HomeMy WebLinkAbout661 Avery Street - Life Safety System Te (4) DYNAMARK
SECURIrY *Quafity MEMO
CENrERS Alarm Systems
TM Since 1985 P.O. Box 1170
"Nationally Known, Locally Owned"
Tolland, CT 06084-1170
LIC #181641 Tel. (860) 872-4050
Fax (860) 875-0493
Avery Street Christian Reformed Church DynamarkCT@comcast.net
661 Avery Street
South Windsor, CT 06074 Date: 5/3/2011
RE: ANNUAL FIRE ALARM TEST
Attached is a copy of the "INSPECTION AND TESTING FORM".
This form was completed upon testing the fire system in your building, as required annually. A
copy must be kept in a file on the property for a minimum of three [3] years and available if
asked for by a building official or fire marshal.
�A ;"P'
Michael G Casieri
CC: Fire Marshal
WO#2119
Blessed 6e the Lord my roc( my refuge and my fortress,
my stronghold, my deliverer, my shiefd in whom I trust.
PSALM 144
72-111
INSPECTION TESTING AND MAINTENANCE
INSPECTION AND TESTING FORM
WO#: 2119 DATE:
SERVICE ORGANIZATION PROPERTY NAME(USER)
NAME: Dynamark Security NAME: Avery Street Christian Reformed Church
ADDRESS: P.O. Box 1170 Tolland,CT 06084-1170 ADDRESS: 661 Avery Street
REPRESENTATIVE: Michael G.Casieri South Windsor,CT 06074
LICENSE NO.: 181641 TELEPHONE: (860)644-2731
TELEPHONE: (860)872-4050 CONTACT: David Hiskes
CHECK HERE IF MAILING ADDRESS IS DIFFERENT❑
MONITORING ENTITY APPROVING AGENCY
CONTACT: CMS CONTACT: South Windsor Fire Marshal
TELEPHONE: 1-800-432-1429 ADDRESS: 1540 Sullivan Avenue
South Windsor,CT 06074
MONITORING ACCOUNT#: FLRPS1562 TELEPHONE: (860)644-2511 ext.217
TYPE TRANSMISSION SERVICE
❑-McCulloh ❑-Weekly
❑-Multiplex ❑-Monthly
®-Digital ❑-Quarterly
❑-Reverse Priority ❑-Semi-Annually
❑-R F ®-Annually
❑-Other(Specify) ❑-Other(Specify)
PANEL MANUFACTURER:Notifier MODEL NO.: SFP 1024 DATE INSTALLED: Unk.
CIRCUIT STYLES: B
NO.OF CIRCUITS: 10
SOFTWARE REV.:
LAST DATE SYSTEM HAD ANY SERVICE PERFORMED: Fire Test 4/6/2010
ALARM INITIATING DEVICES AND CIRCUIT INFORMATION
QTY CKT. STYLE
6 B MANUAL STATIONS
ION DETECTORS
PHOTO DETECTORS
2 B DUCT DETECTORS
HEAT DETECTORS
I B WATERFLOW SWITCHES
1 B SUPERVISORY SWITCHES
1 B OTHER:ANSUL SYSTEM
72-113
f INSPECTION TESTING AND MAINTENANCE
Prima (Main):Nominal Voltage 120v AC ,Am s: 15
Overcurrent Protection Type ,Amps:
Location(Panel Number): Basement Panel"C"Circuit#40
Disconnecting Means Location: Circuit Breaker-Panel in Basement
b. Secondary(Standby):
Storage Battery#1: Amp-Hr.Rating: VDC: AH: Installed:
Storage Battery#2: Amp-Hr.Rating: VDC• E AH: <d Installed:
Calculated capacity to operate system,in ho rs: 24 1 60
Engine-driven generator-dedicated to fire alarm system:
Location of fuel storage:
TYPE BATTERY
❑Dry Cell
❑Nickel Cadmium
®Sealed Lead-Acid
❑Lead-Acid
[]Other(Specify)
c. Emergency or standby system used as a backup to primary power supply,instead of using a secondary power
supply:
❑Emergency system described in NFPA 70,Article 700
❑Legally required standby described in NFPA 70,Article 701
[]Optional standby system described in NFPA 70,Article 702,which also meets the performance requirements
of Article 700 or 701.
PRIOR TO ANY TESTING
NOTIFICATIONS ARE MADE: YES O I WHO TIME
MONITORING ENTITY ❑
BUILDING OCCUPANTS
BUILDING MANAGEMENT ❑ ❑
OTHER(SPECIFY) ❑ I ❑
AHJ(NOTIFIED)OF ANY IMPAIRMENTS ❑ I ❑
SYSTEM TESTS AND INSPECTIONS
TYPE VISUAL FUNCTIONAL COMMENTS
CONTROLPANEL ❑ ❑
INTERFACE EQ. ❑
LAMPS/LEDS ❑ ❑
FUSES ❑ ❑
PRIMARY POWER SUPPLY ❑
TROUBLE SIGNALS ❑ ❑
DISCONNECT SWITCHES ❑ ❑
GROUND FAULT MONITORING ❑ ❑
SECONDARY POWER
TYPE VISUAL FUNCTIONAL COMMENTS
BATTERY CONDITION ❑
LOAD VOLTAGE ❑
DISCHARGE TEST ❑
CHARGER TEST ❑
SPECIFIC GRAVITY ❑
� H
72-115
INSPECTION.TESTING.AND MAINTENANCE
SPECIAL PROCEDURES J COMMENTS:
ON/OFF PREMISES MONITORING YES NO TIME COMMENTS
ALARM SIGNAL ❑
ALARM RESTORAL ❑
TROUBLE SIGNAL ❑
SUPERVISORY SIGNAL Er ❑
SUPERVISORY RESTORAL ❑ ❑
NOTIFICATION THAT THIS YES NO WHO TIME
TESTING IS COMPLETE:
BUILDING MANAGEMENT [�- ❑
MONITORING AGENCY ❑ !�� '
BUILDING OCCUPANTS ❑ ❑
OTHER(SPECIFY) ❑ 1 ❑
THE FOLLOWING DID NOT OPERATE CORRECTLY:
SYSTEM RESTORED TO NORMAL OPERATION: DATE jj TIME
THIS TESTING WAS PERFO D INYC RDANCE WITH APPLICABLE NFPA STANDARDS.
NAME OF INS EC OR: �/ �
DATE:
r
SIGNATURE:
NAME OF OWNER OR REPRESENTATIVE: E L/ k-,d
DATE: ! b
SIGNATURE: