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Perkins Eastman ARCHITECTURE
CONSULTING
INTERIOR DESIGN
PLANNING
PROGRAMMING
March 4, 2014
Hon. Meenakshi Srinivasan
Chair S 0
New York City Board of Standards and Appeals
250 Broadway, 29th Floor
New York, NY 10007
; 7 Re: New York Methodist Hospital
Center for Community Health
505-525 6th Street (Block 1084,
Lots 25, 26, 28, 39-44, 46, 48,
L ' " 50-59, 164, 1001, and 1002)
BSA Cal.No. 289-13-BZ
Dear Chair Srinivasan and Commissioners:
We are submitting this letter in connection with the application by New
York Methodist Hospital ("NYM" or the "Hospital") for a variance to facilitate the
development of a new ambulatory care facility (the "Center") Hospital's main campus in
Brooklyn. This letter and the attached materials provide responses to questions asked by
the Board at the February 11, 2014, public hearing on the application, as set forth below.
1. Provide studies for lesser variance options for the Center that (i) fully comply with
the applicable height and setback regulations in the R7B district and (ii) reduce the
degree of the building's non-compliance with the applicable height and setback
regulations in the R6B district.
Attached to this letter is a Lesser Variance Study prepared by Perkins
Eastman Architects, consisting of illustrative diagrams for alternate designs of the Center
that would require a lesser variance. The Study is a preliminary analysis of how the Hospital's
needed program would be accommodated in such alternate versions of the building. While
further analysis would be needed to finalize the program of such a building, the attached
illustrative diagrams are representative of the nature and degree of program impacts that would
result.
The Lesser Variance Study examines three modifications to the
proposed Center's building envelope: (i) an increased setback at the 4th floor in the R6B
district; (ii) an increased setback at the 5,h through 7th floors in the R6B district; and (iii) an
increased setback at the 6th floor in the R7B district to achieve full compliance with the
R7B height and setback regulations. The portions of the building, as currently proposed,
that would be eliminated by such modifications are shown on the Lesser Variance
Reductions diagrams attached to this letter.
The first lesser variance option would increase the building's setback
from 5th Street in the R6B district by an additional 15 feet, to a total depth of 20 feet from
the street. In the current design for the Center, the western wing of the building contains a
surgical suite with 12 operating rooms (ORs) on the 3rd floor, a post-anesthesia care unit
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PERKINS EASTMAN ARCHITECTS, PC
115 FIFTH AVENUE
NEW YORK, NY 10003
T. 212.353.7200
F. 212.353.7676
WWW.PERKINSEASTMAN.COM
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• The relocation of CSS and Materials Management to a floor with smaller
dimensions requires a reduction of the program area for one or both of these
functions, with impacts on the efficiency of the building's operations. (See Lesser
Variance Study, 4th Floor Plan Diagram)
• To accommodate the surgical suite, the current design for the Center has a stiffer
floor construction at the 3rd floor to reduce vibration and deflection. This stiffer
construction is achieved by utilizing standard-depth beams over shorter spans,
requiring a denser column spacing on the floor immediately below. The more
tightly-spaced columns do not significantly impede the configuration of CSS and
Materials Management, but they would result in compromised or displaced PACU
units if the PACU suite is relocated to the 2nd floor. (See Lesser Variance Study, 2nd
Floor Plan Diagram)
• As an alternative to maintaining standard-depth beams and denser column
spacing on the 2nd floor, the building could be designed with a deeper 3rd floor
construction to achieve the floor stiffness required for the surgical suite. This would
take the form of deeper structural framing members, spanning between fewer,
farther-spaced columns than in the above option, to provide the stiffness required
for the surgical floor. This solution results in either a greater floor-to-floor height
for the floor and, in turn, the building, or a reduced headroom condition on the 2nd
floor, with its associated loss of flexibility, compromised design, and complex
coordination, maintenance, and construction, as described below.
» The location of CSS on the 4th floor with an increased setback from 5th Street would
require that the building's soiled elevator and flanking support spaces be moved
southward to remain within the building envelope. (See Lesser Variance Study, 4th
Floor Plan Diagram) In order to accommodate the relocation of the elevator shaft
and support spaces on the 3rd floor while maintaining sterile connections, the
building's surgical suite must be reduced in size. This would require the
displacement of support space or a reduction in the size of one or more ORs, with
a resulting reduction in services to the community. (See Lesser Variance Study, 3rd
Floor Plan Diagram)
• CSS and Materials Management both rely heavily on the western wing's service
elevators. Moving these facilities two floors up in the building would increase
demand on the service elevators, with impacts on other users of the elevators, and
Perkins Eastman
(PACU) on the 4th floor, and Central Sterile Services (CSS) and Materials Management on
the 2nd floor. As discussed in the application, the vertical adjacencies between these
facilities are needed to create a controlled, sterile environment for the building's surgical
functions and efficient travel distances for patients and staff. The PACU suite contains 36
patient rooms in order to maintain a 3-to-1 ratio to the building's ORs, as required by New
York State Department of Health code. The amount of space for PACU cannot be
reduced in size without requiring a reduction in the number of PACU rooms and, in turn, a
reduction in the number of ORs on the 3rd floor. The Study therefore accomplishes the
additional setback at the 4th floor by swapping the PACU suite with CSS and Materials
Management on the 2nd floor. While this design modification maintains the needed vertical
adjacencies and allows an increased setback at the 4th floor, it creates a number of issues,
including possible impacts on the size of ORs, as follows:
ARCHITECTURE
CONSULTING
INTERIOR DESIGN
PLANNING
PROGRAMMING
The Lesser Variance Study also examines the impacts of providing more
significant setbacks along 5th Street to achieve full compliance with the height and setback
regulations in the R7B district and to reduce the height of the portion of the building in the R6B
district to four stories. In particular, the eastern wing's 6th floor is set back by approximately an
additional 20 feet to the R6 district boundary line, and the western wing's 5th through 7th floors are
set back approximately by an additional 69 feet to the R6 district boundary line. As
demonstrated by the diagrams, the design of the Center cannot be modified as suggested
without significantly reducing the size of or completely eliminating certain departments or
services and compromising the building's flexibility, efficiency, and ability to provide
innovative care programs. In particular:
• Many of the ambulatory surgery and clinical institute facilities would be severely
reduced in size, resulting in a building that leaves the Hospital's programmatic
need for additional space largely unsatisfied. In the Lesser Variance Study, the
Orthopedics Institute is reduced by 1,053 departmental gross square feet (dgsf), or
16%; the Cardiology Institute is reduced by 2,958 dgsf, or 25%; the Cancer Care
Institute is reduced by 11,463 dgsf, or 38%; and the Women's Center is reduced
by 2,343 dgsf, or 15%. The total reduction in clinical program (including the loss
of the hyperbaric chamber facilities, described below) is 22,622 dgsf, which is
more than 1 8% of the 123,208 dgsf accommodated by the current design for the
Center.
• Support facilities that are critical to the operation of the surgical suite would also be
compromised. In the Lesser Variance Study, CSS is reduced by 196 dgsf, or 6%,
and Materials Management is reduced by 538 dgsf, or 28%.
• Certain facilities would be eliminated entirely. In the Lesser Variance Study, the
building would not be able to house any hyperbaric chamber facilities.
• Many healthcare program areas would be relocated or reconfigured, with the
resulting elimination of efficient adjacencies. In the Lesser Variance Study, the
Women's Center on the 7th Floor can be accommodated only by splitting the
department into two spaces, one on each side of the building's circulation core,
resulting in a bifurcation of services, increased travel times, and less efficient
circulation paths for patients and staff. Rapid Response Lab and USP 797
Pharmacy are relocated from the 6lh floor to the 4th floor, two floors away from the
6th floor Institute for Cancer Care that such facilities predominately serve. Further,
mechanical and electrical equipment spaces currently located in the setback areas
would be displaced, requiring a reconfiguration of program areas to
accommodate them in new locations.
In short, a building with the suggested setbacks would be inadequate to satisfy
the Hospital's programmatic needs.
Perkins Eastman
require additional travel times for each delivery made to these spaces. (See Lesser
Variance Study, 4th Floor Plan Diagram)
2. Provide diagrams illustrating the programmatic issues associated with construction a
larger portion of the Center, e.g. up to five stories, over the existing Hospital garage.
Perkins Eastman
The attached Garage Overbuild Study demonstrates the programmatic
deficiencies of a development that includes construction over the existing Hospital garage. The
proposed design configuration of the Center on the U-shaped development site is based on a
design principle by which two distinct circulation paths are provided (i) for patients and (ii) for staff,
oriented around a centrally located core, with patients led progressively toward more controlled,
private, and dedicated spaces—from the waiting area to registration, then to processing, then to
preparation, and finally to treatment in the eastern and western wings of the building. This design
not only provides a rational, efficient circulation network, but it is also needed to accommodate
certain ambulatory care facilities in the building. The surgical suite, for example, must be located
in the Center's western wing because the central core area and eastern wing do not have sufficient
dimensions to accommodate the facilities. The PACU unit and CSS, which must be adjacent to the
surgical suite, are therefore also located in the western wing, on the floors immediately above and
below.
An additional wing located over the existing Hospital garage, with a height of
five stories (or more or less), would not satisfy the Center's programmatic needs because the
geometry would necessitate that it be functionally and operationally segregated from the
remaining portion of the building. Connections could not be made between the garage wing and
the main building because (i) the vehicular driveway and loading area would separate the garage
wing and the rest of the building on the ground floor (see Ground Floor Plan Diagram) and (ii)
security, infection-control, and operational standards for the ambulatory surgery facilities would
prohibit pass-through access to the garage wing on the 2nd through 4th floors, which house CSS,
PACU, and the ORs (see 2nd Floor Plan through 4th Floor Plan Diagrams). A connection would be
possible only at the 5th floor, and even then would create a very long, inefficient circulation
network between the main portion of the new facility and the garage wing of the building—a
circulation network which would run through departments rather than distribute to them
efficiently from a central core. In addition, the program areas within the garage wing and western
wing on the 5th floor would have no functional relationship to each other, and therefore any
connection between them would be detrimental to such programs and introduce security,
infection, and efficiency concerns. (See 5th Floor Plan Diagram)
Such a design would also require an additional vehicular drop-off and
pedestrian entrance on 5th Street, since almost all of the garage wing's floors, including the ground
floor, could not be accessed from the building's central circulation core on 6th Street. This
configuration would require an inefficient utilization of space, with more area dedicated to vertical
and horizontal circulation and vehicular access, and would result in increased vehicular traffic on
5th Street. (See Ground Floor Plan Diagram) In short, the building would have the same
deficiencies as the Complying Development. To the extent that the garage wing complied with
applicable height and setback and rear yard equivalent regulations, it would similarly contain very
narrow floor plates, capable of accommodating only inefficiently small suites for the Hospital's
clinical institutes.
3. Explain why the proposed floor-to-floor heights of the Center, particularly those for the 6th
and 7th floors, are needed.
The floor-to-floor height of most of the proposed Center's floors is 14'-0",
which is appropriate for accommodating the medical facilities and equipment that the
Center may need now or in the future. The consistency of this height among the building's
floors provides appropriate flexibility for the reprogramming of the building.
Perkins Eastman Architects studied an alternate design for the Center in
which the 5th through 7th floors are each reduced in floor-to-floor height by 6 inches to
reduce the total building height by 1'-6". As shown by the attached elevation comparison
ARCHITECTURE
CONSULTING
• NTERlOR DESIGN
PLANNING
PROG R AAA M i N G
Perkins Eastman
and massing comparison, these modifications result in a negligible reduction in the
building's apparent height, while reducing the building's planning flexibility. They also
compromise the efficiency of the building in a number of ways:
• The design, coordination, and maintenance of the building's utilities would
become more complex. The height reduction would require a greater compaction
of overhead utilities and equipment, with various systems lines and equipment
needing to be either split to reduce overall depth or ganged, thereby limiting
access to those lines and the equipment located behind them.
ARCHITECTURE
CONSULTING
iNTERIOR DESIGN
PLANNING
PROGRAMMING
• Similarly, the height reduction would limit routing options for major ductwork and
pipes, requiring a finer level of coordination and fabrication by contractors—with
more conflicts in the field and costly and time-consuming field fixes.
• The height reduction would in some cases require the flattening of ductwork,
resulting in suboptimal height-to-width ratios. Such ratios would result in increased
surface friction, requiring either larger fans or increased demands on fans, with the
associated wear and tear. They would also result in increased face velocities for air
passage in some cases, and in turn reduced patient comfort.
• Design responses to the above problems, where possible, would in many cases
require beam cuts and the utilization of shallower, heavier beams, with significant
added costs.
In light of the significant benefits to be gained by the proposed floor-to-
floor ceiling heights, and the negligible benefit and new issues that would be created by
decreasing such heights, we believe that the proposed design is highly appropriate.
4. Discuss whether the proposed rooftop mechanical enclosures can be set back
farther from 5th Street.
As shown in the attached Equipment Screen Study, consisting of an 8th
Floor Plan Diagram, 9th Floor Plan Diagram, and Section Diagrams, the rooftop
mechanical closures for the proposed Center have been designed to provide the minimum
required clearance around the rooftop equipment currently planned for the building. They
cannot be set back farther from the street for this reason. As the design of the building
advances, we will explore options for the mechanical equipment that may require smaller
enclosures.
We would be pleased to provide the Board with any additional information you
need. Thank you for your consideration.
Very truly yours,
Francis Gunther, AIA
Principal
•3 THROUGH LOT B: R6 R6B
ZONING DISTRICT BOUNDARY
BLOCK C.L.
THROUGH LOT
SKY EXPOSURE PLANE 2.7/1
(NARROW STREET)
149' 5.8" HT.
5TH
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PERMITTED BUILDING ENVELOPE LESSER VARIANCE REDUCTIONS
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Illustrative - For Information only
LESSER VARIANCE STUDY
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Third Floor Plan N
03-04-2013 Scale: 1" = 32'-0"
5TH STREET
6% Reduction (196dgsf) -Location of soiled elevator to be coordinated w/ Surgery Support
3,789dgsf
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LESSER VARIANCE STUDY
BSA NY Methodist Hospital, Brooklyn
The Center for Community Health Fourth Floor Plan
03-04-2014 Scale: 1" = 32-0"
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Illustrative - For Information only
LESSER VARIANCE STUDY
BSA The Center for Community Health NY Methodist Hospital, Brooklyn
Sixth Floor Plan N
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ORTHOPEDICS CLINIC-16,919dgsf
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CARDIOLOGY CLINIC - 9,323dgsf
25% reduction (2,958dgsf)
CANCER CENTER-19,392
38% reduction (11,463dgsf)
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The Center for Community Health BSA NY Methodist Hospital, Brooklyn
Fourth Floor Plan 03-04-2014
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SECURE
CONTROLLED 5TH STREET
CIRCULATION THROUGH WINGS WOULD INTRODUCE SECURITY & EFFICIENCY ISSUES & DISPLACE
PROGRAM AREA
INEFFICIENT CIRCULATION NETWORK
DUPLICATE ACCESS/ CIRCULATION / CONTROL AREAS
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PRIMARY / PATIENT
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WAITING/ORIENTATION
PROCESSING / PREP
TREATMENT/
CONSULTATION
BUILDING SYSTEMS
SUPPORT
•
Garage Overbuild Study ILLUSTRATIVE. FOR INFORMATION ONLY
nym NEW YORI^F METHODIST HOSPITAL
The Center for Community Health Perkins Eastman
BSA NY Methodist Hospital, Brooklyn
Fifth Floor Plan N
03-04-2014
MASSING AS PER 01 -28-2014 SUBMITTAL
MASSING WITH 5TH-7TH FLOOR HEIGHT REDUCTION
NEW YORK METHODIST HOSPITAL CENTER FOR COMMUNITY HEALTH
MASSING COMPARISON NORTH ELEVATION
MARCH 4, 2014 ILLUSTRATIVE. FOR INFORMATION ONLY
T71 » [. + 11M111
MASSING AS PER 01 -28-2014 SUBMITTAL MASSING WITH 5TH-7TH FLOOR HEIGHT REDUCTION
NEW YORK METHODIST HOSPITAL CENTER FOR COMMUNITY HEALTH MARCH 4, 2014 ILLUSTRATIVE. FOR INFORMATION ONLY
MASSING COMPARISON VIEW FROM 5TH ST AND 8TH AVE.
5TH STREET
6TH STREET • Enclosed mechanical area
! I Screened mechanical area
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ILLUSTRATIVE. FOR INFORMATION ONI
Equipment Screen
Study
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BSA The Center for Community Health NY Methodist Hospital, Brooklyn
8th Floor Plan n
2014-03-04
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6TH STREET Enclosed mechanical area
! Screened mechanical area
ILLUSTRATIVE. FOR INFORMATION ONI
Equipment Screen
Study
nym NEW YORK/Mf-THOtJlST HOSPITAl
Perkins Eastman
BSA The Center for Community Health NY Methodist Hospital, Brooklyn
9th Floor Plan n
2014-03-04
ZONING DISTRICT BOUNDARY
BLOCK C.L
SKY EXPOSURE PLANE 2.7 M
(NARROW STREET)
272.1'
COOLING TOWER
W/REQUIRED FREE
AREA AROUND
86.13'.is. 40' 3.72HT. T
1 -Section at Cooling Tower
ZONING DISTRICT BOUNDARY
BLOCK CL
SKY EXPOSURE PLANE2.71
(MARROW STREET)
272.1' ^ 145' 7.9' HT. T
EMERGENCY
GENERATORS TIGHT
TO SCREEN (w/FLUE
EXTENSION ABOVE)
86.13' J,
2 - Section at Emergency Generator
P.L.
ZONING DISTRICT BOUNDARY BLOCK C.L. P.L.
-20'
REQ'D
SETBACK
't it I
CORNER LOT
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AIR HANDLING UNIT
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Perkins Eastman
The Center for Community Health
Equipment Screer
Study
BSA NY Methodist Hospital, Brooklyn
2014-03-04 0