HomeMy WebLinkAboutFire Alarm Test Report 20243gS G.a+Tslpt ?) r,r" Atarmresf Rep
ALARM fr NEW ENGLAND
rt
(tt D
G tO sAL TECHNOIOGY. TOCAL PEOPIE 5
lephone L'
L<ite Name
Address
lbc-
7:)
/.f 4
,/ ,..
nel and Location )sc -t
fJ'ileat Detectors
EI'Smoke Detec{ors
n Manual Pull Station
El'co Detectors
Notifi cation Appliances
El System Battery
ns Who
,t1,", i Start End
'i J <.,.t.-,
I
I
nals
EI Alarm El'Trouble
)o -2e:'/1-800-322-3500 Date
ician
z .4,'./ a-A
a-d{ 64t"-
c<-.*
€1
a/,EJC -^z-C
J L
.zZ z.
SRep
Date 5 'sc;'z
n Supervisory El Restoral
')
SYSTEI' RECORD OF IN8PECTIONAND TE8TINO
Thb (orn l, (o bo nonNebd bl 0ro syslrn taspoo(o,t old bslhg oonlnolot ol lhe thJo of s ry&len tcnl,
tl E N$ bo p0rnlllod lo nodry lhb lorn c, trocd.d lo p/p,vkts a noft ogn[lelc on{or doti Eaord,
lnco,l MA lo nE a,.ascd llnc6,
Attaoh $ddlll,nat ahoolr, ddlo, ot colct lallorB at 0oaoss,,,ty lo Noudb d oontpfalo ftcotd,
hrFellotfi$r th.t Dtlcftlnol Ilrpootlor/Icr! Complolion Dalo/Iinrot
SulD(0o0r{dforn(r}Athiod: _ (yr!fto)
{, PNOFERIY INFORffiATION
Ngflto ofpoporyi
Addrore;
Dsro,ipliqr ofprol* ryi i-, ,..t. l -'-/
}ldnool,,lparly rqG.rfilotho;
*ddr*
P[orro;Pott:
2. TESTINO AND MONITORINO INFORMATION
Torllrrt o,l{[li!ation:
&ldrosr:
Phorto:Ifox:
I
B.rnoll:
ModhrlnS orgsni4libll:
rlddrur:
Phono:Fr)(
,rcdn|rtmlcn ,zf ltl . 1/1G 7 Plrono lho tr
}Icetts ol krnmkslouf
E nrall;
Ptolo lhro 2:
:/z-2.__ /t-,t;-
&{ltyto rt0lofi nhmr aro ]0tmnrnrltts4
8. DOCUMEI{TATION
Gr{fio Im.llo olltr nq$kod ooord doo{rnrntr crrd dt*rpcclfioo0mrc
I. DESCRIPIION OF SYSTEIU OR SERVICE
,LI Cliltolurdf
tbnufrohmri i .1: c
4.2 8ofinntt orrd Ernrrroro
Itlnrrwrre rolklon nrmhr
Plorc
Modol nnmlrr
,1,3 ErlomPovor
,1.31 ldunry @loln) Povor.
Ovlraur$lt Drohcllof VOr a*-*rg--Amnc
--
Dhoomrcllr3 nceot
Oo0lrtHa l0t2thlh{rrtf. r,trlrrlcDr...{L|fl, INi tcm eay to ro*d loi hffid u& cl!rfitr h, md., I fi.rrDl ioragLC trr,aoptdd r||t.. dttsotoa.
,rt .t .rt dt
?
It.umlh
8Y6TEM RECORD OF INEPECTIoN AitD TEeThlO (6olrJr,ood)
4. DESCRIPIION OF 8V$TEn OR SSRVICE fcorrrlr,re.r,,
4,t 2 Sccoldoly Po e!
I),p:locrtlon;
Dsti.D, lypo 0f trpllmbto):v 7A rl
Gthdrld coptc$y of hftlrior l,o drlvo lho syrloxu
ln stnrdby modo(fi orrrs);lrr ahnn rrrodo (ntln*oe);
4,ug
2,":
Monilodfi! o ftrdo$ Ct trctt
Bdflilg rnr3rrn nl 6r loll
BelltlrB oiauth C0rl6olt
Anltorlu firYlrf&rhdlollos co r.d!
O{tcr,ltnrU rd O le.ll
0. ?E6llitoRESuLYs
6l &rlrd lrh{l end nGlole BQulIrnonl
llrDoi
'llrtto:
Tlmo:
Ilm!:
Tlrrel
C([rll0l
C.TONOAUNrtfi,!Ftrncl{Ioolraocl&rI}hasflr!ryt aatLdlor& tlrt d era.hrth$&a]edr,ltor,ltolbro0LaL..ffln (,btajror d$d!r,!oi,
(p,2 ot ll
Vlsusl
lhsp,ollon
I{rollon.l
Tsst
Btd
a a
tr E
tr a
tr tr
tr tr
a'g.
B tr
d a
a a
D n
Vlruol
Inrtoollon
fanoll0nal
To!t
tr tr
tr rl
tr
tr
E
6. NOTIFICATIONS MADE PRIOR TO TE8TINO
6,2 Stcondnry Pouor
0. TEsTlNo iEsULlS (aonllnueil
63 rllara rnd thporvhry Alorus }rltlntlry Dsvlso
Athdr arypbnmhry do*c tol r{crlr &n all hllhrtn dorbot,
6,{ iloltltcollon ADulimor
.{ffml erplmrdrrg epftmc l*{sfreob for all no llodloaopfluuc+
6., Ixlil h.r BqE[nnert
Anaoft aEploma*rry lnt rhc. colrlororrl tcst rt0ols for olt hb loooou,onoiar.
Cltr,/lll hil.tfu I glxBt tE Ln, ClraBl,l tdw / nn *w Coeol l$e&t
66 Snpotrttng Enllsll llfnllllodrg
Oo I
d.7Itubtrc Euorgency Alarm Relortllg Sytlom
Common16
?orrbls
c6gi$lol0t2tll0 m.Ptra. eirts,l$el'Irhor r|t.orLdlhroaadarrlg|r4ralt|nb|t,tt ,imr|rtt $r,aahrq rlda.Ix,t&,!oto.'
(p. 3 ot ,l)
YoE No Ttmo
a'tr
tr tr
u tr
w-tr
tr u
tr D
Yos l{o Ilme
tr
B
_a_
tr
u -'CI
-n-tr
n tr
tr tr
8YBTEM RECoRD oF INBPECIIoN AND TEST|No (conltnuod)
SYSTEM RECoRD OF lllSpECTtoN AND TEBTTNO fcor,rrrued,
7. iIOTIFICATIONS TTIATTESYINO 18 OOil'PTEIE
t lorrlto lrg o4anlzatlot Cort ett ,ti,i-.,['7 L,4.,
&lldLu t mtcno
Bn[dln! oe$pr[tt
Aolhorlty hvl,tgirrilrldlor
Ollrtr,lfrcsrlrd
B, SYSTEM RESTORED TO NORMAL OPERATION
Dr(ol
Oulhd,
Cod6of
Conltot:
Co stt
Thro:
rnot
flmo;
fnlql
Ano:
.S 2cr'za7 'l\ro:
0. cERnfloATlott
Tlir.y.ls.r qpol{td tsdn trrr tocn lrpootcd aad toctcd aooordl6 toNfprl, ?r, 1013 ldtlotr, Cfiaptor l.l.
$ignul:zi-"a /),.1l:L..-n-:-Pinlcd nrund:
Tlrto:Orgonlzrllol:,4,t,,{Phorrs:
Qno[rlanllom (ro&r to 10,13]
tO. DEFEOT8 OB MAIFUNdNONE NOT CORRECTED AT OONCLU8ION OF SYSTEM INSPECTION,TEsTINO, OR MAINTENANCE
I0.I Aecsplrlceb, Ormeror. Ovnertl Rolrcrcnlatlgo,
Tlrc lbo rf or rr rho rylt|n 0 CD.df .d hmhr- **,** n$n,i^ Br.o ..:-l; -!ee.'ri'/
&gnnbntlor:'l'ittc:Phor$
o.'lttfrlO20ltrLbidfr.frl*lcorlrdrlNoo,f rbsrrrrrtcc.rLdraak*rdqrlDr..trl,f|,llrr.a.rr,ln.uoclt c.rhd&,..llr d.r.dacrat lh'fD.
lo4o{4}
{;J-
ALARM fr NEW ENGLAND
)))(tt
G I,OBAI IECHNOTOGY. TOCAL PEOPI,E
Property
2^*X/..*-"1 t i. lL<
Notes/Remmmendatlon
r ' l.-./ .)//. !t/./ i, "\.,
Date of lnspection Type of Sensivity P=Pass
Detector Location Detector S/D Type F=Fail
rl /fto-/a
)a,4
/Ja.1
13,.,.1"",i "-l-,,.)L^",-.lo,-rlr^
h*- , ,:..1.,,., )Oc ."., >,/r." J
)J" . ., ,, ". 7 /i,ztt A,,.rlu
l,Ll."_.l*tt X,'u,/.t
E t;j--lxa co -&.. "-ro(
:7.2"o. 1 iY,.., ,A^..,y'u
)".s tl* At -: %t-*t^.",t^
7".t );r., 7't."-- /A tl frLr Ccs a*r.{o--,4
y. S'11, :u"; //<tt l*,tt 9t
/-,.-ttt, h"; t/at*(c)-*+ -4-.-r',, ,-\
t .itr, .*a;t/,tt jt'dtl /",
?.J 1/, -YL,-' t&,t v,;r/L CO /o. , ..(
Z-!t, f-),.^,.- lta L..*,
1,.1 an B"A-.,- il".-tt!.
lir Ll^,,,,- i'v/-+1 L r/r,
Ls il'- a.,<.*4 I
;.,),//. d^.^(o +4--..1-
I
II
I
-I
I
I