Why does Management Studio add the second alter table "CHECK CONSTRAINT" for a foreign key constraint ALTER TABLE [dbo].[REMINDER_EMAIL]  WITH CHECK ADD  CONSTRAINT 
  [FK__REMINDER_EMAIL__FACILITY_ID] FOREIGN KEY ( [FACILITY_ID] )
  REFERENCES [dbo].[FACILITY] ( [FACILITY_ID] )

ALTER TABLE [dbo].[REMINDER_EMAIL] CHECK CONSTRAINT [FK__REMINDER_EMAIL__FACILITY_ID]
With foreign key and check constraints, specifying CHECK or NOCHECK enables or disables it.  It's just explicit DDL that is generated by the GUI that, in your case, enables the foreign key constraint:


  { CHECK | NOCHECK } CONSTRAINT
  Specifies that constraint_name is
  enabled or disabled. This option can only be used with FOREIGN KEY and
  CHECK constraints. When NOCHECK is specified, the constraint is
  disabled and future inserts or updates to the column are not validated
  against the constraint conditions. DEFAULT, PRIMARY KEY, and UNIQUE
  constraints cannot be disabled.


Reference: BOL ALTER TABLE

It is redundant and unnecessary, but I just take it as "verbose". If I was to defend it forcefully, I'd say it leaves the script reader without any question of functionality.