32A-227 (10) FIRE ALARM AND EMERGENCY COMMUNICATION SYSTEM INSPECTION AND TESTING FORM
To be completed by the system inspector or tester at the time of the inspection or test.
It shall be permitted to modify this form as needed to provide a more complete and/or clear record.
Insert N/A in all unused lines.
Attach additional sheets,data,or calculations as necessary to provide a complete record.
Date of this inspection or test: 10-26-2018 Time of inspection or test: 8:45
1. PROPERTY INFORMATION
Name of property: COLLEGE CHURCH SCHOOL,LOGAN.KIRPATRICK
Address: 48 POMEROY TERRACE NORTHAMPTON.MA 01060
Description of property: CHURCH
Occupancy type: COMM
Name of property representative: RICHARD
Address:
Phone: 559-0235 Fax: 586-0063 E-mail:
Authority having jurisdiction over this property: NFD
Phone: Fax: E-mail:
2. INSTALLATION,SERVICE,AND TESTING CONTRACTOR INFORMATION
Service and/or testing organization for this equipment: Security&Fire Integrations LLC
Address: 73 Gunn Road Southampton MA 01073
Phone: 413-203-2008 Fax: 413-203-2015 E-mail: office@securityfireintegrations.com
Service technician or tester: Dave
Qualifications of technician or tester: ALARM TECH
A contract for test and inspection in accordance with NFPA standards is in effect as of: =018
The contract expires: 2019 Contract number: Frequency of tests and inspections: YRLY
Monitoring organization for this equipment: NFD
Address:
Phone: Fax: E-mail:
Entity to which alarms are retransmitted: NFD#0331 Phone:
3. TYPE OF SYSTEM OR SERVICE
®Fire alarm system(nonvoice)
❑Fire alarm with in-building fire emergency voice alarm communication system(EVACS)
❑Mass notification system(MNS)
❑Combination system,with the following components:
❑Fire alarm ❑EVACS ❑MNS ❑Two-way,in-building,emergency communication system
❑Other(specify):
Copyright 0 2009 National Fire Protection Association.This form may be copied for individual use other than for resale.It may not be copied for commercial sale or distribution.
3. TYPE OF SYSTEM OR SERVICE (continued)
NFPA 72 edition: Additional description of system(s):
3.1 Control Unit
Manufacturer: SILENT KNIGHT Model number: 5820 XL
3.2 Mass Notification System ®This system does not incorporate an MNS.
3.2.1 System Type:
❑In-building MNS--combination
In-building MNS--stand-alone ❑Wide-areaMNS ❑Distributed recipient MNS
❑Other(specify):
3.2.2 System Features:
❑Combination fire alarm/MNS ❑MNS ACU only ❑Wide-area MNS to regional national alerting interface
❑Local operating console(LOC) ❑Direct recipient NNS(DRMNS) ❑Wide-area MNS to DRMNS interface
❑Wide-area MNS to high-power speaker array(IIPSA)interface ❑In-building MNS to wide-area MNS interface
❑Other(specify):
3.3 System Documentation
®An owner's manual,a copy of the manufacturer's instructions,a written sequence of operation,and a copy of the record
record drawings are stored on site. Location: in contra
3.4 System Software ®This system does not have alterable site-specific software.
Software revision number: Software last updated on:
®A copy of the site-specific software is stored on site. Location: 3FI Office
4. SYSTEM POWER
4.1 Control Unit
4.1.1 Primary Power
Input voltage of control panel: 120 Control panel amps: 15
4.1.2 Engine-Driven Generator ®This system does not have a generator.
Location of generator:
Location of fuel storage: Type of fuel:
4.13 Uninterruptible Power System ®This system does not have a UPS.
Equipment powered by a UPS system:
Location of UPS system:
Calculated capacity of UPS batteries to drive the system components connected to it:
In standby mode(hours): In alarm mode(minutes):
Copyright 02009 National Fire Protection Association.This form maybe copied for individual use other than for resale.It may not be copied for commercial sale or distribution.
4. SYSTEM POWER(continued)
4.1.4 Batteries
Location: PANEL Type: SEALED Nominal voltage: 24 Amp/hour rating: 7
Calculated capacity of batteries to drive the system:
In standby mode(hours): In alarm mode(minutes):
❑ Batteries are marked with date of manufacture.
4.2 In-Building Fire Emergency Voice Alarm Communication System or Mass Notification System
®This system does not have an EVACS or MNS.
4.2.1 Primary Power
Input voltage of EVACS or MNS panel: EVACS or MNS panel amps:
4.2.2 Engine-Driven Generator ❑This system does not have a generator.
Location of generator:
Location of fuel storage: Type of fuel:
4.23 Uninterruptible Power System ❑This system does not have a UPS.
Equipment powered by a UPS system:
Location of UPS system:
Calculated capacity of UPS batteries to drive the system components connected to it:
In standby mode(hours): In alarm mode(minutes):
4.2.4 Batteries
Location: Type: Nominal voltage: Amp/hour rating:
Calculated capacity of batteries to drive the system:
In standby mode(hours): In alarm mode(minutes):
❑Batteries are marked with date of manufacture.
4.3 Notification Appliance Power Extender Panels This system does not have power extender panels.
4.3.1 Primary Power
Input voltage of power extender panel(s): Power extender panel amps:
4.3.2 Engine-Driven Generator ❑This system does not have a generator.
Location of generator:
Location of fuel storage: Type of fuel:
4.33 Uninterruptible Power System ❑This system does not have a UPS.
Equipment powered by a UPS system:
Location of UPS system:
Calculated capacity of UPS batteries to drive the system components connected to it:
In standby mode(hours): In alarm mode(minutes):
Copyright®2009 National Fire Protection Association.This form maybe copied for individual use other than for resale.It may not be copied for commercial sale or distribution.
4. SYSTEM POWER(continued)
4.3.4 Batteries
Location: Type: Nominal voltage: Amp/hour rating:
Calculated capacity of batteries to drive the system:
In standby mode(hours): In alarm mode(minutes):
❑Batteries are marked with date of manufacture.
5. ANNUNCIATORS ®This system does not have annunciators.
5.1 Location and Description of Annunciators
Annunciator 1:
Annunciator 2:
Annunciator 3:
6. NOTIFICATIONS MADE PRIOR TO TESTING
Monitoring organization Contact: NTON FD Time: 8:00
Building management Contact: Time:
Building occupants Contact: Time:
Authority having jurisdiction Contact: Time:
Other,if required Contact: Time:
7. TESTING RESULTS
7.1 Control Unit and Related Equipment
Visual Functional
Description Inspection Test Comments
Control unit
i
Lamps/LEDs/LCDs
Fuses ❑ ❑
Trouble signals
Disconnect switches
Ground-fault monitoring ❑ ❑
Supervision ❑ ❑
Local annunciator
Remote annunciators ❑ ❑
Power extender panels ❑ ❑
Isolation modules ❑ ❑
Other(specify) ❑ ❑
Copyright 0 2009 National Fire Protection Assodation.This form may be copied for individual use other than for resale.It may not be copied for commercial sale or distribution.
7. TESTING RESULTS (continued)
7.2 Control Unit Power Supplies
Visual Functional
Description Inspection Test Comments
120-volt power
Generator or UPS ❑ ❑
Battery condition
Load voltage ❑ ❑
Discharge test ❑ Cl
Charger test ED
Other(specify) ❑ ❑
71
7.3 In-Building Fire Emergency Voice Alarm Communications Equipment
Visual Functional
Description Inspection Test Comments
Control unit ❑ ❑
Lamps/LEDs/LCDs ❑ ❑
Fuses ❑ 1 ❑
Primary power supply ❑ 1 ❑
Secondary ower supply ❑ ❑
Trouble signals ❑ ❑
Disconnect switches ❑ ❑
Ground-fault monitoring ❑ ❑
Panel supervision Cl ❑
System performance ❑ ❑
Sound pressure levels ❑ ❑
Occupied ❑Yes ❑No
Ambient dBA
I
Alarm dBA
(attach report with locations,values,
and weather conditions
System intelligibility ❑ ❑
❑CSI ❑STI
(attach report with locations,values,
and weather conditions
Other(specify) ❑ ❑
Copyright 02009 National Fire protection Association.This form may be copied for individual use other than for resale.It may not be copied for commercial sale or distribution.
7. TESTING RESULTS(continued)
7.4 Notification Appliance Power Extender Panels
Visual Functional
Description Inspection Test Comments
Lamps/LEDs/LCDs ❑ ❑
Fuses ❑ ❑
Primary power supply ❑ ❑
Secondaty power supply ❑ ❑
Trouble signals ❑ ❑
Ground-fault monitoring ❑ I ❑
Panel supervision ❑ ❑
Other(specify) ❑ ❑
7.5 Mass Notification Equipment
Visual Functional
Description Inspection Test Comments
Functional test ❑ ❑
Resetl ower down test ❑ ❑
Fuses ❑ ❑
Primary power supply ❑ ❑
UPS power test ❑ ❑
Trouble signals ❑ ❑
Disconnect switches ❑ ❑
Ground-fault monitoring ❑ ❑
CCU security mechanism ❑ ❑
Prerecorded message content ❑ ❑
Prerecorded message activation ❑ ❑
Software backup performed ❑ ❑
Test backup software ❑ ❑
Fire alarm to MNS interface ❑ ❑
MNS to fire alarm interface ❑ ❑
In-building MNS to wide-area ❑ ❑
MNS
Copyright 0 2009 National Fire Protection Association.This form may be copied for individual use other than for resale.It may not be copied for commercial sale or distribution.
7. TESTING RESULTS (continued)
7.5 Mass Notification Equipment(continued)
Visual Functional
Description Inspection Test Comments
MNS to direct recipient MNS ❑ ❑
Sound pressure levels ❑ ❑
Occupied ❑Yes ❑No
Ambient dBA
Alarm dBA
(attach report with locations,values,
and weather conditions
System intelligibility ❑ ❑
❑CSI ❑STI
(attach report with locations,values,
and weather conditions)
Other(specify) ❑ ❑
7.6 Two-Way Communications Equipment
Visual Functional
Description Inspection Test Comments
Phone handsets ❑ ❑
Phone jacks ❑ ❑
Off-hook indicator ❑ ❑
Call-in signal ❑ ❑
System performance ❑ ❑
System audibility ❑ ❑
System intelligibility ❑ ❑
Radio communications ❑ ❑
enhancements stem
Area of refuge communication ❑ ❑
system
Elevator emergency ❑ ❑
communications system
Other(specify) ❑ ❑
Copyright®2009 National Fire protection Association.This form maybe copied for individual use other than for resale.It may not be copied for commercial sale or distribution.
7. TESTING RESULTS(continued)
7.11 Auxiliary Functions
Visual Functional
Description Inspection Test Comments
Door-releasing devices ❑ ❑
Fan shutdown ❑ ❑
Smoke management/smoke control ❑ ❑
Smoke damper operation ❑ ❑
Smoke shutter release ❑ ❑
Door unlocking ❑ ❑
Elevator recall ❑ ❑
Elevator shunt trip ❑ ❑
MNS override of FA signals ❑ ❑
Other(specify) ❑ ❑
7.12 Alarm Initiating Device
® Device test results sheet attached listing all devices tested and the results of the testing
7.13 Supervisory Alarm Initiating Device
❑ Device test results sheet attached listing all devices tested and the results of the testing
7.14 Alarm Notification Appliances
❑ Appliance test results sheet attached listing all appliances tested and the results of the testing
7.15 Supervisory Station Monitoring
Description Yes No Time Comments
Alarm signal ® ❑
Alarm restoration ® ❑
Trouble signal ❑ ❑
Trouble restoration ❑ ❑
Supervisory signal ❑ ❑
Supervisory restoration ❑ ❑
P %2. v=ia. -14.6.2 4 (c. 9 ci'i'..
Copyright®2009 National Fire Protection Association.This form maybe copied for individual use other than for resale.It may not be copied for commercial sale or distribution.
7. TESTING RESULTS (continued)
7.11 Auxiliary Functions
Visual Functional
Description Inspection Test Comments
Door-releasing devices ❑ ❑
Fan shutdown ❑ ❑
Smoke management/smoke control ❑ ❑
Smoke damper operation ❑ ❑
Smoke shutter release ❑ ❑
Door unlocking ❑ ❑
Elevator recall ❑ ❑
Elevator shunt trip ❑ ❑
MNS override of FA signals ❑ ❑
Other(specify) ❑ ❑
7.12 Alarm Initiating Device
® Device test results sheet attached listing all devices tested and the results of the testing
7.13 Supervisory Alarm Initiating Device
❑ Device test results sheet attached listing all devices tested and the results of the testing
7.14 Alarm Notification Appliances
❑ Appliance test results sheet attached listing all appliances tested and the results of the testing
7.15 Supervisory Station Monitoring
Description Yes No Time Comments
Alarm signal ® ❑
Alarm restoration ® ❑
Trouble signal ❑ ❑
Trouble restoration ❑ ❑
Supervisory signal ❑ ❑
Supervisory restoration ❑ ❑
�e
_ �;a
Copyright 0 2009 National Fire Protection Association.This form maybe copied for individual use other than for resale.It may not be copied for commercial sale or distribution.
8. NOTIFICATIONS THAT TESTING IS COMPLETE
Monitoring organization Contact: NTON FD Time: 11:30
Building management Contact: Ken Strong Time: 11:30
Building occupants Contact: Time:
Authority having jurisdiction Contact: Time:
Other,if required Contact: Time:
9. SYSTEM RESTORED TO NORMAL OPERATION
Date: 10-26-2018 Time: 11:30
10. CERTIFICATION
10.1 Inspector Certification:
This system,as specified herein,has been inspected and tested according to all NFPA standards cited herein.
Signed: Dave P SIG ON FILE Printed name: Dave P Date: 10-26-2018
Organization: SFI LLC Title: ALARM TECH Phone: 413-203-2008
10.2 Acceptance by Owner or Owner's Representative:
The undersigned has a service contract for this system in effect as of the date shown below.
Signed: Printed name: Date:
Organization: Title: Phone:
Copyright 0 2009 National Fire Protection Association.This form may be copied for individual use other than for resale.It may not be copied for commercial sale or distribution.
J
DEVICE TEST RESULTS
(Attach additional sheets if required)
Device Type Address Location Test Results
SCHOOL-REPLACED In control 2-12 Volt DC
BATTERY
HEATS ELEC BACK&ENTR CK
HORN ELEC HALL CK
HEAT AT FIRE PANEL CK
BELL&DIALER ( AT PANEL f CK
HORN HALL BY DOOR 10 CK
PULL HALL BY DOOR 10 CK
HEATS 19A FRONT&BACK I CK
PULL&HORN BY RM 23&24 CK
HEAT BOILER RM CK
FRONT/BACK
Smoke Acclimates Thru out building CK clean
LOGAN-SK 5208 PANEL
PULL HALL, 1ST LEFT, 1ST CK
RIGHT
BATTERYS
CHARGING 27.31
KIRKPATRICK
ZONE 1 IST FL&BASE CK
ZONE 2 2ND FL SMOKES CK
ZONE 3 PULL STATIONS CK
ZONE 4 GARAGE HEATS I CK
BATTERYS
CHARGING 27.24
Copydght 0 2009 National Fire Protection Association.This form may be copied for individual use other than for resale.it may not be copied for commercial sale or distribution.