44,000 SF ground-up extension to a multi-story community healthcare center expanded treatment rooms, testing areas, labs, conference rooms, bathrooms, offices and suites, all handicapped accessible, with work performed to ICRA standards while the existing facility remained occupied by staff and the public. Vibration monitors were installed during pile-driving, lead contaminated soil removed, and a conflicting gas line relocated. Scope included foundation work, new electric, water service and sprinkler pump, curtain walls, limestone cladding, structural steel, roofing and waterproofing, elevators, stairs, lighting, security, and expanded Life Safety FA and nurse-call station monitoring systems. Coordination with NY State Dept of Health obtained inspections to open. The two buildings are connected via a ground floor ramp and stairs; provisions were built into the upper floors for future breakthroughs for additional transitions.