HomeMy WebLinkAbout27 Spielman Road - Life Safety System Te (3) SECURI 7 -) I Quality
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MEMO
CENTERS Alarm Systems
---d A Since 1985 P.O. Box 1170
"Nationally Known, Locally Owned" Tolland, CT 06084-1170
LIC #181641 Tel. (860) 872-4050
Fax (860) 875-0493
Rising Stars Child Care DynamarkCT@comcast.net
27 Spielman Road
South Windsor, CT 06074 Date: 4/23/2015
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.
Michael G Casieri
CC: Fire Marshal
WO# 0296
�BCessed 6e the Lord my rock my refuge and my fortress,
my stronghold, my deliverer, my shield in whom I trust.
PSALM 144
ti
INSPECTION AND TESTING FORM
W04: 0296 DATE:
�3�5
SERVICE ORGANIZATION PROPERTY NAME(USER)
NAME: Dynamark Security NAME: Rising Stars Child Care
ADDRESS: P.O. Box 1170 Tolland,CT 06084-1170 ADDRESS: 27 Spielman Road
REPRESENTATIVE: Michael G. Casieri South Windsor, CT 06074
LICENSE NO.: 181641 TELEPHONE: (860)528-7529
TELEPHONE: (860)872-4050 CONTACT: Jeff or Rene Welsh
CHECK HERE IF MAILING ADDRESS IS DIFFERENT
MONITORING ENTITY APPROVING AGENCY
CONTACT: CONTACT: South Windsor Fire Marshal
TELEPHONE: ADDRESS: 1540 Sullivan Avenue
South Windsor,CT 06074
MONITORING ACCOUNT#: NOT MONITORED TELEPHONE: (860)644-2511 ext.217
TYPE TRANSMISSION SERVICE
®-Digital ®-Annually
PANEL MANUFACTURER: Firelite MODEL NO.: MS 5024 UD DATE INSTALLED: 6/20/08
CIRCUIT STYLES: B
NO. OF CIRCUITS: 5
SOFTWARE REV.:N/A
LAST DATE SYSTEM HAD ANY SERVICE PERFORMED: Fire Test 12/12/2013
ALARM INITIATING DEVICES AND CIRCUIT INFORMATION
QTY CKT. STYLE
5 B MANUAL STATIONS
ION DETECTORS
20 B PHOTO DETECTORS
DUCT DETECTORS
2 B HEAT DETECTORS
WATERFLOW SWITCHES
SUPERVISORY SWITCHES
OTHER: (SPECIFY)
Y
POWER SUPPLIES:
Primary(Main):Nominal Voltage 110V ,Amps: 15
Overcurrent Protection Tye Breaker ,Amps: 15
Location(Panel Number): Basement
Disconnecting Means Location: #5
b. Seconda (Standb ):
Storage Battery#1: Amp-Hr.Rating: VDC:j AH: ( Installed: 12/2013
Storage Batter #2: 1 Amp-Hr.Rating: VDC: AH:,-7, Installed:6/2008
Calculated capacity to operate system,in hours: 24 60
TYPE BATTERY
®Sealed Lead-Acid
PRIOR TO ANY TESTING
NOTIFICATIONS ARE MADE: YES NO WHO TIME
MONITORING ENTITY ❑ ❑
BUILDING OCCUPANTS '®
BUILDING MANAGEMENT ❑
OTHER(SPECIFY) ❑ ❑
AHJ(NOTIFIED)OF ANY IMPAIRMENTS ❑ ❑
SYSTEM TESTS AND INSPECTIONS
TYPE VISUAL FUNCTIO COMMENTS
CONTROLPANEL
INTERFACE EQ. ❑ ❑
LAMPS/LEDS
FUSES ❑
PRIMARY POWER SUPPLY
TROUBLE SIGNALS
DISCONNECT SWITCHES ❑ ❑
GROUND FAULT MONITORING ❑ ❑
SECONDARY POWER
TYPE VISU FUNCTIONAL COMMENTS
BATTERY CONDITION
LOAD VOLTAGE
DISCHARGE TEST LT
CHARGER TEST ❑ —
y �
72-115
INSPECTION.TESTING.AND MAINTENANCE
SPECIAL PROCEDURES/COMMENTS:
ON/ ' PREMISES MONITORING 'YES NO TIME COMMENTS
ALARM SIGNAL ❑ —
ALARM RESTORAL ❑
TROUBLE SIGNAL 0, ❑
SUPERVISORY SIGNAL ❑ ❑
SUPERVISORY RESTORAL ❑ ❑
NOTIFICATION THAT THIS YES NO WHO TIME
TESTING IS COMPLETE:
BUILDING MANAGEMENT ❑
MONITORING AGENCY Cfi ❑
BUILDING OCCUPANTS ❑ ❑
OTHER(SPECIFY) ❑ ❑
SYSTEM RESTORED TO NORMAL OPERATION: DATE �Z. TIME Q
THIS TESTING WAS PERF ED I ArORDIANCF�WITH APPLICABLE NFPA STANDARDS.
NAME OF INSPECTOR: �. ` / I/1
DATE: /a3G�J
SIG
NATURE:
NATURE:
NAME OF O ER OR REPRESENTATIVE:
DATE:Li
SIGNATURE r r: