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Occupancy: Cape Cod Insulation
l8 Reardon Circle
South Yarmouth , MA 02664
Site Contact:
Telephone (508)694-6748
Alarm System is a (X) Fire System
Alarm System Reports to
ALARM INSPECTION REPORT
( ) Security System
(X) Cape Cod Alarm Co., Inc.( ) Other: Local
By: Rick Kilpatrick
Signature:
The Alarm System at the above location was tested.
Comments:
Date Tested: 09/02114
MA Contractors License # 1592C
*lnsrnllinq, Srnvicinq nnd Monironinq o[ Srcuniry, Finr, nrrrd CCTV Sysrrrus*
(ro&l798,6116 " (8OO) 468-8100
Fnx: Officr (508l, 198.1666 * Fnx: Crnrnql Srnrion (108]760,2012
MA Licrnsr No. lI92C
Inspection and Testing Report
Property: Cape Cod Insulation
Transmission Type:
( ) Mcculloh
( ) Multiptex
(X) Digital
( ) Reverse Polarity
RF()
()
Inspection Schedule( ) Weekly
( ) Monthly
( ) Quarterly( ) Semi-Annually
(X) Other: Anruallv
Model Number: SK 5208
Circuit Styles: Class B
Software Rev.:
Master Box
Panel Manufacture: Silent Knight
Location: Entry hall ofoffice area
Number of Circuits: 5
Last date system had any service performed: 09/02/14
Last date that any software or configuration was revised:
Alarm Initiating Devices and Circuit Information
Circuil Style
Class B
Class B
Manual Stations
Ion Detectors
Photo Detectors
Duct Detectors
Heat Detectors
Water flow Switches
Supervisory Switches
Annunciator
Carbon Monoxide Detectors
Local Smoke Detectors
Comments
_Class B
Class B
Transient Suppressors
Remote Annunciators
Notifi cation Appliances
Audible
Visual
Speakers
Voice Clarity
P
(
(
(
(x
(x
(
(
ASS
)
)
)
)
)
)
)
Fail
()
()
()
()
()
()
()
Qty of
_4_
2
-L_L_
Loc. & SAI
Phone Set
Phone Jacks
Off Hook Indicator
Amptifier
Tone Generator
Catl In Signal
System Performance
Specify
Specifr
Specify
Specify
Specify
Inspection and Testing Report
Property: Cape Cod Insulation
Initiating and Supervisory Device Tested and Inspections
Device Visual Functional Factory Meas. PassType Check Check Setting Setting
Emergency Communications Equipment
Visual Functional Comments
Interface Equipmentual Functional Simulated Operation
Spccial Hallard Systems
2
Secondary (Stand-by) Battery
Storage Battery: Amp-Hr Rating _8_ Calculated
Type of Battery( ) dry cell( ) nickel cadium
(X) sealed lead acid( ) lead acid
Irail
()
()
()
()
()
()
()
()
()
()
()
()
()
()
()
()
()
()
()
)
)
)
)
)
)
)
(
(
(
(
(
(
(
()
()
()
()
()
Vis
()
()
()
()
()
()
()
()
()
()
Calculated capacity to operate system in hours:_ 24 60
Engine -driven Generator Dedicated to Fire Alarm System:
Location of Fuel Storage:
( ) other
Inspection and Testing Report
Property: Cape Cod Insulation
Emergency or standby system used as a backup to primary power supply, instead ofusing
a secondary power supply:
Emergency system described in NFPA 70, articte 700
Legally required standby described in NFPA 70, article 701
Operational standby system described in NFPA 70, article 702, which also meets the
performance requirements of article 700 or 701 .
Prior to Testing
()
()
()
Notifications Are Made
Monitoring Entity
Building Occupants
Building Management
Other:
AHJ notified of any impairments
Control Panel
Interface Equipment
Lamps/LED's
Fuses
Primary Power Supply
Trouble Signals
Disconnect Switches
Ground Fault Monitoring
Secondary Power
Battery Condition
Load Voltage
Discharge Test
Charger Test
Specific Gravity
Bells
Homs
Mini-sounders
yes
(x)
(x)
(x)
()
()
no
System Tests & Inspections
Visual Functional
()
()
()
()
()
Comments
(x)
(x)
(x)
cx)(x)
(x)
()
()
(x)
(x)
(x)
()
()
()
(x)
(x)
(x)
()
()
(x)
()
()
()
(x)
(x)
()
()
()
Alarm Indicating Appliances and Circuit Information
Qty of Circuir Style ety of
Strobes
Speakers
Hom,/Strobes 8
4
Circuit Style
Class B
Number of indicating circuits: 3 Are circuits supervised? (X ) yes ( ) no
Class B
Inspection and Testing Report
Property: Cape Cod Insulation
Supervisory Signal Initiating Devices and Circuit Information
Qty Circuit Style
Building Temp.
Site Water Temp
Site Water Level
Fire Pump Power
Fire Pump Running
Fire Pump Auto Position
Fire Pump/Pump Controller Trbl.
Generator In Auto Position
Switch Transfer
Generator Engine Running
Other
Signaling Line Circuits
Quantity and style (see NFPA 72, table 3-6.1) ofsignaling line circuits connected to
system: Qty Style(s)
Stem Power Supplies
Primary (main): Nominal Voltage _l l0v_, Amps _20_
Overcurrent Protection: Type _Circuit Breaker_, Amps
Location (panel no.)
Disconnecting Means Location
Special Procedures:
Comments:
On/Off Premises MonitoringYes No
Alarm Signal (X ) ( ) Supervisory Signal
Alarm Restoral (X) ( ) Supervisory Restoral
Trouble Signal (X ) ( )
Notifications That Testing Is Complete
Yes No
Building Management (X) ( ) Building Occupants
Monitoring Agency (X) ( ) other (specifu)
The following did not operate conectly:
Yes
()
()
No
)
)
No
()()
Yes(x) (
( )(
System Returned to normal operation on 09102114 at I l:30
Ga/z, Goil,il/a,>rru G*., 9rrr.
Occupancy: Cape Cod Insulation
l8 Reardon Circle
South Yarmouth, MA 02664
Site Contact:
Telephone (508)694-6748
Alarm System is a (X) Fire System
Alarm System Reports to:
2O4 AA gaor.l4..4z goai
Eledl ga".,.o*Ik,.(a.aaJtaa.,lA o267s
ALARM INSPECTION REPORT
( ) Security System
(X) Cape Cod Alarm Co., Inc.( ) Other: Local
The Alarm System at the above location was tested.
Comments:
Date Tested: 09113/13 By: Rick Kilpatrick
S ignature
MA Contractors License # 1592C
*lnstellinq, Srnvicinq nnd Monironinq o[ Srcuniry, Finr, and CCW Sysrems*
(508l. 198.6^6. (8OO) 468.8100
Fnx: Olficr (r08l' 198.1666 * Fex: Crrrnnl Srnrion (IOg)760.2012
MA Licrnsr No. ll92C
Inspection and Testing Report
Property: Cape Cod Insulation
Panel Manufacture: Silent Knight
Location: Entry hall of office area
Number of Circuits: 5
Last date system had any service performe d: 09 I 13 I 13
Last date that any software or configuration was revised:
Alarm Initiating Devices and Circuit Information
Inspection Schedule
( ) Weekly
( ) Monthly
( ) Quarterly( ) Semi-Annually
(X) Other: Annuallv
Model Number: SK 5208
Circuit Styles: Class B
Software Rev.:
Circuit Style
Class B
Class B
Manual Stations
Ion Detectors
Photo Detectors
Duct Detectors
Heat Detectors
Water flow Switches
Supervisory Switches
Arrnunciator
Carbon Monoxide Detectors
Local Smoke Detectors
Comments
Transient Suppressors
Remote Annunci ators
Notifi cation Appliances
Audible
Visual
Speakers
Voice Clarity
ass
)
)
)
)
)
)
)
P
(
(
(
(x
cx
(
(
Fail
()
()
()
()
()
()
()
Transmission Type:
( ) Mcculloh
( ) Multiplex
fi) Digital
( ) Reverse Polarity
O RI'
( ) Master Box _
Qty of
_4_
-]-
-L____2_
_Class B_
_Class B_
Inspection and Testing Report
Property: Cape Cod Insulation
Initiating and Supervisory Device Tested and Inspections
Loc. & SA{Device Visual Functional Factory Meas. PassType Check Check Setting Setting
Emergency Communications Equipment
Visual Functional Comments
Phone Set
Phone Jacks
Off Hook Indicator
Amplifier
Tone Generator
Call In Signal
System Performance
Interface Equipment
isual Functional Simulated Operation
Specifr
Specifo
Specifu
Specify
Specifu
Special Hallard Systems() ( )() ( )
Secondary (Stand-b1') Battery
Location of FueI Storage:
_2_ Storage Battery: Amp-Hr Ratirg _g_ Calculated
Calculated capacity to operate system in hours:_ 24 - 60
Engine -driven Generator Dedicated to Fire Alarm System:
Fail
()
()
()
()
()
()
()
()
()
()
()
()
()
()
()
()
()
()
()
()
()
()
()
()
()
()
)
)
)
(
(
(
()
()
()
()
()
()
()
()
Type of Battery( ) dry cell( ) nickel cadium
(X) seated lead acid( ) lead acid ( ) other
Inspection and Testing Report
Property: Cape Cod Insulation
Emergency or standby system used as a backup to primary power supply, instead ofusing
a secondary power supply:
Emergency system described in NFPA 70, article 700
Legally required standby described in NFPA 70, article 701
Operational standby system described in NFPA 70, article 702, which also meets the
performance requirements ofarticle 700 or 701.
Prior to Testing
()
()
()
Notifications Are Made
Modtoring Entity
Building Occupants
Buildhg Management
Other:
AHJ notified of any impairments
Control Panel
Interface Equipment
Lamps/LED's
Fuses
Primary Power Supply
Trouble Signals
Disconnect Switches
Ground Fault Monitoring
Secondary Power
Battery Condition
Load Voltage
Discharge Test
Charger Test
Specific Gravity
Bells
Homs
Mini-sounders
yes
o0
(x)
(x)
S;"stem Tests & Inspections
no
()
()
()
()
()
()
()
Visual
oc)
cx)(x)
()
()
00()
()
()
(x)
cx)()
()
()
Functional
(x)
cx)
cx)
cx)(x)
00()
()(a
cx)(x)
()
()
()
Comments
Alarm Indicating Appliances and Circuit Information
Qty of Circuit Style Qty of
Strobes 1
Speakers
Hom,/Strobes 8
Circuit Style
Class B
Class B
Number of indicating circuits: 3 Are circuits supervised? (X ) yes ( ) no
Inspection and Testing Report
Property: Cape Cod Insulation
Supervisory Signal Initiating Devices and Circuit Information
Qty Circuit Style
Building Temp.
Site Water Temp
Site Water Level
Fire Pump Power
Fire Pump Running
Fire Pump Auto Position
Fire Pump,iPump Controller Trbl.
Generator In Auto Position
Switch Transfer
Generator Engine Running
Other
Signaling Line Circuits
Quantity and style (see NFPA 72, table 3-6.1) ofsignaling line circuits connected to
system: Qty.Style(s)
Stem Power Supplies
Primary (main): Nominal Voltage _1 10v_, Amps _20_
Overcurrent Protection: Type _Circuit Breaker_, Amps
Location (panel no.)
Disconnecting Means Location
Special Procedures:
Comments
On/Off Premises MonitoringYes No
Alarm Signal (X ) ( ) Supervisory Signal
Alarm Restoral (X ) ( ) Supervisory Restoral
Trouble Signal (X ) ( )
Notifications That Testing Is Complete
Yes No
Building Management (X) ( ) Building Occupants
Monitoring Agency (X) ( ) other (speci$)
The following did not operale correctly:
Yes
)
)
No
()
()
(
(
Yes No(x)( )( )( )
System Returned to normal operation on 09/13/13 at l5:30