Fillable FIRE ALARM ACCEPTANCE TEST

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FIRE ALARM ACCEPTANCE TEST

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70 Church Street, White Plains, New York 10601
Phone: (914) 422 - 1269 * Fax: (914) 422 - 1471
DEPARTMENT OF BUILDING
CITY OF WHITE PLAINS
Fire Alarm Acceptance Test 11/14
http://www.cityofwhiteplains.com
____________________________: HAS TESTED ALL THESE DEVICES ON PRIMARY AND SECONDARY
POWER SUPPLIES. ALL DEVISES ARE FUNCTIONING IN ACCORDANCE WITH APPLICABLE CITY OF
WHITE PLAINS, NFPA STANDARDS AND MANUFACTURES SPECIFICATIONS. IF THERE IS ANY
ADDITIONAL INFORMATION YOU REQUIRE, PLEASE FEEL FREE TO CONTACT US AT ANY TIME.
THE FOLLOWING IS A LIST OF INITIATING, SUPERVISORY AND ANNUNCIATING DEVICES CONNECTED
TO THE FIRE ALARM SYSTEM LOCATED AT ABOVE REFERENCED LOCATION:
FIRE ALARM ACCEPTANCE TEST
Date:
White Plains Building Department
70 Church Street
White Plains, NY 10601
Fire Alarm Permit#
Site Location: SBL#:
Tenant Name:
Related Building Permit#
Unit/Space #:
Smoke Detectors
Remote Led's for above ceiling SD
Quantity Description of devices installed (LIST ALL DEVICES)
Heat Detectors
Horn Strobes
Water Flow Switch Monitor Modules
Tamper Switch Monitor Modules
Speaker Strobes
Strobes Only
Pull Station
Other, Be Specific
Installer License# NYS Unique#
License Installer's Signature:
Print Name:
Company :
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FIRE ALARM ACCEPTANCE TEST

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Completed 17 July 2020

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