periodic 2022 .%,oc" The Commonwealth of Massachusetts
'r i .. City of Northampton
w
'46._ R JES Qn
New and Renewal Certificate of Inspection s"`' xo`�
In accordance to 780 CMR Chapter 1 (The Ninth Edition of the Building Code) and Chapter 110 and the Acts of 2004,to further
enhance fire and life safety, this certificate of inspection is issued to the premise or structure or part there as herein identified.
Issued to Identify Name of Establishment: Certificate No.
D'ANGELO 0038
Located at Identify property address including street number, name city or town and county Certificate Expiration
388 KING ST, Northampton 09/30/2022
18D-039-001
Use Group Classifications Allowable Occupant Load
A-2 50
This certificate of inspection is hereby issued by the undersigned to certify that the premise,structure or portion thereof as herein specified has been inspected for
general fire and life safety features.This certificate shall be framed behind clear glass and/or laminated and posted in a conspicuous place within the space as directed
by the undersigned. Failure to post or tampering with the contents of the certificate is strictly prohibited.
Name of Municipal Name of Municipal
Fire Chief CHIEF JON DAVINE Building Inspector JONATHAN S. FLAGG Date of Inspection 09/30/2022
Signature of Signature of Municipal
Municipal Fire Chief Building Inspector Date of Issuance 09/30/2022
City of Northampton
Massachusetts mow? - r
r
y r.
DEPARTMENT OF BUILDING INSPECTIONS A,(
U
1,,,,,E a- 212 Main Street • Municipal Building ; ^f, ����
Northampton, MA 01060 / t'N 4.
PERIODIC INSPECTIONS /
Q C /1 7
44
^.n OcQ <2
APPLICATION FOR REQUIRED INSPECTIO, tiq;'n0�/,G
61
G Y V 39 O .414 O asp ONS
PREMISE AME: D'ANGELOS
PREMISE ADDRESS: OWNER(S) OF RECORD: /,'E �,,,t'LO/AN- Ay/Wife ER'c /c.-C-'
OWNERS: Ki„06- STieLecT
ADDRESS: T:
TELEPHON! NO: q13 - c?4,- q 9 7(u
NAME ON ERTIFICATE: pejo C:vG-441Alb fitiNcitriie. EA`h' %C, Digr4 -2)IA,JgtJ O
TYPE OF B SINESS
USE GROW:
INSPECTION FEE $100 C /L# q 7RCl0
Please corn.fete and return this application to the Department of Building Inspections, 212 Main Street,
Northam•t o n MA 01060. We will contact you to arrange a time to inspect your property. If this information is
not correct, •r if you no longer own this property, please note any changes at the bottom or on the back of this
form and rei rn 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 n.me: ' � '� w -
Applicant Ti le: Lia/C6P---)
11 iLl e4hg--,
Telephone (7 ?1 ( /YI )1 1/ f
Preferred inspection time/date
Comments:
J
SYSTEM RECORD OF INSPECTION AND TESTING
Inspection/Test Start Date/Time:9/14/22 9:38 AM Inspection/Test Completion Date/Time:9/14/22 10:45 AM_______
Supplemental Form(s)Attached:Q Yes ❑No
1. PROPERTY INFORMATION
Name of property:D'Angelo Sxrilled_Sandwiches..._.___
Address:388 King St..Northampton.MA 01060
Description of property:Restaurant
Name of property representative:Jim Porier
Address:
?hone: Fax: __ E-mail:ticensseueaaainos.com
2. TESTING AND MONITORING INFORMATION
Testing organization:TargetAlartn SSystems.Inc.
Address:795 Homestead Ave..Holyoke.MA 01040
Phone:413-533-0050 Fax:413-532-0752 E-mail:tarPotr l.c ____
Monitoring organization:Critcom Monitoring Services
Address:PO Box 521769.Longwood,FL 32750
Thone:800-631-2299 Fax: E-mail:------...__................_.__..
Account number:_ELDM-14062 Phone line 1:N/A Phone line 2:N/A
Means of transmission:Sole Path LTE Radio
Entity to which alarms are retransmitted:Northampton Fire Dept. ___ Phone:413-5I7__1_100
3. DOCUMENTATION
Onsite location of the required record documents and site-specific software:
office
4. DESCRIPTION OF SYSTEM OR SERVICE
4.1 Control Unit
Manufacturer:DMP Model number:XR200
4.2 Software Firmware
Firmware revision number:112
4.3 System Power
4.3.1 Primary(Main)Power Utility Rm.
Nominal voltage:120AC Amps:20 Location: __
Dvercurrent protection type:Breaker Amps:20 Disconnecting means location:
Utility room
NFPA 72(p.1 of 4)
El5 2016 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.No other reproduction or transmission in any form permitted without written permission of NFPA.For inquiries or to report unauthorized
use,contact licensing@nfpa.org.
SYSTEM RECORD OF INSPECTION AND TESTING (continued)
4. DESCRIPTION OF SYSTEM OR SERVICE (continued)
4.3.2 Secondary Power FACP and FOPS
Type:Battery Location:
Battery type(if applicable):Sealed Lead Add
Calculated capacity of batteries to drive the system:
In standby mode(hours):24 In alarm mode(minutes):60
5. NOTIFICATIONS MADE PRIOR TO TESTING
Monitoring organization Contact:Via ADO Time:9:38 AM
Building management Contact:On Site Time:9:15 AM
Building occupants Contact:On Site --__ Time:9:15 AM,.
Authority having jurisdiction Contact:NHFD Time:9:15 AM
Other,if required Contact: Time:
6. TESTING RESULTS
6.1 Control Unit and Related Equipment
Visual Functional
Description Inspection Test Comments
Control unit 0 LEI
Lamps/LEDs/LCDs O ❑ _
Fuses ❑ ❑ N/A Uses thermal Breaker
Trouble signals O 0
Disconnect switches O ❑
Ground-fault monitoring Il El
Supervision 0 Il
Local annunciator 0 CI
Remote annunciators ❑ ❑ None
Remote power panels ❑ ❑ None
❑ ❑
6.2 Secondary Power
Visual Functional
Description Inspection Test Comments
Battery condition 0 0 None
Load voltage ❑ ❑
Discharge test ❑ 0
Charger test 0 0
Remote panel batteries ❑ 0
NFPA 72(p.2 of 4)
0 2016 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.No other reproduction or transmission in any form permitted without written permission of NFPA.For inquiries or to report unauthorized
1:01
use,contact Iicensing@nfpa.org.
SYSTEM RECORD OF INSPECTION AND TESTING (continued)
6. TESTING RESULTS (continued)
6.3 Alarm and Supervisory Alarm Initiating Device
Attach supplementary device test sheets for all initiating devices.
6.4 Notification Appliances
Attach supplementary appliance test sheets for all notification appliances.
6.5 Interface Equipment
Attach supplementary interface component test sheets for all interface components.
Circuit Interface l Signaling Line Circuit Interface /Fire Alarm Control Interface
6.6 Supervising Station Monitoring
Description Yes No Time Comments
Alarm signal 0 ❑ Attached Activity Report
Alarm restoration El 0
Trouble signal 0 ❑
Trouble restoration ❑ ❑
Supervisory signal 0 ❑
Supervisory restoration II 0
6.7 Public Emergency Alarm Reporting System
Description Yes No Time Comments
Alarm signal ❑ 0 None
Alarm restoration 0 ❑
Trouble signal ❑ ❑
Trouble restoration ❑ ❑
Supervisory signal ❑ ❑
Supervisory restoration ❑ ❑
NFPA 72(p.3 of 4)
colCO 2016 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.No other reproduction or transmission in any form permitted without written permission of NFPA.For inquiries or to report unauthorized
use,contact licensing@nfpa.org.
SYSTEM RECORD OF INSPECTION AND TESTING (continued)
7. NOTIFICATIONS THAT TESTING IS COMPLETE
Monitoring organization Contact:1/ja App Time:10:45 AM
Building management Contact:On Site Time:10:45 AM
Building occupants Contact:On Site Time:10:45 AM
Authority having jurisdiction Contact:NHFD _ Time:10:30 AM
Other,if required Contact: Time:
8. SYSTEM RESTORED TO NORMAL OPERATION
Date: 09/14/2022 Time:10:45 AM
9. CERTIFICATION
This system pecified herein hash inspected and tested according to NFPA 72,2013 edition,Chapter 14.
Signed71-1. 4 Printed name:Brian W.O'Connot Date:09/14/2022
Organization:Target Alarm Systems,Inc. Title: President_ _ Phone:513-530-1792
Qualifications(refer to 10.5.3):MA License C 1352
10. DEFECTS OR MALFUNCTIONS NOT CORRECTED AT CONCLUSION OF SYSTEM INSPECTION,
TESTING,OR MAINTENANCE
None
i 10.1 Acceptance by Owner or Owner's Representative:
The unders' ed acc Id the
test report for the system as specified herein:
Signed: /' V l/t/"`�` Printed name: �m M'� Date: IP I)7' —
n, ' r
Organization: D!u Cr VA Title: l J C! LV-/ 'l.0a3?!(A1 Wt/ ov-4/417-)4q7
I-)4
NFPA 72(p.4 of 4)
El ®2016 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 distnbution.No other reproduction or transmission in any form permitted without written permission of NFPA.For inquiries or to report unauthorized
use,contact licensing@nfpa.org.
INITIATING DEVICE
SUPPLEMENTARY RECORD OF INSPECTION AND TESTING
Inspection/Test Start Date/Time:9/14/22 9:38 AM Inspection/Test Completion Date/Time:9/14/22 10:45 AM
Number of Supplemental Pages Attached:
1. PROPERTY INFORMATION
Name of property:D'Angelo Grilled Sandwiches
Address:388 King St.,Northampton,MA 01060
2. INITIATING DEVICE TEST RESULTS
Device Type Address Location Test Results
Pull Station 1 North Exit OK
Pull Station 2 East Exit OK
Pull Station 3 Rear Kitchen Exit OK
Heat Detector 4 Rear Kitchen OK
Heat Detector 5 Grill Area OK
Smoke Detector 500 Utility Room OK
Smoke Detector 501 North Dining Room OK
Smoke Detector 502 East Dining Room OK
NFPA 72(p.1 of 2)
El ®2016 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.No other reproduction or transmission in any form permitted without written permission of NFPA.For inquiries or to report unauthorized
use,contact licensing@nfpa.org.
NOTIFICATION APPLIANCE
SUPPLEMENTARY RECORD OF INSPECTION AND TESTING
Inspection/Test Start Date/Time:S/14/22 9:38 AM_ Inspection/Test Completion Date/Time:9/14/22 10:45 AM
Number of Supplemental Pages Attached:
1. PROPERTY INFORMATION
Name of property:D'Angelo Grilled Sandwiches ___
Address:388 King St..Northampton.MA 01080
2. NOTIFICATION APPLIANCE TEST RESULTS
Appliance Type Location/Identifier Test Results
Hom Strobe North Dining Room OK
Horn Strobe South Dining Room OK
Strobe Men's Room OK
Strobe Ladies Room OK
Red Beacon East Exterior OK
----
Horn Strobe Kitchen OK
NFPA 72(p.1 of 2)
El
®2016 National Fire Protection Association.This form may be copied for individual use other than for resale.It may not be copied for commercial sate
or distribution.No other reproduction or transmission in any form permitted without written permission of NFPA.For inquiries or to report unauthorized
use,contact licensing@ nfpa.org.
Location Name: DANGELO GRILLED SANDWICHES
Location Address: 388 KING ST
Event CS# Zone Event Zone Comment User# User Name Incident# Area tch Raw Operator
Date/Time Descripti ignal
on
09/14/2022 FLDM14062 3923 - Cat: GEN LATES-
10:45:00 Expired xtst
AM Test
09/14/2022 FLDM14062 000 OPE004 - *Test -Area 0 0 User# 0 0 1*,DMP-
10:27:20 Open Area_Desc S3,g0P,Ta
AM by sk:3340
Usr#: 0
Name:
USER ON
PREMISES,
Cellular
modem
seqno:
042
09/14/2022 FLDM14062 R RES499 - *Test zone: 2, 1,DMP-
10:25:43 Restore Zn_Type: S3,r, (2) ,
AM (LOG) Fire Task:3340
Zn_Desc:
FIRE
Cellular
modem
seqno:
041
09/14/2022 FLDM14062 100 OPE004 - *Test -Area 1 0 User# 0 1 1*,DMP-
10:25:09 Open Area_Desc S3,gOP,Ta
AM by sk:1340
Usr#: 0
Name:
GROUP,
Cellular
modem
seqno:
040
09/14/2022 FLDM14062 S121 TRO999 - CELL DATA 2,DMP,S12
10:24:11 Trbl (C) OVERAGE 1,Task:33
AM LOG *Test 40
09/14/2022 FLDM14062 02 FIR664 - *Test zone: 2, 1,DMP-
10:24:01 Fire (C) MAIN E/E Zn_Desc: S3,aFI, (2
AM FD-PR-CL PULL STA FIRE ) ,Task:33
Cellular 40
modem
seqno:
038
Location Name: DANGELO GRILLED SANDWICHES
Location Address: 388 KING ST
097Y4/2822 FLDII]4062—7 RES499 - *Test zone: 9, —1,DMP-
10:20:45 Restore Zn_Type: S3,r, (9) ,
AM (LOG) Superviso Task:1340
ry
Zn_Desc:
PROTECTIO
N LOOP
Cellular
modem
segno:
037
09/14/2022 FLDM14062 R RES499 - *Test zone: 1, 1,DMP-
10:20:10 Restore Zn_Type: S3,r, (1) ,
AM (LOG) Fire Task:3340
Zn_Desc:
FIRE
Cellular
modem
segno:
036
09/14/2022 FLDM14062 01 FIR664 - *Test N. zone: 1, 1,DMP-
10:19:36 Fire (C) DOOR PULL Zn_Desc: S3,aFI, (1
AM FD-PR-CL STATION FIRE ) ,Task:13
Cellular 40
modem
segno:
035
09/14/2022 FLDM14062 R RES499 - *Test zone: 3, 1,DMP-
10:13:05 Restore Zn_Type: S3,r, (3) ,
AM (LOG) Fire Task:1340
Zn_Desc:
FIRE
Cellular
modem
seqno:
034
09/14/2022 FLDM14062 09 SUP013 - *Test zone: 9, 1,DMP-
10:12:04 Supry STROBE Zn_Desc: S3,aSV, (9
AM (PR-CL) TROUBLE 0 PROTECTIO ) ,Task:13
Sec N LOOP 40
Cellular
modem
seqno:
033
Location Name: DANGELO GRILLED SANDWICHES
Location Address: 388 KING ST
09/14/2022 FLDM14062 H — RES499 - *Test zone: 97 1,DMP-
10:12:00 Restore Zn_Type: S3,r, (9) ,
AM (LOG) Superviso Task:3340
ry
Zn_Desc:
PROTECTIO
N LOOP
Cellular
modem
segno:
032
09/14/2022 FLDM14062 03 FIR664 - *Test zone: 3, 1,DMP-
10:11:27 Fire (C) REAR KIT Zn_Desc: S3,aFI, (3
AM FD-PR-CL DR PULL FIRE ) ,Task:33
STA Cellular 40
modem
segno:
031
09/14/2022 FLDM14062 R500 RES499 - *Test zone: 1*,DMP-
10:07:33 Restore 500, S3,r, (500
AM (LOG) Zn_Type: ) ,Task:33
Fire 40
Zn_Desc:
FIRE
Cellular
modem
seqno:
030
09/14/2022 FLDM14062 09 SUP013 - *Test zone: 9, 1,DMP-
10:07:31 Supry STROBE Zn_Desc: S3,aSV, (9
AM (PR-CL) TROUBLE 0 PROTECTIO ) ,Task:33
Sec N LOOP 40
Cellular
modem
seqno:
029
09/14/2022 FLDM14062 R RES499 - *Test zone: 9, 1,DMP-
10:05:00 Restore Zn_Type: S3,r, (9) ,
AM (LOG) Superviso Task:1340
ry
Zn_Desc:
PROTECTIO
N LOOP
Cellular
modem
seqno:
028
Location Name: DANGELO GRILLED SANDWICHES
Location Address: 388 KING ST
@9 34�2O22 -FLDM1t062— 0 -- FIRsb4_ *Test Zn_Desc: 1,DMP-
10:04:27 Fire (C) UTILITY FIRE S3,aFI,Ta
AM FD-PR-CL RM SMK Cellular sk:1340
DET modem
seqno:
027
09/14/2022 FLDM14062 S07 20 - *Test Sent via PATH1 1,DMP,S07
10:00:06 Timer CELL , (@L) ,Tas
AM Test Path: 01 k:3340
(Primary)
09/14/2022 FLDM14062 09 SUP013 - *Test zone: 9, 1,DMP-
09:57:25 Supry STROBE Zn_Desc: S3,aSV, (9
AM (PR-CL) TROUBLE 0 PROTECTIO ) ,Task:33
Sec N LOOP 40
Cellular
modem
seqno:
025
09/14/2022 FLDM14062 R502 RES499 - *Test zone: 1*,DMP-
09:57:23 Restore 502, S3,r, (502
AM (LOG) Zn_Type: ) ,Task:33
Fire 40
Zn_Desc:
FIRE
Cellular
modem
seqno:
024
09/14/2022 FLDM14062 R501 RES499 - *Test zone: 1*,DMP-
09:57:19 Restore 501, S3,r, (501
AM (LOG) Zn_Type:
) ,Task:33
Fire 40
Zn_Desc:
FIRE
Cellular
modem
seqno:
023
09/14/2022 FLDM14062 R500 RES499 - *Test zone: 1*,DMP-
09:57:15 Restore 500, S3,r, (500
AM (LOG) Zn_Type: ) ,Task:13
Fire 40
Zn_Desc:
FIRE
Cellular
modem
seqno:
022
Location Name: DANGELO GRILLED SANDWICHES
Location Address: 388 KING ST
$9-t14/202 2 FLDM14062 09 SUF0-13 - *Test zone: 9, 1,DMP-
09:57:13 Supry STROBE Zn_Desc: S3,aSV, (9
AM (PR-CL) TROUBLE 0 PROTECTIO ) ,Task:33
Sec N LOOP 40
Cellular
modem
seqno:
021
09/14/2022 FLDM14062 502 FIR664 - *Test E Zn_Desc: 1,DMP-
09:56:40 Fire (C) DINING FIRE S3,aFI,Ta
AM FD-PR-CL SMOKE DET Cellular sk:3340
modem
seqno:
020
09/14/2022 FLDM14062 501 FIR664 - *Test N Zn_Desc: 1,DMP-
09:55:34 Fire (C) DINING FIRE S3,aFI,Ta
AM FD-PR-CL SMOKE DET Cellular sk:1340
modem
seqno:
019
09/14/2022 FLDM14062 R RES499 - *Test zone: 9, 1,DMP-
09:55:30 Restore Zn_Type: S3,r, (9) ,
AM (LOG) Superviso Task:1340
ry
Zn_Desc:
PROTECTIO
N LOOP
Cellular
modem
seqno:
018
09/14/2022 FLDM14062 500 FIR664 - *Test Zn_Desc: 1,DMP-
09:54:54 Fire (C) UTILITY FIRE S3,aFI,Ta
AM FD-PR-CL RM SMK Cellular sk:1340
DET modem
seqno:
017
09/14/2022 FLDM14062 09 SUP013 - *Test zone: 9, 1,DMP-
09:54:52 Supry STROBE Zn_Desc: S3,aSV, (9
AM (PR-CL) TROUBLE 0 PROTECTIO ) ,Task:33
Sec N LOOP 40
Cellular
modem
seqno:
016
Location Name: DANGELO GRILLED SANDWICHES
Location Address: 388 KING ST
09/14/2022 FLDM14062 R RES499 *'Kest zone:,- 1,DMP-
09:53:22 Restore Zn_Type: S3,r, (9) ,
AM (LOG) Superviso Task:1340
ry
Zn_Desc:
FIRE
SUPERVISO
RY
Cellular
modem
segno:
015
09/14/2022 FLDM14062 09 SUP013 - *Test zone: 9, 1,DMP-
09:45:21 Supry STROBE Zn_Desc: S3,aSV, (9
AM (PR-CL) TROUBLE 0 FIRE ) ,Task:33
Sec SUPERVISO 40
RY
Cellular
modem
segno:
014
09/14/2022 FLDM14062 ONTEST - *Test Cat: GEN BRIAN DKSJ
09:38:47 Placed On Expires: OCONNOR
AM Test 09/14/202
2
10:45:00
All Zones
09/14/2022 FLDM14062 1999 - TARGET BRIAN DKSJ
09:38:27 Contact ALARM OCONNOR
AM P/C SYSTEMS
Verified
09/14/2022 FLDM14062 S07 20 - 1,DMP,S07
06:23:30 Timer ,Task:334
AM Test 0
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` AA Alarm System Monitoring Certificate
. ..%. Issue Date: October 3,2022 -- =
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Certificate Number: 20221003-900387975 _- `�_��
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' ~- In Service Date: 6/18/2021 10:53:00 AM
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f- � Alarm Owner Information Installation Company Information r
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- 388 KING ST 795 HOMESTEAD AVENUE max`
jY;M GIVE ADDRESS/CITY
':' ' = NORTHAMPTON, MA 01060 HOLYOKE, MA 01040 •
4 (413)584-9776 (413)533-0050 `"'
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S";�" To Whom it May Concern: u
' „ ,,= As of the "In Service Date" listed above the Central Station is monitoring the following ''.
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x)' „;• :. conditions at the premises described under "Alarm Owner Information" on this certificate:
at'+••y:•`t— Burglary X Panic/Hold Up Temperature Carbon Monoxide x'
.`� " `.
:(►;,;;•• • X Fire Medical/Emergency Water Detection Other: .*,
Lam_ ~'
,•A'- The alarm monitoring service provided may entitle you to a discount on your home owner's "^'a�M . ,;
" -" -• insurance. Send this certificate to your insurance company for the appropriate premium '^_~I-
tM•<'!.t '. ; discount. •':+;
N$ . .
.
�;"7"; Security Monitoring Services, Inc.d/b/a Criticom Monitoring Services has been inspected and listed with
xT»r.".0, - .. 4•{ ,�.r►z.
itl�:ti T ... Underwriters Laboratories, Inc.as a UL listed Central Station. Our Underwriter's Laboratories identification ..;,..
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{•` Security Monitoring Services, Inc.d/b/a Criticom Monitoring Services License Numbers: "'{' `.
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