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FM Inspection Sheet Town of Queensbury-Building and Codes- Fire Marshal 742 Bay Road-(518)761-8256 Building (518)761-8206 Fire Marshal Case Number: CC-0419-2019 Case Module: Permit Inspection Date: Thu Oct 31, 2019 Inspection Status: Passed Inspector: Mike Palmer Inspection Type: OCC-Inspections Job Address: 24 NATIVE DR Parcel Number: 308.20-1-9.2 Queensbury, NY 12804 Contact Type Company Name Name Primary Owner JAG I, LLC Granted Permission JAG I, LLC Applicant JAG I, LLC Contractor JAG I, LLC Architect Monarch Design Group LLC Checklist Item Status Fire Marshal Passed Exit Access Passed Exit Enclosure Passed Exit Discharge Passed Locks and Latches Passed Oct 31,2019 Page(1) • . , r Checklist Item Status Sign: Normal Passed Add additional combo pac rear exit enclosure Sign: Backup Passed Main Aisle Width Passed Secondary Aisle Width Passed Fire Extinguisher Hung Passed Inspection of Extinguisher Passed Evac Plan Passed Post Emergency Lighting Interior Passed Emergency Lighting Exterior Passed Clearance to Electrical Passed Electrical Wiring Enclosed/Labeled Passed Breakers front corridor panel GP2 Breaker 11 and 8 Combustibles in Equipment Rooms Passed Oct 31,2019 Page(2) Checklist Item Status No Smoking Signs Passed Storage Passed Verify after move in LP storage cage in front requires impact protection Interior Finishes Passed Hang FE main lobby Add eschuteon plate main lobby Replace ceiling tiles main lobby CO Detectors Passed Verify Clearance to Sprinkler/Ceiling Passed FIRE ALARM Annual Passed HVAC Shutdown Passed Verify duct detection Sprinkler System Annual Passed Sprinkler FDC Passed Knox Box: installed/checked Passed Very key when locks are changed, need keys for Angio Occupancy Cycle Passed Oct 31,2019 Page(3) Checklist Item Status Fv VP.B. V. Palmer,Mike Oct 31,2019 Page(4) K _ a E Town of Queensbury- Building and Codes- Fire Marshal 742 Bay Road -(518)761-8256 Building (518)761-8206 Fire Marshal Case Number: CC-0419-2019 Case Module: Permit Inspection Date: Tue Oct 8, 2019 Inspection Status: Partial Pass Inspector: Mike Palmer Inspection Type: OCC-Inspections Job Address: 24 NATIVE DR Parcel Number: 308.20-1-9.2 Queensbury, NY 12804 Contact Type Company Name Name Primary Owner JAG I, LLC Contractor JAG I, LLC Architect Monarch Design Group LLC Applicant JAG I, LLC Granted Permission JAG I, LLC Checklist Item Status Fire Marshal Passed Exit Access Passed Exit Enclosure Passed Exit Discharge Passed Locks and Latches Passed Oct O8,2019 Page(1) Checklist Item Status Sign: Normal Passed Add additional combo pac rear exit enclosure Sign: Backup Passed Main Aisle Width Passed Secondary Aisle Width Passed Fire Extinguisher Hung Passed Inspection of Extinguisher Passed Evac Plan Failed Post Emergency Lighting Interior Passed Emergency Lighting Exterior Passed Clearance to Electrical Passed Electrical Wiring Enclosed/Labeled Passed Breakers front corridor panel GP2 Breaker 11 and 8 Combustibles in Equipment Rooms Passed Oct 08,2019 Page(2) Checklist Item Status No Smoking Signs Passed Storage Failed Verify after move in LP storage cage in front requires impact protection Interior Finishes Passed Hang FE main lobby Add eschuteon plate main lobby Replace ceiling tiles main lobby CO Detectors Failed Verify Clearance to Sprinkler/Ceiling Passed FIRE ALARM Annual Passed HVAC Shutdown Failed Verify duct detection Sprinkler System Annual Passed Sprinkler FDC Passed Knox Box: installed/checked Failed Very key when locks are changed, need keys for Angio Occupancy Cycle Passed Oct 08,2019 Page(3) Checklist Item Status F Palmer,Mike Oct 08,2019 Page(4) Town of Queensbury- Building and Codes- Fire Marshal 742 Bay Road-(518)761-8256 Building (518)761-8206 Fire Marshal Case Number: CC-0419-2019 Case Module: Permit Inspection Date: Tue Oct 1, 2019 Inspection Status: Partial Pass Inspector: Mike Palmer Inspection Type: OCC-Inspections Job Address: 24 NATIVE DR Parcel Number: 308.20-1-9.2 Queensbury, NY 12804 Contact Type Company Name Name Applicant JAG I, LLC Granted Permission JAG I, LLC Contractor JAG I, LLC Architect Monarch Design Group LLC Primary Owner JAG I, LLC Checklist Item Status Fire Marshal Passed Exit Access Passed Exit Enclosure Passed Exit Discharge Passed Locks and Latches Passed Oct 01,2019 Page(1) wr Checklist Item Status Sign: Normal Failed Add additional combo pac rear exit enclosure Sign: Backup Passed Main Aisle Width Passed Secondary Aisle Width Passed Fire Extinguisher Hung Passed Inspection of Extinguisher Passed Evac Plan Failed Post Emergency Lighting Interior Passed Emergency Lighting Exterior Passed Clearance to Electrical Passed Electrical Wiring Enclosed/Labeled Passed Breakers front corridor panel GP2 Breaker 11 and 8 Combustibles in Equipment Rooms Passed Oct 01,2019 Page(2) Checklist Item Status No Smoking Signs Passed Storage Failed Verify Interior Finishes Failed Hang FE main lobby Add eschuteon plate main lobby Replace ceiling tiles main lobby CO Detectors Failed Verify Clearance to Sprinkler/Ceiling Passed FIRE ALARM Annual Passed HVAC Shutdown Failed Verify duct detection Sprinkler System Annual Passed Sprinkler FDC Passed Knox Box: installed/checked Failed Very key when locks are changed Occupancy Cycle Passed Oct 01,2019 Page(3) Checklist Item Status F Palmer,Mike Oct 01,2019 Page(4) -- 1 NEW YORK ,_ DATE OF ORDER 10/15/19 WORK ORDERED BY FIRE & SECURI'ilY ORDER TAKEN BY PHONE .��\\ .... ., P.O.NO. ::rnn>r„,,.-,...::.I racy i..-"•.:o�, PROTECTION SYSTEM- INSPECTION REPORT JOB NAME/NO. Angio Dynamics JOB LOCATION Name Native Development Group(Angio Dynamics) INSTALLATION DATE LAST INSPECTION 5/8/19 Address 24 Native Drive INVOICE DATE J08 PHONE City Queensbury State NY Zip 12804 INSPECTION SYSTEM INFORMATION J INFORMATION d z Qa LL SYSTEM EQUIPMENT MANUFACTURE MS-92000DLS&FCPS24FS6(NAC Power Supply) R.O.R.Heat SYSTEM INSTALLER ✓ New York Fire&Security Fixed Heat ✓ SYSTEM APPLICATION Warehouse Smoke Detector ✓ TYPE OF SYSTEM Fire Alarm and Sprinkler Monitoring Duct Detector 3 ✓ MAINTENANCE PROGRAM BY New York Fire&Security Flame Detector / CALL LIST UP TO DATE Yes Pull Station ✓ REMARKS u '> Low Temp ✓ N G Door Contacts O ✓ Motion Detectors ✓ 20 Photobeams CONTROL PANEL AGENT TANK COMMUNICATION DEVICES Sprinkler Water Flow ✓ A.C.Voltage 121.2 weight A.C.Voltage Sprinkler Low Air ✓ D.C.without Load 27.6 Last Hydro D.C.without Load Sprinkler Tamper D.C.with Load Batt A: 12.34 Gauge Pressure D.C.with Load Batt A: Water Bug ✓ Water Detector D.C.with Load Batt B: 12.32 Serial# D.C.with Load Batt B: 1 ✓ Air Hand.Shutdown ✓ POWER SUPPLY AGENTTANK POWER SUPPLY o Bed Shaker ✓ A.C.Voltage weight A.C.Voltage Door Release a D.C.without Load Last Hydro D.C.without Load C Duct Damper ✓ Equipment Shutdown 3 ✓ D.C.with Load Batt A: Gauge Pressure D.C.with Load Batt A: A.C.Voltage �/ D.C.with Load Batt B: Serial# D.C.with Load Batt B: C D.C.Voltage ✓ a Battery / O Detection Circuit ✓ This is the inspection report for the addition of three duct smoke detectors and 1 CO detector in the Angio U Audible Circuit V/ space. Remote Annunciator / Audible Devices 41 Y / N Y EVisual Devices 86 ✓ m Q Pre.Discharge ✓ Signs as Needed / Selector Valves ✓ The testing performed and noted on this inspection report is based on NFPA 72 guidelines Piping ✓ Nozzles ✓ Mm Tanks ✓ INSPECTOR d � Gauges �/ INK Solenoid ✓ I hereby acknowledge the satisfactory completion of the above described work. Manual Release ✓ SYSTEM FUNCTIONAL Time Delay ✓ _ SYSTEM NON-FUNCTIONAL Remote Station Trans. ✓ IP/Cell Communicator 1 ✓ DISCREPANCIES NOTED ABOVE Voice Dialer ✓ v Phone Line/Digital 10/15/19 Dialer ✓ signature(Title) Date