Standards (CBES) (3021 V.S.A. § 53). Applicants must provide evidence that their project at least complies with the CBES. This can be done through the web-based tool COMCheck. The CBES do not create a rebuttable presumption with respect to Criterion 9(F). Therefore, the project must incorporate the best available technology for energy efficiency and reflect principles of energy conservation, including reduction of greenhouse gas emissions from the use of energy. For more information about CBES, contact the Public Service Department at toll-free at 1-800-642-3281 (in-state only) or 802-8283183.
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Act 250 Criteria 9(F) Energy Conservation
Evidence of compliance with the Commercial Building Energy Standards (CBES) does not provide a presumption of compliance under criterion 9(F). Therefore, even if an applicant provides the evidence necessary to demonstrate that a subdivision or development complies with the CBES as required, the applicant still must meet the other explicit requirements of criterion 9(F). Pursuant to 10 V.S.A. § 6086(a)(9)(F), an applicant must demonstrate “the planning and design of the subdivision or development reflect the principles of energy conservation, including reduction of greenhouse gas emissions from the use of energy, and incorporate the best available technology for efficient use or recovery of energy.”
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Act 250 Criteria 9(F) Energy Conservation