FIRE INSPECTION REPORT I: YNCO FIRE PROTLCT:I['iN INC.
cOVI'tACIaus-I'MAN't"E S-i\Sl'ALA'Fl0V5
Styl c-Repairs--1nspectios
Grant Avenue,Burlington,MA 01803
Telephone(7$1)221-0111 fax(781)229-8323
S/29/19
RE: 120 Washington St
Salem, Ma
To whom it may concern,
We have completed the fire sprinkler installation at the above caption location. All work
conforms to National Fire Protection Association standard 13 as required by Massachusetts State
Building Code.
Glenn Iozzo
Lynco Fire Protection, Inc.
LYNC O FIRE PROTECTION, INC .
19 Grant Avenue, Burlington,MA 01803
781-221-0111
Contractor's Material and Test Certificate for Aboveground Piping
PROCEDURE
Upon completion of work,inspection and tests shall be made by the contractor's representative and witnessed by the property owner or
their authorized agent.All defects shall be corrected and system left in service before contractor's personnel finally leave the job.
A certificate shall be filled out and signed by both representatives, Copies shall be prepared for approving authorities,owners,and
contractor. It is understood the owner's representative's signature in no way prejudices any claim against contractor for faulty material,
poor workmanship,or failure to comply with approving authority's requirements or local ordinances.
Property name 120 Washington St Date 5/29/19
Property address 120 Washington St Salem, Ma
Accepted by approving authorities(names) Salem Fire Dept
Address
Plans Installation conforms to accepted plans 0 Yes ❑No
Equipment used is approved ®Yes Q No
If no,state deviations
Has person in charge of fire equipment been instructed as to location of ®Yes ❑No
control valves and care and maintenance of this new equipment?
If no,explain
Have copies of the following been left on the premises?
Instructions 1.System components instructions ®Yes Q No
2.Care and maintenance instructions 0 Yes Q No
3.NFPA 25 ®Yes ❑No
4.With whom have the copies been left?
Location of Supplies buildings
system
Year of
Make Model manufacture Orifice size Quantity Temperature rating
Globe QR pendant 2018 1/2 18 155
Sprinklers Viking coin 2018 1/2 183 175
Globe Res pendant 2018 1/2 160 155
Pipes and Type of pipe steel
fittings Type of fittings east Iron
Maximum time to operate through test
Alarm device connection
Alarm valve
or flow Type Make Model Minutes Seconds
indicator vain flow Potter VSR-F 0 35
For individual use.No other reproduction or transmission in any form permitted. i of 3'
LVNCO FIRE P RO`I'EC HON, INC:".
19 Gi-ant Avenue, Burlington, MA 01803
781-221-0111
Dry valve Q,O.D
Make Model Serial No. Make Model Serial No.
N/A
Time to trip through Water Air Trip point air Time water reached Alarm operated
Dry pipe test connection a.b pressure pressure pressure test outleta,b properly
operating Minutes Seconds si
test p psi
psi Minutes Seconds Yes No
Without
Q.O.D.
With
Q.O.D.
If no,explain
Operation ❑Pneumatic ❑Electric ❑Hydraulics
Piping supervised El Yes ❑No I Detecting media supervised ❑Yes [I No
Does valve operate from the manual trip,remote,or both control stations? Q Yes Q No
Deluge and Is there an accessible facility in each circuit If no,explain
for testing?
preaction
valves ❑Yes ❑No
Does each circuit operate Does each circuit operate Maximum time to operate
Make Model supervision loss alarm? valve release? release
Yes No Yes No Minutes Seconds
N/A
Location and Make and
Pressure- floor model Setting Static ssure Residual pressure(flowing) Flow rate
reducing Flow
valve test Inlet(psi) Outlet(psi) Inlet(psi) Outlet(psi) m
N/A
Hydrostatic: Hydrostatic tests shall be made at not less than 200 psi(13.6 bar)for 2 hours or 50 psi(3.4 bar)
above static pressure in excess of 150 psi(10.2 bar)for 2 hours.Differential dry pipe valve clappers shall be left
Test open during the test to prevent damage. All aboveground piping leakage shall be stopped.
description Pneumatic: Establish 40 psi(2.7 bar)air pressure and measure drop,which shall not exceed 1'/2 psi(0.1 bar)in
24 hours. Test pressure tanks at normal water level and air pressure and measure air pressure drop,which shall
not exceed 1'/�psi 0,1 bar in 24 hours.
All piping hydrostatically tested at N/A psi( bar)for hours If no,state reason
Dry piping pneumatically tested ❑Yes ❑No per NFPA 25.2.1.6
Equipment o erates property ®Yes ❑No
Do you certify as the sprinkler contractor that additives and corrosive chemicals,sodium silicate or derivatives of
sodium silicate,brine, or other corrosive chemicals were not used for testing systems or stopping leaks?
E Yes ❑No
Drain Reading of gauge located near water supply Residual pressure with valve in test connection
Tests test I test connection: 78psi( bar open wide: 80psi( bar
Underground mains and lead-in connections to system risers flushed before connection made to sprinkler piping
Verified by copy of the Contractor's Material and Test C1 Yes ❑No Other Explain
Certificate for Underground Piping. existing service
Flushed by installer of under ound sprinkler piping ❑Yes ❑No
If powder-driven fasteners are used in concrete,has ❑Yes ❑No If no,explain
representative sample testing been satisfactorily
completed? N/A
a Measured from time inspector's test connection is opened,
b NFPA 13 only requires the 60-second limitation in specific sections.
For individual use.No other reproduction or transmission in any form permitted. 2 of 3
I. YNCO FIRE PROTECTION, INC.
19 (_grant Avenue.Burlington, MA 01803
781-221-0111
Blank testing Number used Locations Number removed
gaskets
Welding piping ❑Yes C@ No
If es...
Do you certify as the sprinkler contractor that welding procedures used complied with the ❑Yes ❑No
minimum requirements of AWS 82.1,ASME Section IX Welding and Brazing Qualifications,
or other applicable qualification standard as required by the AHJ?
Do you certify that all welding was performed by welders or welding operators qualified in ❑Yes ❑No
accordance with the minimum requirements of AWS 82.1,ASME Section IX Welding and
Welding Brazing Qualifications,or other applicable qualification standard as required by the AHJ?
Do you certify that the welding was conducted in compliance with a documented quality ❑Yes ❑No
control procedure to ensure that(1)all discs are retrieved;(2)that openings in piping are
smooth,that slag and other welding residue are removed;(3)the internal diameters of piping
are not penetrated;(4)completed welds are free from cracks,incomplete fusion,surface
porosity greater than IAA in.diameter,undercut deeper than the lesser of 25%of the wall
thickness Or'/32 in.;and(5)completed circumferential butt weld reinforcement does not
exceed 3132 in.?
Cutouts
(discs) Da you certify that you have a control feature to ensure that all cutouts discs are retrieved? Yes ❑No
Hydraulic Nameplate provided If no,explain
data
nameplate I ®Yes ❑No
Sprinkler contractor removed all caps and straps? Z Yes ❑No
Date leftin service with all control valves open
Remarks
turned on daily
Name of sprinkler contractor
LYNCO FIRE PROTECTION
Tests witnessed
Signatures The property owner or their authorized agent(signed) Title Date
For spri ontractor ed) Title Date
PM 5/29/19
Additional explanation and notes
For individual use.No other reproduction or transmission in any form permitted. 3 of 3