HomeMy WebLinkAboutFire Alarm System Record of Completion 2026FIRE ALARI SYSTET RECORD OF COIPLETIOII
To be conpleted by thc system ihstallation contractor at lhe tide oftystem acceptance and aryanal.
l. Protacbd Proparty lntormador
Name of property ; c,trdoglu Gafr$tr
Addrcss: 121 Carrp Str at, Unit t130, lEsl Ya{r!od!
Dcscription ofpropeny: Singb hmity ,lidai€
Occupancy typc: R3
Name of propeny rcprcscntarivc: Clllfrtlt GaLetr.
Address: 'l2l Canp Stlrt. Unil t130. lr\bsl Yanrodl
Phone: l -97&793{1516 Fax: E.m.il: .irirtlP(egtd.corn
Autho.it-v havinS jurisdiction ovcr this p.opert): Yrrnoilllt Fir! & Bldg oc9t.
Phonc: (508) 398-2212 Fa,<: E-mait:
2. Flr! Al.rm Sy.tom l]ltrll.don, S.rvlc., rnd T.ldng lnronnrlion
Installation contra.tor for this equipment: Capo Cod Ahrrrl Co. lnc-
Addrcss: 2(x Old Tw too!. Road. t &.f Yrrltodtr, !tbs. 02673
Phonc: 5oC-3*G116 Fa\: 5(E3gGt666 E-mail: Blocscodd.fln.co.n
Scrvice organizatioo for this .quipmcnt: cap. cod Abrm Co. lnc.
Address: 20,1 Old lowihosta Ro.d, li\bst Yamros0r, Ua86. 02673
Phooe: 5G3S{i16 Fax: 5(E!e}6466 E.mail: BiI0c+rcod.im-corn
Location ofas.buill drawings: Locarion of Historical Tcst Rcpons:
Location of system opcration and maintena[cc mafluals:
A contract for test and inspcction in acco.dancc with NFPA stafldads is in effcct as of
contractcd testing comp6ny: cape cod Alarn co. lnc.
Addrcss: 2oa oH Toutho.rta Ro.d. $&8r Yrmdi, u88 02673
Phone: 50G39E6316 Fax: 5003*5666 E-mail: BllCcFdd..trl.cori
Contract cxpires: ConEact number: Frequcncy ofmutine inspections
3. Type ot Fito Alatm Sy3tam ot Sarvlcc
.vFP,-l Zr. Chapter Rcfercncc ofSystcm T)?€:
Name oforganization rcccivingalarD siSnals with Phoic nu,mbcJs /i/ oPPlicoble):
Alann: Capc Cod Alam Co. lnc Phone: lGt 4316
Supervisory: Capc Cod Alsrm Co lnc Phone: 5G!00'6316
Trouble: CapG Cod Ahrm Co. lnc Phonc: li(!.d}6l|16
Entity io which alarms 8re retm[smitled: caPe cod Abrm co lnc Phonc: l"DS'316
Melhod of rclraosmission of alafl$ to lhat organizatioo or locatioo:
c.ptllir o 2oog tr6dd F6 Plla.dqr A..eltl ih6 lo'i nry b @'d iot dlvrl' 6' ot't. 'l!! ld t"tL h htY td b' G4'd ld c..na'o'l l.i' c br{
If Chapter 8, notc thc mcans of transmission from thc protcctcd prEmiscs to thc cantral station:
E Digital alarm communicator E Mcculloh E Multiplex ! 2-way radio E l -way radio O N/A
lf Chaptcr 9, notc thc v"p€ ofconncction: D Local cncrgy EShunt ENiA
J.l Sy.t !| Soft*..G
Op€rating systcm (cxccutivc) software revision lcvcl: OSC 1616
Sitc-specific software rcvision dale: Revision completcd by:
,t. Sign ling Llno Ci.cuits
Characteristics olsignoling line ctcuits conn cted to rhis s.ystem (see NFPA 72 a. Table 6 6 l)-
Q,uartity: 0 Stylc: Class:
5. Al..m-lnldrtng DcvlcG3 .nd Clrrult3
Characterbtics ol inilialing device circuits conrccted to lhis syskm (see NFPA 77'. Tabb 6.5):
Qusnriry: (6) ryta+ snlokes Style: B Class: Hrllh.d low voltags
5.1 MrDurl loitirliog Dcvi.6
J.l,l M.nr.l Prll St ak N Number ofmanual pull stations: N/A
Tr?c ofdcviccs: E Addrcssable E conv.dtional D codcd D Transmitkr EN/A
5.2 Aotom.tic lnitirti!8 D.vic.s
5.2,1 Arc. SEokc Dctactor. Numbcr of smokc dctcclors: (06) 4WIA.A SltE*d. Sa0divty ot al07 wt'l n limits,
<< PASSED >>
(03) 122aT Ca6on lldlodd. tLbe!, <<r ISSED>>
Typc ofcoveragc: E Complctc area E Paflialarea E NooEquircd partialar.i EN/A
Typc ofdevices: E Addressable E Coovcntional E Codcd I Transmincr EN/A
Typc ofsmoke dstcctor sensing tcchnology: O lonization I Photo€lecric
5,2.2 Duat Sookc Ddcctort Numb€r ofduct smokc detecto.s: t l
Typc of covcragc:
Typc ofdcviccs: E eddrcssaUtc 0 Convc[tional I Codcd I Traasmitter EN/A
Typc of smoke dctcctor sensing tcchnologj/ | E Ionization D Photoclectric
5.2.3 ll..t D.t.clors Number ofhcat detectors: O
Typc ofcovcrage: D CorDplcte arca [tPanial arca E Nonrequircd parrial arca !NZe
'lypcofdevices: E Addreisablc El Coovcntional I Coaca fl fransmittcr EN/A
5.2,4 Sprinkl.r W.t.rllow D.tr.torr Number ofwaterlloiv detectors: 0
Type ofdcvices: E Addressable I Conventional flcoded I Transminer E]N/A
S.2.5 Ahrrlr Vcrilic.tto[ Numbcr ofdevices subjcct to alam verificatio[:
Ala.m vcrification on rhis syst.m is: D Enabled 8l Disabled E Scr for s€cords
b *r)c4rlll c 2000 r'r.r.ir Fr ftoi..r6 Atcr.rs rn.r rda o., b. cop.d rd fir$drrr @ c,tr . rrn id r.!.- n i., @r b. .oa.d rq .o6Bid ,* " *;;
6. Suporvi.ory SlgnalJnili.6ng D.vicr! and Clicuits
6,1 SprinkLr Syrtan Numbo of valvc supcrvisory switches: 0
Type ofdcvices: B Addrcssabl€ [ Convcntional Q Codcd ! Transmincr EN/A
5.2 Fir. Prmp
Type offircpump: O Elecric E Dies€l
Type of fire pump supcrvisory dcviccs: E Addrcssable EJ Convcntional E Coded El Transmittcr E N/A
Firc Pump Functions Supcftiscd
! Fire pump power E Fire pump running E Fire pump phase rcversal E S€l€ctor switch not in auto
! Engine or controlpanelt oublc E Low fuel
Olhcr: tl/A
63 Engitrc,Drivo Gan.ntor
Typc ofgdrcrator supeftisory dcvices: E Addressable f] Convcntional E Codcd O Traasmittd E N/A
! Engine or control prnel trouble D Ccnerator running E Selector switch oot in auto I Low fircl
olher:
7. Annunclato6
7.1 Arnu!.i.to. I E lrcll E Rcmotc
Type:o Addresrable D Directory D G.ehic EN/A Location:
7.2 Annuacirtor 2 ! Local ! Rcmotc
Type: o Addrcssable ! Dircctory E Graphic EN/A Location:
7J Annunci.tor J D Local E Remote
Type: tr Addressable D Directory E Craphic EN/A Location:
E. Al.fm l{oulic.don Dovice!.nd Circult3
t l EmcrS.nry voicc Ahrn Saivic.
Numb€r ofsinSle voice alarm channels: 0 Numbcr ofmultiple voicc alarm channels:
Number ofspeatcrc: Number ofsp.aker zones:
&2 T.lcphooc Jtckr
Numbe. of lclephonc jscks installed: 0 Numbcr of lclephonc handsets storcd on silc:
Typc of lclcphonc systcm instaltcd: E Elcclrically powcrcd E Sound Powcrcd E N/A
EJ Noovoicc Audibh syttlm
Chotoctetittks o/ nolifrcalion dewce circuils connecled lo this systern (tee NFPA 72', Toble 6 5):
Quantiry: o Style: Class:
clg,rdnc2oo9N,|Icif,.PYo|d&tod.tElI}rrrmon!.6,.dlq,xl'$d'don!..in5id.6!5rm.yiolD.c.'gll,€cnoi.r.d *-"t')
E.4 Typ.. rnd Qr.naiticr of Noovoicr Nodlic.tirn Applirnc.. ln tllcd
Bells: Wilh visual dcvice: Homs: with visu.ldcvic.:
Chimes: With visual dcvica: Bclls: With visualdevice:
Visual dcvices without audiblc dcvices: o|her (dexribc): N/A
9. Emergoncy cont ol Funcdont Acuvatgd
E Holdopcn door rcle.sinS dcvic6 fl Smoke managemcnt or smokc control
ElDoorunlocking E Elevaror rccall I otrcr
lo.SFbm Pouer Supply
l0.l Prinrry Pow.r
Nominal voltage: 16 5VAC A.rUs: 4OVA
Ovcrcurrent paotection: Typc: Ampsi
Location (of primary supply panclbo6rd):
DisconncctinS mcans location:
lOJ Seodrry Powcr
Loc.tion: ,*ah P.ncl Typc: Nominal voltagc: CuEcnt raling:
Numb.r ofslandby banerics: I Amp hour rati'lg: 7AH
Locrtion of emergency gcncratoa:
Location of ftrel storagc:
Calculaa€d c.pacity of secondary powcr to drive thr system
In standby modc: In alarn node:
11. Rccord of Sysbm ln.t llrtion
Fill @t ortet all inttallation is complete atd viring has been checked lor opens. shorls, gtowtd fauhs, oal inprqet
brunching. b beIorc conducting operotiorsl occeptonce tesls.
The system has becn installed in accordance with the followint NFPA standards: (Notc any o. all lhat apply.)
ENFPATf rlNFP-4 7d. Anicle76o
! Manufacturer's published instructions E Other (plcasc speciry):
Slstcm devialioos from rcfcrcnccd NFPA standa'ds:
sie*a,lilllb.{&t)Ptinted namc: \Mlliam Fallon
Title: Salca / lnstall Mgr
Date. 03-27'i6
Phonc: 50&36431 6OrganizationC.p. Cod Ali.rm, Co.
lnc
(iors)
cogr{ai G 2009|'a.lsJ Fn Prd..to.r art.o.tio n! rri m., b cop.d id.nivxd q o!- rh- t r.-b I n.t nor b..rp{rd to. coln!{tr.b o..r.hhnon
12. Record of System Oper.tl,on
All operational featu.cs and functions ofthis systerr w.re tcslcd by or in trc pr.scnc. of thc signd shown bclow. on the dalc
shown bclow. ard wc.e fourd to bc op€r.fing p.opcrly in acco.dancc with thc rcquircments of
ENFPA 72r ENFPA 7f . Arricle ?60
E Manufacturcr's publish€d instructions 8l othcr (plcasc sp.ciry):
E Documentatioo ill accordaNr wilh lnspection alld Testing Fo.m (Fi8urc 10.6.2.3 ofXFP,4 72i) is attached
Signcd: Printed mmc: Jrn oagaby Datc: 820"6
Organization: Cap€ Cod Alam, Co. Tiile: T!dx*i.n Phonc: I €083*61116
lnc
1 3. Cardfi cationa rnd Approvalr
l3.l Syrt.trr Inrt lhlio! Cortr.ctor
This syslem 8s specified herein has been installed aod test€d according to all NFPA grndards cilcd hercin
Signed: Printcd oame: Dat.:
Orgarization: Title: Phonc:
13.2 SyltcD ScrvicC Cortrrctor
This systcm as spccified hcrcin has bc€n installed and tcstcd accordilg to all NFPA sranda.ds citcd hcrcin.
s;en"a, DIAb"ac0b Darc: 0!27-26
Phonc: t(f,$t{:}'16O.ganization Capc Cod Alarm Co
lnc
l3J CGnt..l St.lior
This system as specit'ied hercin will he monitored accordint to all NFPA standards cited hcrein
s,e,,.a l)IlL-#!a,,Printed narnc: William Fallon
Title: SaLs / lnslall Mgr
Daler 0327-26
Phonc !(P39E{.1}l 6OrganizationCape Cod Ah.m Co
lnc
Printed narnc: Wltam Fallon
Title: Salca / lllsttll M9,
l.!.4 Propcrty Rcpr6ana.tivr
I accept this syst m as having bcca installcd and tested to its specificalions and all NFPA stardards cited herein.
Signcd: Printcd oallle: Ctlttogarr G.lLehlr Date:
Organization: Tillc: Pto9.,fy ,*.t .rit 6'rc Phonc: 1-97&793{5'16
1.1.5 Auahority H.vitrg Juridlction
I have wiLcssed a sarisfactory acceptancc test of this systern and lind it to b€ installed ard operating properly in accordance
*ith its approvcd plans and specificarions. its approved s€quence ofoperations, and with all NFPA standards cited hcrein.
SiSned: Printed name: Date:
Organization: Title: Phonc:
Gort)
C.rrr{an C 269 terd F.. Plor-16 &to<nl'd Th. im m., b. ..t.d rr .drdud (!. orrr ,D tb. t6a. n 6., ttd n ..r.d ld €nmrEr .* ( d3rautd