HomeMy WebLinkAboutFire Alarm System Inspection - Inspection - 115 PHILLIPS BROOKS ROAD 12/31/2019 IMPACT FIRE SERVICES, LL
20 HA PSH I F E DRIVE
{ HUDS N NH 03051
r :.:... a 603.293. 31
IMPACT 4
,603.589.2051
FIRE V~.GETFIREPROTECTION.COM
FIDE ALARM SYSTEM INSPECTION MASTER ELECTRICIAN##:
Inspected to the state adopted version of N PA 72 MA- 23A; NH-13117 I
WORK ORDER# :17615189 DATE:12/2312 19 2:0 pr EST, 12/3 /20'1 CUSTOMER ID:
BILL T * SHIP To:
NORTH AND OVER PUBLIC SCHOOLS EARLY CHILDHOOD CENTER
ATTN:ACCOUNTS PAYABLE,566 MAIN STREET 113 PHI LLIPS BROOK FAD
NORTH TH AND OVER MA 01845 NORTH AND OVER iA 0184
Phone: 9 3 0 -9 16 Contact:GARY ROBERTS
Email: Phone: 9 8 99 - 6 3
ANNUAL. SEMIANNUAL QUARTERLY ❑ sE BITIV11-Y
ARRIVAL TITLE:8:45am DEPARTURE TIME:1 : pm
PASS FAIL
A. PANEL CON F I G U RATI N:Firelite Ms-9600 UdIs
DETECTION CLASS: CLASS A: w CLASS B: ❑
SIGNAL CIRCUIT CLASS: CLASS r El CLASS Bt X El 1-1
PANEL LOCATION:Middle left fire alarm closet
BATTERIES: VOLTAGE NO LOAD;
12v 12a 2013
Bt B.
0 ❑
QUANTITY: VOLTAGE LOAD:
2 100%
Cr ANNUNCIATOR R TYPE:N/A C. Li E]
REMOTE PANEL TYPE:Silent Kn1Qht Evac Panel(2) 12v 7ah Batteries 2 1 100% EJ
TYPE:Purer Supply By Facp 2 12v 7ah Batteries(2013) 100%
D. D
TYPE:Power Supply By Fan ( 12v 7ah Batteries 2013 100% '
TYPE: ❑ ❑
Ea PANELGROUND: TERM: TO: READ: E. ❑ ❑
TYPE F F E11 TE BASTE BOX#� RADIO MASTER BOX# 1362 F` COMMUNICATION DIGITAL COMMUNICATOR: OTHER:
Fa ❑
❑ ❑
G, OFF LINE TIME: :50arrr I2: 5 n REPORTS ITS TO:North Andover FD
�.
N LINE TIME: REPORTS TO:
....
SINGLE
PULL I F FIXED SMOKES DUST STATION C. .
DETECTORS SIDE DETECTORS
TEST FAIL TEST FAIL TEST FAIL TEST FAIL TEST FAIL TEST FAIL TEST FAIL
CITY 9 0. 3 0 74 3 100 31 0
Speaker
MINI Outside
�T MINI HORN Horn/Strobe Speak er/strobe Visual Only my Beason
TEST FAIL TEST FAIL TEST FAIL TEST FAIL TEST FAIL TEST FAIL TEST FAIL
TIC 50 0 30 0 1
Page 1 of
IMPACT FIRE SERVICES, LL
26 H MPSHIRE DRIVE
H DS N NH 03051
IM ACT 0 :603.293.7631
�++ pp I* : 603.589.2051
IR VVWW.GETFIREP TE TI N. O
FIRE ALARM SYSTEM INSPECTION MASTER ELECTRICIAN
Inspected to the state adopted version of NFPA 72 MA- o 3 ; NH- 13117 M
WORK ORDER 17615189 S ATE: 1212312019 9 -.0 Opm EST, 1 1311 91 STO M E R ID:
H. Explanation of FailedDevices:
Norge
1. The inspector suggests that following necessary improvements. However, these suggestions
are not the result of an engineering survey. These are recommendations based on current code.
Nome
J. Adjustments or corrections made:
Nome
K. Inspection and suggested improvements were discussed with the undersigned Owner or
Owner's Re resentatle. Fol Yes ❑ No
1 11 11 9 THIS IS NOT Al INVOICE
CUSTOMER'S&IGNATIME DATET PART# DESCRIPTION.IPTI PACE AMOUR'
IN TO I'S IRIN D Ni E
1 / 1119
TE AT DATE
MioAaer Rich, Ross Gadsby, Griffin G.
TECBNICIAN PRINTED AME LICENSE
F-1 13ILLING ADDRESS CONFIRMED
Page
r IMPACT FIRE SERVICES,LLC
26 HAM PSHIRE DRIVE
HUD50N NH 03051
IMPA C T O :603.293.7531
F:603.589.2051
ADDITIONAL SERVICE WWWGETFIREPROTECTION.COM
FIRE (NFL/INSPECTION COMMENTS MASTER ELECTRICIAN#:
DEVICE INSPECTION REPORT MA-20423A; NH- 13117 M
Page 3 of 7
WORK ORDER#: ,�7�,��,f$9 DATE: CUSTOMER ID:
12/2312019 02:0(}pm EST, 12/31f2019
DEVICE MODEL LOCATION ZONE NOTES/COMMENTS: PASS FAIL.
TYPE
Pull East Exit By Room 115 2M067 �✓
CQ Classroom 115 2M099 z El
CO Classroom 118 2M099 Q
Smoke Hallway Near Classroom 118 2DO68 Q ❑
Smoke Hallway By Classroom 121 2D069 �✓
CO Classroom 121 2M089 � ❑
CO Classroom 112 2M099 �✓ El
CO Classroom 124 2M099 Q ❑
CO Classroom 109 2M099 z El
Smoke Data Room 2D070 z '❑
Stroke Outside Electric Room 2D071 �✓
Smoke Inside Electric Room 2U072 ✓❑
Smoke Outside Classroom 132 2D074 Z El -
CO Classroom 135 2M098 Q ❑
Smoke Outside Sprinkler Room 2DQ73 ✓�
Smoke Inside Sprinkler Roam 2D075 Q ❑
CO Classroom 137 2M098 Q
Smoke Hallway By Classroom 146 2D076 Q ❑
CO Classroom 146 2M098 ✓�
Smoke Hallway bear 143 2D077 ✓Q
Pull East Exit By Room 143 2M078 ❑d
CO Classroom 140 2M098 ❑✓ El
CO Classroom 143 2M098 �✓
Smoke Director Once 2Dp82 QLi
Smoke Main Office 1 Q028 Q El
Pull Main Office 1 M029 �✓ El
❑ BILLING ADDRESS CONFIRMED
CUSTOMER'S SIGNATURE-DATE TECHNICIAN'S SIGNATURE-DATE
CUSTOMER'S PRINTED NAME
IMPACT FIRE SERVICES, LLC
_ 26 HAMPSHIRE DRIVE
HUDSON NH 03051
PACT O:603.293.7531
F:803.589.2051
ADDITIONAL SERVICE V" WGETFIREPROTEC710N.COM
FIRE INFO/INSPECTION COMMENTS MASTER ELECTRICIAN#:
DEVICE INSPECTION REPORT MA-2�423A; NH-'(3117 M
Page 4 of 7
WORK ORDER#: .�76'�5189 DATE' CUSTOMER ID:
12/23/2019 02:OOpm EST, 'f2/31/2019
DEVICE MODEL LOCATION ZONE NOTES/COMMENTS: PASS FAIL
TYPE
Smoke Hallway Outside Main Office 1b027 R] El
Heat ROFt Main Entrance 1 D026 ❑✓
Smoke Hallway Near Nursing Rm 1 D024 z El
......................
Smoke Outside Room 221 1 D023
Pull Main entrance 1 M025
Smoke Nursing Room 1 p021 ❑✓
Smoke Restroom By Room 221 1 D020 �✓
Smoke Room 229 1 C3022 d❑
CO Room 221 1 M008 Z El
Smoke Restroom By Rm 215 1 R018 RIEl
Smoke Hallway By Room 215 1 D030 Q
Smoke Room 215 1 D086 �✓
Smoke Room 215 1 b084 �✓ � -
CO Room 215 1 M085
Pull Room 215 Exit 1M087z El
Heat ROR Kitchen 1 D082 ❑d ❑
CO Kitchen 1 M088 Q
Heat ROF2 Receiving Rm 218B 1 n095 Q✓ ❑
Pull Receiving Rm 216B Exit 1M089 Q✓
: El
.................................
Smoke Kitchen Office 11]098 Q✓
Smoke Classroom 201 1 D009 Z El
....................
CO Classroom 201 1M005 ❑� Li
Stroke Classroom 201 Restroom 1 D010 ❑✓
Smoke Classroom 214 1D007 ❑✓ F-1
CO Classroom 214 1 M(}04 ❑✓ ❑
Smoke Classroom 214 Restroom 1 D008 ❑d
❑ BILLING ADDRESS CONFIRMED
CUSTOMER'S SIGNATURE-DATE TECHNICIAN'S SIGNATURE-DATE
CUSTOMER'S PRINTED NAME
IMPACT FIRE SERVICES,LLC
26 HAMPSH[RE DRIVE
�#UDSON NH 03051
€f- I M PACT O :603.293.753'1
F :603.589.2051
ADQITIONAL.SERVICE WWW.GETFIREPROTECTION.COM
FIRE INFO/INSPECTION COMMENTS MASTER ELECTRICIAN#:
DEVICE INSPECTION REPORT MA-20423A; NH- 13117 M
Page 5 of 7
WORK ORDER#: CUSTOMER ID:
17695'E89 DATE: 12/23/2019 02:00pm SST, 12/31/2019
DEVICE MODEL LOCATION ZONE NOTES/COMMENTS: PASS FAIL
TYPE
Smoke Hallway Outside Rm 213 1 D039 �✓ ❑
Smoke Room 213 1 D017 Q ❑
Smoke Room 202 1 D011 Q ❑
co Room 202 1 M006 Q ❑
Smoke Room 202 Restroom 1D012 �✓
Smoke Outside Roam 212 1 D031 ❑✓ ❑
Smoke Room 212 1 n016 �✓ El
Smoke Room 211 1 DO05 ✓� ❑
CO Room 219 1 M003 Q ❑
Smoke Room 211 Restroom 1 D006 RIEl
Smoke Room 210 1 D003 RI El
CO Room 210 1 M002 ❑✓ ❑
Smoke Room 210 Restroom 1 D004 Z El -
Smoke Outside Room 209 9 D033 �✓ ❑
Smoke Room 209 'f D015 Q✓ ❑
Smoke Roam 203 1 D013 ❑✓ El
CO Room 203 1 M007
Smoke Room 203 Restroom 1 D014 ❑✓ ❑
Smoke Electric Room By Room 203 1 D035 �✓ ❑
Smoke Outside IT Closet 'i D034 �✓ ❑
Smoke 17 Closet 1 D036 Q ❑
Smoke Restroom By Room 208 1D037 ❑� Li
Smoke Room 208 1 D00'E �✓ El
CO Room 208 1M001 z El
Smoke Room 208 Restroom 9 D002 R1 El
Smoke Restroom By Room 208 1 D032 Z El
❑ BILLING ADDRESS CONFIRMED
CUSTOMER'S SIGNATURE-DATA TECHNICIAN'S SIGNATURE-DATE
CUSTOMER'S PRINTED NAME
IMPACT FIRE SERVICES, LLC
26 HAMPSHIRE DRIVE
HUQSON NH 03051
IMPA C T O: 603.293.7531
F:603.589.2051
ADDITIONAI.SERVICE V" WGETFIREPR07EC710N.COM
FIRE INFO/INSPECTION COMMENTS MASTER ELECTRICIAN#:
DEVICE INSPECTION REPORT MA-20423A; NH-13117 M
Pages of 7
WORK ORDER#: 17615189 DATE: CUSTOMER ID:
12/23/2019 Q2:QOpm EST, 12/31/2019
DEVICE MODEL LOCATION ZONE NOTES/COMMENTS: PASS FAIL
TYPE
Pull Exit By Room 390 1M039 �✓
Smoke Room 310 1 D066 ❑✓ El
CO Room 310 1 M018 Q✓
Smoke Hall Near Room 310 1 D040 �✓
Smoke Room 301 1 b041 RI El
CO Roam 301 1 M009 Q El
Smoke Roam 301 Restroom 1 D042 ✓Q
Smoke Hallway By Roam 304 1 D046 Q✓ ❑
Smoke Room 344 1 D050 RI El
CO Room 304 1MQ12 Q
Smoke Room 304 Restroom 't C}051 ❑d El
Smoke Room 303 1 D048 E El
CO Room 303 1 M011 Q✓
Smoke Room 303 Restroom 1 D049 ❑�
Pull Exit By Room 302 1 M045 ❑✓
Smoke Hallway By Room 303 1 U047 z El
Smoke Room 302 1 D(}44 21 El
CO Room 302 1 M010 z
Smoke Room 302 Restroom 1 b043 Q✓
Smoke Room 305 1 D053 Q El
CO Room 305 1 M013 Q
: El
Smoke Room 305 Restroom 1D052 �✓
Smoke Room 306 1 U054 z El
CO Room 346 'f M014 ❑✓
Smoke Room 306 Restroom 1 D055 ❑✓
Smoke Hallway By Room 306 9 D060 Z El :
❑ BILLING ADDRESS CONFIRMED
CUSTOMER'S SIGNATURE- DATE TECHNICIAN'S SIGNATURE-DATE
CUSTOMER'S PRINTED NAME
• IMPACT FIRE SERVICES, LLC
26 HAMPSHIRE DRIVE
HUDSON NH 03051
�r I M PACT O :603.293.7531
F :603.589.2051
ADDITIONAL SERVICE VAWGETFIREPROTECTION.COM
FIRE INFO/INSPECTION COMMENTS MASTER ELECTRICIAN#:
DEVICE INSPECTION REPORT MA-20423A;NH-'f3117 M
Page 7 of 7
WORK ORDER#: .�7615189 DATE: 12/23/2019 02:Otlpm EST, 12/31/2019 CUSTOMER 1D:
DEVICE MODEL LOCATION ZONE NOTES/COMMENTS. PASS FAIL
TYPE
Smoke Room 309 1D065 Q✓
CO Room 309 1M017 ❑✓
Smoke Room 309 Restraam 1 D064 Z El
Smoke Hallway By Room 307 1b079 ❑✓
Smoke Room 307 1 D057 z El
co Room 307 1 M015 ✓�
Smoke Room 307 Restroom 90056 ✓❑ El
..........
Smoke Roam 308 'f D082 ❑✓
CO Room 308 1MQ16 Q
Smoke Room 308 Restroorn 1D063- ✓Q
Full Exit By Room 308 1 M058 z El
Smoke Halfway By Room 305 1 D061 v
Duct Hallway By Room 308 1 M12't Q✓ EJ
Duet Hallway By Room 308 1M120 Q
Duct Outside Room 301 1M122 Q
Duct outside Room 304 1M124 Q
Duct Hallway By Room 303 1 M123 ❑✓ ❑
Duct Hallway By Electric Room 1 M125 ✓�
Duct Hallway By Room 211 1 M128 ❑✓
Duct Outside Room 212 1M127 �✓
Duct Outside Room 213 1M128 �✓
Duct Outside Room 221 1M130 Q✓
Smoke Roof Access Rm 1 D018 ❑ El
El El
El El
El El
F-I BILLING ADDRESS CONFIRMED
CUSTOMER'S SIGNATURE-DATA TECHNICIAN'S SIGNATURE-DATE
CUSTOMER'S PRINTED NAME