Loading...
32C-058 (3) •• c cn 0 . ap �j 0 0 0 11111b.J i� E-_, •�O :F:. (...) _I—, 4 c ..) --7....(: ,c:,, c q -5. ul Q.) f:: .,,,qiii .z: E..„ ` U O t et C ci 'mil"CI 656 0 w Z 0 A ti4 N 7 iv z GL a co vJ ro = "�J � W Nz �t ' . o av � . O L k t,ci) p _i 4 c.) 4 y q Cg ,�' a N d Q) ilimi • W 0 el C) o N ' Wm, a ti Q(11 � O o a O O E' v' ,--1 j ci=cn O N W °' 0 0 O W v w Q c K R a E. = '"' U 04 3 M °z O V ca N ' v vE CG N --.. a, '-E.::1 t `o g _() wo c., z 04 z , w +� q ,z4 fl a � co V 06 N U 11 co 3 ro 0 0 dl N -- -I U 4.1 A a : ti �, ro v E UU 0 w U, a •r{ 41 O 0 0 0 0 •ri H co a 3 g. c -- 0 6 'J FIRE ALARM AND EMERGENCY COMMUNICATION SYSTEM INSPECTION AND TESTING FORM To be completed by the system inspector or tester at the time of the inspection or test. It shall be permitted to modify this form as needed to provide a more complete and/or clear record. Insert N/A in all unused lines. Attach additional sheets,data,or calculations as necessary to provide a complete record. Date of this inspection or test: 2/7/13 Time of inspection or test: 12:30 1. PROPERTY INFORMATION 1 Name of property: NORTHAMPTON LODGING/BODWICH ASSOC ' + ( Address: 129 PLEASANT STREET NORTHAMPTON,MA 01060 li{ DEC 12 2013 Description of property: LODGING If Electrir F i `' Occupancy type: COMM -- r `ir='pections Name of property representative: JOHN PITZI Address: Phone: 586-6908,207-671-6179 Fax: 549-9389 E-mail: Authority having jurisdiction over this property: NFD Phone: Fax: E-mail: 2. INSTALLATION,SERVICE,AND TESTING CONTRACTOR INFORMATION Service and/or testing organization for this equipment: INDUSTRIAL RESIDENTIAL SECURITY,LLC Address: 73 GUNN ROAD,SOUTHAMPTON,MA 01073 Phone: 413-527-3353 Fax: 413-527-0230 E-mail: IRSCO @IRSCOSYSTEMS.COM Service technician or tester: TROY HACKWORTH Qualifications of technician or tester: LICENSED TECH 286-C A contract for test and inspection in accordance with NFPA standards is in effect as of: NA The contract expires: Contract number: Frequency of tests and inspections: YRLY Monitoring organization for this equipment: COPS Address: WILLIAMSTOWN NJ Phone: 800-633-2677 Fax: E-mail: Entity to which alarms are retransmitted: 4X-7506 Phone: 800-633-2677 3. TYPE OF SYSTEM OR SERVICE ®Fire alarm system(nonvoice) ❑Fire alarm with in-building fire emergency voice alarm communication system(EVACS) ❑Mass notification system(MNS) ❑Combination system,with the following components: ❑Fire alarm ❑EVACS ❑MNS ❑Two-way,in-building,emergency communication system ❑Other(specify): NFPA 72. Fig. 14.6.2.4(p. 1 of 11) Copyright©2009 National Fire Protection Association.This form may be copied for individual use other than for resale.It may not be copied for commercial sale or distribution. Ju Li DEC 12 2013 • iji 3. TYPE OF SYSTEM OR SERVICE (continued) Electn�,FI:-urbinc jnsNzctions Norths:mplon, MA 01060 NFPA 72 edition: Additional description of system(s): 3.1 Control Unit Manufacturer: SILENT KNIGHT Model number: 5204 3.2 Mass Notification System ®This system does not incorporate an MNS. 3.2.1 System Type: ❑In-building MNS—combination ❑In-building MNS—stand-alone ❑Wide-area MNS ❑Distributed recipient MNS ❑Other(specify): 3.2.2 System Features: ❑Combination fire alarm/MNS ❑MNS ACU only ❑Wide-area MNS to regional national alerting interface ❑Local operating console(LOC) ❑Direct recipient MNS(DRMNS) ❑Wide-area MNS to DRMNS interface ❑Wide-area MNS to high-power speaker array(HPSA)interface El In-building MNS to wide-area MNS interface ❑Other(specify): 3.3 System Documentation ❑An owner's manual,a copy of the manufacturer's instructions,a written sequence of operation,and a copy of the record record drawings are stored on site. Location: 3.4 System Software ❑This system does not have alterable site-specific software. Software revision number: Software last updated on: ❑A copy of the site-specific software is stored on site. Location: 4. SYSTEM POWER 4.1 Control Unit 4.1.1 Primary Power Input voltage of control panel: 120 Control panel amps: 4.1.2 Engine-Driven Generator ®This system does not have a generator. Location of generator: Location of fuel storage: Type of fuel: 4.1.3 Uninterruptible Power System ®This system does not have a UPS. Equipment powered by a UPS system: Location of UPS system: Calculated capacity of UPS batteries to drive the system components connected to it: In standby mode(hours): In alarm mode(minutes): NFPA 72, Fig. 14.6.2.4(p. 2 of 11) Copyright©2009 National Fire Protection Association.This form may be copied for individual use other than for resale.It may not be copied for commercial sale or distribution. 3 0 6-4 4. SYSTEM POWER(continued) 4.1.4 Batteries Location: PANELL Type: SEALED Nominal voltage: 12 Amp/hour rating: 7 Calculated capacity of batteries to drive the system: In standby mode(hours): In alarm mode(minutes): ❑Batteries are marked with date of manufacture. 4.2 In-Building Fire Emergency Voice Alarm Communication System or Mass Notification System ®This system does not have an EVACS or MNS. 4.2.1 Primary Power Input voltage of EVACS or MNS panel: EVACS or MNS panel amps: 4.2.2 Engine-Driven Generator ❑This system does not have a generator. Location of generator: Location of fuel storage: Type of fuel: 4.2.3 Uninterruptible Power System ❑This system does not have a UPS. Equipment powered by a UPS system: Location of UPS system: Calculated capacity of UPS batteries to drive the system components connected to it: In standby mode(hours): In alarm mode(minutes): 4.2.4 Batteries Location: Type: Nominal voltage: Amp/hour rating: Calculated capacity of batteries to drive the system: In standby mode(hours): In alarm mode(minutes): ❑Batteries are marked with date of manufacture. 4.3 Notification Appliance Power Extender Panels ❑This system does not have power extender panels. 4.3.1 Primary Power Input voltage of power extender panel(s): Power extender panel amps: 4.3.2 Engine-Driven Generator ❑This system does not have a generator. Location of generator: Location of fuel storage: Type of fuel: 4.3.3 Uninterruptible Power System ❑This system does not have a UPS. Equipment powered by a UPS system: Location of UPS system: Calculated capacity of UPS batteries to drive the system components connected to it: In standby mode(hours): In alarm mode(minutes): NFPA 72, Fig. 14.6.2.4(p. 3 of 11) Copyright®2009 National Fire Protection Association.This form may be copied for individual use other than for resale.It may not be copied for commercial sale or distribution. 3c2C — v�� 4. SYSTEM POWER(continued) 4.3.4 Batteries Location: Type: Nominal voltage: Amp/hour rating: Calculated capacity of batteries to drive the system: In standby mode(hours): In alarm mode(minutes): ❑Batteries are marked with date of manufacture. 5. ANNUNCIATORS ®This system does not have annunciators. 5.1 Location and Description of Annunciators Annunciator I: Annunciator 2: Annunciator 3: 6. NOTIFICATIONS MADE PRIOR TO TESTING Monitoring organization Contact: COPS Time: 12:30 Building management Contact: JOHN Time: 12:30 Building occupants Contact: Time: Authority having jurisdiction Contact: Time: Other,if required Contact: Time: 7. TESTING RESULTS 7.1 Control Unit and Related Equipment Visual Functional Description Inspection Test Comments Control unit Lamps/LEDs/LCDs Fuses ❑ ❑ Trouble signals Disconnect switches ❑ ❑ Ground-fault monitoring ❑ ❑ Supervision ❑ ❑ Local annunciator Remote annunciators ❑ ❑ Power extender panels ❑ ❑ Isolation modules ❑ ❑ Other(specify) ❑ ❑ NFPA 72, Fig. 14.6.2.4(p. 4 of 11) Copyright®2009 National Fire Protection Association.This form may be copied for individual use other than for resale.It may not be copied for commercial sale or distribution. 3tc — © 5 7. TESTING RESULTS(continued) 7.2 Control Unit Power Supplies Visual Functional Description Inspection Test Comments 120-volt power Generator or UPS ❑ ❑ Battery condition ® ® 13.7,13.7-DIALER 13.6 Load voltage ❑ ❑ Discharge test ❑ ❑ Charger test ® ® 13.8-DIALER 13.8 Other(specify) ❑ ❑ 7.3 In-Building Fire Emergency Voice Alarm Communications Equipment Visual Functional Description Inspection Test Comments Control unit ❑ ❑ Lamps/LEDs/LCDs ❑ ❑ Fuses ❑ ❑ Primary power supply ❑ ❑ Secondary power supply ❑ ❑ Trouble signals ❑ ❑ Disconnect switches ❑ ❑ Ground-fault monitoring ❑ ❑ Panel supervision ❑ ❑ System performance ❑ ❑ Sound pressure levels ❑ ❑ Occupied ❑Yes ❑No Ambient dBA Alarm dBA (attach report with locations,values, and weather conditions) System intelligibility ❑ ❑ ❑CSI ❑STI (attach report with locations,values, and weather conditions) Other(specify) ❑ ❑ NFPA 72, Fig. 14.6.2.4(p. 5 of 11) Copyright©2009 National Fire Protection Association.This form may be copied for individual use other than for resale.It may not be copied for commer5:04 e or distribution. 3&C- o 7. TESTING RESULTS (continued) 7.4 Notification Appliance Power Extender Panels Visual Functional Description Inspection Test Comments Lamps/LEDs/LCDs ❑ ❑ Fuses ❑ ❑ Primary power supply ❑ ❑ Secondary power supply ❑ ❑ Trouble signals ❑ ❑ Ground-fault monitoring ❑ ❑ Panel supervision ❑ ❑ Other(specify) ❑ ❑ 7.5 Mass Notification Equipment Visual Functional Description Inspection Test Comments Functional test ❑ ❑ Reset/power down test ❑ ❑ Fuses ❑ ❑ Primary power supply ❑ ❑ UPS power test ❑ ❑ Trouble signals ❑ Cl Disconnect switches ❑ ❑ Ground-fault monitoring ❑ ❑ CCU security mechanism ❑ ❑ Prerecorded message content ❑ ❑ Prerecorded message activation ❑ ❑ Software backup performed ❑ ❑ Test backup software ❑ ❑ Fire alarm to MNS interface ❑ ❑ MNS to fire alarm interface ❑ ❑ In-building MNS to wide-area ❑ ❑ MNS NFPA 72. Fig. 14.6.2.4(p. 6 of 11) Copyright®2009 National Fire Protection Association.This form may be copied for individual use other than for resale.It may not be copied for commercial sale or on sac J o � , 7. TESTING RESULTS(continued) 7.5 Mass Notification Equipment(continued) Visual Functional Description Inspection Test Comments MNS to direct recipient MNS ❑ ❑ Sound pressure levels ❑ ❑ Occupied ❑Yes ❑No Ambient dBA Alarm dBA (attach report with locations,values, and weather conditions) System intelligibility ❑ ❑ ❑CSI ❑STI (attach report with locations,values, and weather conditions) Other(specify) ❑ ❑ 7.6 Two-Way Communications Equipment Visual Functional Description Inspection Test Comments Phone handsets ❑ ❑ Phone jacks ❑ ❑ Off-hook indicator ❑ ❑ Call-in signal ❑ ❑ System performance ❑ ❑ System audibility ❑ ❑ System intelligibility ❑ ❑ Radio communications ❑ ❑ enhancement system Area of refuge communication ❑ ❑ system Elevator emergency ❑ ❑ communications system Other(specify) ❑ ❑ NFPA 72, Fig. 14.6.2.4(p. 7 of 11) Copyright 0 2009 National Fire Protection Association.This form may be copied for individual use other than for resale.It may not be copied for commercial sale or distribution. 6--V 7. TESTING RESULTS(continued) 7.7 Combination Systems Visual Functional Description Inspection Test Comments Fire extinguishing monitoring ❑ ❑ devices/system Carbon monoxide detector/system ❑ ❑ Combination fire/security system ❑ ❑ Other(specify) ❑ ❑ 7.8 Special Hazard Systems Visual Functional Description(specify) Inspection Test Comments ❑ ❑ ❑ ❑ ❑ ❑ 7.9 Emergency Communications System ❑ Visual ❑ Functional ❑ Simulated operation ❑ Ensure predischarge notification appliances of special hazard systems are not overridden by the MNS. See NFPA 72,24.4.1.7.1. 7.10 Monitored Systems Visual Functional Description(specify) Inspection Test Comments Engine-driven generator ❑ ❑ Fire pump ❑ ❑ Special suppression systems ❑ ❑ Other(specify) ❑ ❑ NFPA 72. Fig. 14.6.2.4(p. 8 of 11) Copyright®2009 National Fire Protection Association.This form may be copied for individual use other than for resale.It may not be copied for commercial sale or distribution.5.--.67 3(7;1_ 7. TESTING RESULTS(continued) 7.11 Auxiliary Functions Visual Functional Description Inspection Test Comments Door-releasing devices Fan shutdown ❑ ❑ Smoke management/smoke control ❑ ❑ Smoke damper operation ❑ ❑ Smoke shutter release ❑ ❑ Door unlocking ❑ ❑ Elevator recall ❑ ❑ Elevator shunt trip ❑ ❑ MNS override of FA signals ❑ ❑ Other(specify) ❑ ❑ 7.12 Alarm Initiating Device ❑ Device test results sheet attached listing all devices tested and the results of the testing 7.13 Supervisory Alarm Initiating Device ❑ Device test results sheet attached listing all devices tested and the results of the testing 7.14 Alarm Notification Appliances ❑ Appliance test results sheet attached listing all appliances tested and the results of the testing 7.15 Supervisory Station Monitoring Description Yes No Time Comments Alarm signal ® ❑ Alarm restoration ® ❑ Trouble signal ® ❑ Trouble restoration ® ❑ Supervisory signal ❑ ❑ Supervisory restoration ❑ ❑ NFPA 72. Fig. 14.6.2.4(p. 9 of 11) Copyright©2009 National Fire Protection Association.This form may be copied for individual use other than for resale.It may not be copied for commercial sale or distribution. 3e2 3 <g` 8. NOTIFICATIONS THAT TESTING IS COMPLETE Monitoring organization Contact: Time: Building management Contact: JOHN Time: 14:30 Building occupants Contact: Time: Authority having jurisdiction Contact: Time: Other,if required Contact: Time: 9. SYSTEM RESTORED TO NORMAL OPERATION Date: 2/7/13 Time: 14:30 10. CERTIFICATION 10.1 Inspector Certification: This system,as specified herein,has been inspected and tested according to all NFPA standards cited herein. Signed: TROY HACKWORTH Printed name: TROY HACKWORTH Date: 2/6/13 SIG ON FILE Organization: IRS,LLC Title: LICENSED TECH 286C Phone: 527-3353 10.2 Acceptance by Owner or Owner's Representative: The undersigned has a service contract for this system in effect as of the date shown below. Signed: JOHN PITZI SIG ON Printed name: JOHN PITZI Date: 2/7/13 FILE Organization: NTON LODGING Title: PROP MGR Phone: 207-671-6179 NFPA 72, Fig. 14.6.2.4(p. 10 of 11) Copyright C 2009 National Fire Protection Association.This form may be copied for individual use other than for resale.It may not be copied for commercial sale or distribution. 3 - a 6---4F DEVICE TEST RESULTS (Attach additional sheets if required) Device Type Address Location Test Results SMOKES/HEAT/CO 1 BASEMENT CK SMOKES/HEAT/CO 2 1ST FLOOR CK SMOKES/HEATS/CO 3 2ND FLOOR CK PULL STATIONS 4 BASE, 1ST,2ND CK *NOTES: -INDIVIDUAL ROOMS NOT INSPECTED PER JOHN -HEAT IN BASEMENT KITCHEN REPLACED- PAINTED -CO DET IN UNIT A BASEMENT REPLACED -PULL STATION 1ST FLOOR MID REPLACED NFPA 72, Fig. 14.6.2.4(p. 11 of 11) Copyright©2009 National Fire Protection Association.This form may be copied for individual use other than for resale.It may not be copied for commercial sale or distribution. 3�r o 5