38A-048 (2) City of Northampton
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` 212 in reet • Municipal Building
Notithampton, MA 01060
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BF,R ODIC INSPECTIONS
Electric,Plumbing&Gas lnspec ions
Northampton, MA 01060 ( Application Sent on February 25, 2015
PREMISE NAME: SERVICE NET
PREMISE ADDRESS: 91 GROVE ST
OWNER(S) OF RECORD:
OWNERS: ADDRESS:
NORTHAMPTON, MA. 01060
TELEPHONE NO: _ 6`7 9 -- ,7-7 yf
NAME ON CERTIFICATE: SERVICE NET
TYPE OF BUSINESS � lr//144 w-
USE GROUP:
INSPECTION FEE: $ 75.00 J 1p
Please complete and return this application to the Department of Building Inspections, 212 Main Street,
Northampton, MA 01060. We will contact you to arrange a time to inspect your property. If this information is
not correct, or if you no longer own this property, please note any changes at the bottom or on the back of this
form and return it to the building department. Feel free to contact us if you have any questions. We can be
reached at (413) 587-1240. Thank you.
Applicant name:
Applicant Title:_Telephone
Preferred inspection time/date A..,.A- A�jz i L
ServiceNet
Integrated Human Services
129 King Street e Northampton, MA 01060 e 413.585.1300 e Fax 413.582.4252 e www.servicenet.org e Susan L. Stubbs, C.E.O.
Pinner Agency
DEVICE TEST RESULTS
(Attach additional sheets if required)
Device Type Address/Zone Location Test R alts P
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PES—Photo-Elec Smoke MPS—Manual Pull Station HDT—Heat Detector
SFS—Sprinkler Flow Switch STS—Sprinkler Tamper Switch SSS—Sprinkler Supervisory Switch
HSS—Hood Suppression Switch CO—Carbon Monoxide Detector DSD—Duct smoke detector
HST—Hon/Strobe STB—Strobe EXB—External Beacon
SPST—Speaker/Strobe SPKR—Speaker EBEL—Electro-Mech--ii:a?Bell
Sery i9
ceNet
Integrated Human Services
129 King Street • Northampton, MA 01060 • 413.585.1300 • Fax 413.582.4252 • www.servicenet.org • Susan L. Stubbs, C.E.O.
DEVICE TEST RESULTS
(Attach additional sheets if required)
Device Type Address/Zone Location Test Results (P/F)
PI
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AIs a 3-
1
PAS 12
P 5 7 bq Av b K Y�r `4
C, 0 /G S'T�3�`+e cam'�/
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PES—Photo-Elec Smoke MPS—Manual Pull Station HDT—Heat Detector
SFS—Sprinkler Flow Switch STS—Sprinkler Tamper Switch SSS--Sprinkler Supervisory Switch
HSS—Hoy d Suppression Switch CO—Carbon Monoxide Detector DSD—Duct smoke detector
HST—Hom/Strobe STB—Strobe EXB—External Beacon
SPST—Speaker/Strobe SPKR—Speaker EBEL—Electro-Mechanical Bell
ServiceNet
Integrated Human Services
1 1 1 1 129 King Street • Northampton, MA 01060 • 413.585.1300 • Fax 413.582.4252 • www.servicenet.org • Susan L. Stubbs, C.E.O.
UnitedC1}
Way
CITIZEN SECURITY CORP.
87 Center St. Ludlow,MA 01056
(413) 547-6512
FIRE ALARM TEST/INSPECTION ACKNOWLEDGEMENT Page , f of
Inspection Date/ 31/ 1.5- Time In Time Out Tech(s) init.SG /WS/ /
Inspection Frequency:. ❑Weekly ❑Monthly DQuarterly )Semi-annually tAllnually
JOB LOCATION
Name: LSD u t Q-, IT T ACCT#: //-7y78'
Address: roy-t . ST Floors 01 Contact Name_y—b%4 Gip SS
City: �J rhAwt F 7-AA State MA Zip p Il v Contact#q[3-,5 -25-- O(4a7
CONTROL PANEL
Mfr./Mod#&5L J4 Oper.Voltage # Sig. line circ. Circ. Style
#of Zones_ Circuit style(s) _ #of Notification Circuits_ Circuit Styles)
Primary Power Source(circ,brkr. loc. & Locked? YAP Dedicated (7N
Secondary Power Source Type �Ite(W 111 u Amp hour ratingj2.6 Ad Battery-Date_/_3 i
PANEL RESPONSES TO TROUBLE CONDITIONS ` /
Zone Trouble: [
ormal ❑Abnormal(see notes) NAC Trouble: Normal ❑Abnormal (see notes)
AC power loss: Normal ❑Abnormal(see notes) Battery fault: N46rmal ❑Abnormal(see notes)
Ground fault: N;Kormal ❑Abnormal(see notes)
ANCILLARY DEVICES AND FUNCTIONS
Annunciator location(s) ! dQON be o R Operation: L�tormal ❑Abnormal (see notes)
Elevator Recall JAJ/A Operation: ❑Normal ❑Abnormal (see notes)
HVAC shutdown Operation: ❑Normal [Abnormal (see notes)
COMMUNICATION
City Tier Transmission Type: ❑Local ❑McCulloh ❑Multiplex ACT ❑Polarity reversal ❑RF
f tJ� Response to alarms: al ❑Abnormal (see notes)
Response to troubles: Normal ❑Abnormal (see notes)
Central. Sta.: Transmission Type: ❑Local ❑McCulloh ❑Multiplex MJA-CT []Polarity reversal ❑RF
Response to alarms: formal ❑Abnormal(see notes)
Response to troubles: i!�Ko-rmal ❑Abnormal(see notes)
Fire Dept.Name e y� F • Fire Dept. Phn.#
Central Station Name Central Station Phn.# 7
Notes
Technician's Signature �� Lic-# C-373
Customer Signature Date
J.
z
Commonwealth OfMassachusetts
City ofNorthampton Map: Block: Lot:
38A 048 001
In Accordance With The Massachusetts State Building Code, Section 110, This
CERTIFICATE OF INSPECTION
is issued to SERVICE NET INC
I Certify that I have Inspected the RI Group Residence known as Grove Street Inn
located at 91 GROVE ST, in the City of Northampton
The Means OfEgress Are Sufficient For The Following Number Of Persons:
BY STORY
Story Capacity Story Capacity
First Floor 5 Second Floor 15
BY PLACE OF ASSEMBLY OR STRUCTURE
Place of Assembly or Structure Capacity Location Place of Assembly or Structure Capacity Location
CI-2015-0087 04/06/2015 04/06/2016 (�*—
Certificate Number Date Certificate Issued Date Certificate Expires Building Of cial, Kyle J. Scott
**A COPY OF THIS CERTI FICA TF, MAST BE POSTE D IN CL1-,AR IIII.ff NEAR ALL ENTRANCES **
212 Main Street-Rm 100*NORTHAMPTON,MA*Phone:(413)587-1240*Fax:(413)587-1272