HomeMy WebLinkAboutDevice Inspection Report - Inspection - 120 MAIN STREET 5/26/2020 IMPACT FIRE SERVICES, L.L.0
26 HAMPSHIRE DRIVE
HUbSON NH 03451
IMPACT 0 .fifl3293.7531
F:603.589.2051
FIRE
ADDITIONAL SERVICE �WGETFIREPROTECTION.COM
1NFOIlNSPECTiQN COMMENTS MASTER ELECTRICIAN#:
DEVICE INSPECTION REPORT MA-20423A;NH-'I3117M
Page 3 of 3
WORK ORDER#: 18872871 DATE' 05/26/2020 07:00am EDT CUSTOMER 1D:
DEVICE MODEL LOCATION ZONE NOTES/COMMENTS: PASS FAIL
TYPE
Smoke 2nd Floor Elevator lobby 1 D039 Q
Smoke Elevator Machine Room 1 D035 z
0
Smoke Ground Floor Elevator Lobby 1 D036 �✓
Smoke 1st door Handicap Elevator Lobby 1 D038 Z El
Smoke 1st Floor Elevator Lobby 1 D037..... Q
El El
El El
El El
El El
El- El
El El
El El
El El
Ei El
El El
Ei El
El CI
0 El
El El
El El
El
Ei El
El El
El El
❑ BILLING ADDRESS CONFIRMED
CUSTOMER'S SIGNATURE-DATE TECHNICIAN'S SIGNATURE-DATE
CUSTOMER'S PRINTED NAME
IMPACT FIRE SERVICES,LL
26 HAMPSHIRE DRIVE
HUDS N NH 03051
IM ACT 3 .
: 03. 93.7 31
F:6 0 . 89. 91
FIRE %�".GETFIREPROTEGTION.COM
ELEVATOR INSPECTION MASTER ELECTRICIAN#:
Inspected to the state adopted version of N PA 72 MA, 04 3A;NH-13117 M
WORK ORDER 18872671 DATE0 128l 020 07:00am EDT
BILLTO: SHIP TO:
TOWN OF NORTH AND VER-DIVISION OF PUBLIC WORKS NORTH AND VER TOWN HALL
ATTN:STE1 E POSTED FACILITIES DIRECTOR,384 OSGOOD STREET 120 MAIN STREET
NORTH AND OVER MA 01845 NORTH AND OVER MA 01845
Phone: 978 8-9 10 Contact: STEPHEN FOSTER
Email: SFoster@northandoverma.gov Phone: 078 8 - 8 0
ELEVATOR INSPECTION
ARRIVAL TIME.7.00arn DEPARTURE"I 1 M E: : 0am
PASS FAIL
A. PANEL CONFIGURATION:Notifier
DETECTION CLASS: CLASS : CLASS B:
SIGNAL CIRCUIT CLASS. CLASS A. CLASS B. ❑ A.
PANEL LOCATION:Main Entrance
ELEVATOR OPERATION:
Elevator Recall Test
B. B.
COMPANY OF RECORD:Associate Elevator Co m pany
1A
C. SHUNT TRIP C. ❑ � ❑
D. LOCATION OF SHUNT:
E, LOCATION OF FEED TO SHUNT TEMP:
TYPE OF REMOTE MASTER BOX# RADIO PIASTER BOX#1
F. ITAL� I �I IUI I T R: ETHER: F.
COCIIIUNIATII ❑
G. CUFF LINE TIME. 7:30a'r'I REPORTS TO:North Andover FD G. El
ON LANE TIDE= 8,30amREPORTS T .
FIXED SMOKES
TEST FAIL TEST FAIL
CITY 0
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IMPACT FIRE SERVICES,LLC
26,HAMS RE DRIVE
HUDSON W03051
ib4PACT 0:603.293.7531
F:603.5W2051
WWW,.GETF�IREPRO'TECTION,.COM
F'IRSE
MASTER ELECTRICIAN
ELEVATOR INSPECTION MA-20423AI;N H 13117 M
Inspected to,the state adopte:d version of NFPA 72
WORK ORDER TbATE: ....... CUSTOMER, ID:
H. Explanatlion of Failed Devicesil.-I
None
1. The minsplector suggests 'that following necessary improvements. However,, these suggestions
IF
are, not the result of an engineering survey. These are recommendations based on current code,
None
j ions, made.
None
K. Inspection and suggested improverne I nts were discussed with the undersigned Owner or
Owner's Representative. Yes No
THIS IS NOT AN INVOICE=
tA=vll 2 0 BILLING ADDRESS CONFIRMED
5/26/2020
CUSTOMERS SIGNATURE - DATE TECHNICIAN'S SIGNATURE— DATE
CUSTOMER'S PRINTED NAME
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