17C-253 (9) Cellar Carbon monoxide detector 1038 T-0 K
Comments:
1)CO2 Detector at base of cellar stairs is continually beeping—This device is not part of fire alarm system,but should be
replaced
If you would like the deficiencies above repaired on a time and material basis please initial next to the repairs you would like
corrected,then print,sign,and date below. Request for repairs can be faxed or emailed to our office
RE, Clinical Support Options
Customer Printed Name: Authorized Signature: Date:
Page 3 of 3
Are the smoke detectors sensitivity test results within the devices marked range or 4%obscuration light gray smoke? N
Are all alarm notification appliances free of damage and operate per manufacture specifications? Y
Have all magnetic door holders been tested, and found to be operating satisfactory? NA
System annunciators are identified and operating correctly? Y
SYSTEM SUPElZV15lC?N, NI3 MONlTt ARING:
Qid the supervision station receive the correct initiating device within 90 seconds? Y
Did the fire department receive a signal from the communicator or city box? Y
Location Device Type Device#f Results
Tamper water flow Module Supervisory 8701 1001 OK
First floor front entry Module Supervisory 870 1002 OK
First floor front stairwell Smoke detector 8710 1003 OK
First floor left office Smoke detector 8710 1004 OK
First floor left Pull station 8700D 1005 OK
First floor living room Smoke detector 8710 1006 OK
First floor Carbon monoxide detector Aug-13 1007 OK
First floor center hall Smoke detector 8710 1008 OK
First floor left bedroom Smoke detector 8710 1009 OK
First floor center stairwell Smoke detector 8710 1010 OK
First floor kitchen hall Smoke detector 8710 1011 OK
Kitchen exit Pull station 8700D 1012 OK
First floor waiting area Smoke detector 8710 1013 OK
Waiting area Pull station 8700D 1014 OK
First floor rear office Smoke detector 8710 1015 OK
First floor rear office left Smoke detector 8710 1016 OK
Rear exit Pull station 8700D 1017 OK
Second floor front Smoke detector 8710 1018 OK
Second floor front Carbon monoxide detector Aug-13 1019 OK
Second floor conference room Smoke detector 8710 1020 OK
Second floor left Pull station 8700D 1021 OK
Second floor right front bedroom Smoke detector 8710 1022 OK
Second floor front hall Heat detector-Combo 8713 1023 OK
Second floor center hall Carbon monoxide detector Oct-13 1024 OK
Second floor right side bedroom Heat detector-Combo 8713 1025 OK
Second floor center Carbon monoxide detector Aug-13 1026 OK
Second floor center stairwell Heat detector-Combo 8713 1027 OK
Second floor center stairwell Pull station 8700D 1028 OK
Second floor left bedroom Heat detector-Combo 8713 1029 OK
2nd floor rear stairs Pull station 8701 1030 OK
Second floor left office Heat detector-Combo 8713 1031 OK
Second floor rear office Smoke detector 8710 1032 OK
Second floor office Smoke detector 8710 1033 OK
Second floor rear exit-Office right Pull station 8701 1034 OK
Second floor rear office Smoke detector 8710 1035 OK
Bottom of cellar stairs Smoke detector 8710 1036 OK
Above FACP Smoke detector 8710 1037 OK
Attic Stairs Smoke detector 8710 1039 OK
Page 2 of 3
j MA#1452
845 Airport Industrial Park Road
Westfield, MA 01085
Phone 413-568-3547
Fire Alarm inspection &Test Report
Customer: Clinical Support Options
Address: 29 North Main Street, Florence, MA
Date of Inspection: 11812015
Inspector Bob Pevlin&Sean Schnopp Nicet# 198375
Customer Contact: Lisa or Paul
Location Phone Number: 413-586-2973/Office#586-5382
System Normal Upon Departure: YES "Signature on file"
Panel Location: basement
Panel Model: Faraday MPC 6000
System Type: Addressable
Fire Department: Northampton Fire Department
Monitoring Company: Account# : 1551019-Affiliated Central
SLC: 1 Loop 252 Points
SLC Type: Class B
Heat Detector Type
Pull Station Type/Style 8700D
Smoke Detector Type/Style: 8710&8713
Main Powers 120v 15amp
Disconnect Location: Basement Panel I CKT# 23
Auxiliary Power: (2) 12 volt 18amp hr 1/2015
Battery Voltage: 27.7V
Battery Drain Voltage Before: 27.1V
Battery train Test Voltage After: 125.7V
Procedure Used to Perform Voltage Drain Test? lin Accordance with NFPA 72 Chapter 14 Section 9
Remote Annunciator: JRDCI Located in Main Hall
YIN NA
Y=Satisfactory N=Unsatisfactory N/A=Not Applicable
FIRE ALARM CONTROL PANEL:
Are all the alarm zones labeled at the control panel? y
Do all control panel lamps and LEDs illuminate? y
Are control panel terminations secure? y
Does an open wiring on initiating or indicating circuits cause panel to go into trouble? Y
Does the earth ground detection work properly? y
Is the location of breaker feeding the alarm panel been identified? y
Does the control panel go into trouble with loss of AC feed,or loss of battery power? Y
SYSTEM BATTERIES:
Are system batteries free of leaks or corrosion? y
Are battery charging systems operating correctly and in the state of charge? Y
Are system batteries within manufactures replacement dates and/or proper current or voltage recommendations? Y
SYSTEM?COMPONETS: . '
Have. smoke detectors been checked for sensitivity at the proper intervals? N
Page 1 of 3
Mal [ichvPlumbing& Heating Inc.
14 Conway Street/PO BOX 94
South Deerfield, MA8lB7S
413-773-0734
March 2@i2O15
[SO-Administrative Ofhcey
8Atvvood Drive
Suite 301
Attention: Paul Arsenault
Northampton, K8Al06O
Work Location:29 North Main Street, Florence, MA
Boi|er#1'HB Smith BmilerS/VV-6
Relief Valve---------------Ok
Low Water Cutoff-----CJk
Change Site Glass-------[]k
install chemical to condition water in boiler(EZ Steam Conditioner)----------Ok
Boiler#2-Crain Sunny Day 7'1Q2Gas
Install 911SFedderBachflmvvPreventer
Install 30 pound 37A Pressure Relief Valve
Install 2 Taco#6H| Vents
Check Cemented Chimney around flu to prevent carbon monoxide
Check 3 Bradford White SD Gallon Natural Gas Water Heaters
Vent, Relief and Temp------------[)k
KUa| C}chy '
"PROVIDING EXCELLENT SERVICE FOR OVER 65 YEARS"
MASSACHUSETTS FIRE TECHNOLOGIES, INC.
57 YORK.STREET, WEST SPRINGFIELD, MA 01089
P.O. BOX 8, WEST SPRINGFIELD, MA 01090
(+++ F (413)731-8000* FAX(413) 746-9570
www.massfire.com
*EXTINGUISHER SERVICE *24 HOUR SERVICE •HALON ALTERNATIVE SYSTEMS
*ANSUL SYSTEM *FREE SURVEYS *TRAINING CLASSES
Clinical & Support Options April 21, 2015
29 North Main Street
Florence, MA
Aft: Paul Arsenault
parsenault @csoinc.org
Paul ;
Thank you for choosing Massachus6ffs Fire Technologies to take care of your extinguishers
for the above address. The fire extinguishers have been"inspected per NFPA 10 codes and are on
an annual schedule for March of each,yeel
At the present time your thirteen extinguishers are in compliance and were last inspected
during the month of March 2015.
Please do not hesitate to call'.If u,have any questions or concerns.
Sinceely
Susan Trystas
Susan Przystas
General Manager
SBPfcmm
l
FIRE CERTIFICATE OF INSPECTION
Name of Facility
Address of Facili
Was inspected on 7-/ CL-j(<�:
Date Name of Inspector
I HEREBY CERTIFY THAT THIS FACILITY COMPLIES ALL STATE FIRE
CODES AND LOCAL ORDINANCES.
YES NO
If answer is "NO", indicate violations and recommendations.
Violations:
Recommendations:
ISSUED 6Y:
e
Signature: Head of Fire Department
Or his designee
r