RECORD OF INSPEC.& TEST. RPT #180-0908 NFPA 72
A SYSTEM RECORD OF
Fire Alarm& INSPECTION AND TESTING
Security Integration
Report No: 1802-0908
Inspection/Test Start Date: Friday, February 09,2018 Start Time: 8:00 AM
Inspection/Test Completion Date: Friday, February 09, 2018 Completion Time: 2:00 PM
Supplemental Form(s)Attached[Form(no.of pages)]:
1 PROPERTY INFORMATION
Name of property: HARBORLIGHT COMMUNITY
Address: 43 BOSTON ST.SALEM MA 01970
Description of property: HOUSING
Name of property representative: Kristen Carlson
Address: PO Box 507 Beverly, MA 01915
Phone: 978-922-1305 Fax: E-mail:
2 TESTING AND MONITORING INFORMATION
Testing organization: TOCCO FIRE ALARM&SECURITY INTEGRATION
Address: 29 COOK STREET, UNIT A, BILLERICA, MA,01821
Phone: 978-663-0292 Fax: 978-663-9366 E-mail: firealarm@toccocorp.com
Monitoring organization: FIRE DEPARTMENT
Address:
Phone: 1-978-772-4600 Fax: E-mail:
Account number. 70005848 Phone line 1: Phone line 2:
Means of transmission: AES RADIO
Entity to which alarms are retransmitted: CETRALARM Phone: 800-639-2066
3 DOCUMENTATION
On-site location of the required record documents and site-specific software: IN PANEL
4 DESCRIPTION OF SYSTEM OR SERVICE
4.1 Control Unit
Manufacturer. SEIMENS Model number. FC901
4.2 Software and Firmware
Firmware revision number
4.3 System Power
4.3.1 Primary(Main)Power
Nominal voltage: 120V Amps: 20 Location: HP CKT 1
Overcurrent protection type: BRKR Amps: 20 Disconnecting means location: BASEMENT
NFPA 72
SYSTEM RECORD OF
Fire Alarm& INSPECTION AND TESTING
Security Integration
Report No: 1802-0908
4 DESCRIPTION OF SYSTEM OR SERVICE (continued)
4.3.2 Secondary Power
Type: BATTERY Location: IN PANEL
.................. .............. .. .
Battery type(if applicable): SEALED LEAD
Calculated capacity of batteries to drive the system: 2x12v8AH
In standby mode(hours): 24 In alarm mode(minutes): 5
5 NOTIFICATIONS MADE PRIOR TO TESTING
Monitoring organization Contact: CENTRALARMTime: 8:00 AM
Building management Contact: Time:
Building occupants Contact: Time:
Authority having jurisdiction Contact: _ Time:
Other,if required Contact: Time:
6 TESTING RESULTS
6.1 Control Unit and Related Equipment
Description Visual Functional Comments
Inspection Test
Control unit ❑ El PASSED
Lamps/LEDs/LCDs ❑ CD PASSED
Fuses ❑ C1i PASSED
Trouble signals ❑ O PASSED
Disconnect switches ❑ Cl PASSED
Ground-fault monitoring ❑ CD PASSED
Supervision ❑ CD PASSED
Local annunciator �PASSED
Remote annunciators ❑ CD NIA
Remote power panels ❑ CO PASSED
6.2 Secondary Power
Description Visual Functional Comments
Inspection Test
Battery condition_ ❑ Cl .PASSED
Load voltage ❑ CO PASSED
Discharge test ❑ CD PASSED
Charger test ❑ PASSED
Remote panel batteries ❑ C] PASSED
� v
rip
- NFPA 72
SYSTEM RECORD OF
Fire Alarm& INSPECTION AND TESTING
Security Integration
Report No: 1802-0908
6 TESTING RESULTS (continued)
6.3 Alarm and Supervisory Alarm Initiating Device
Attach supplementary device test sheets for all initiating devices.
8 Manual Station Rate/Rise Heat Detector 1 Tamper
.................
13 Smoke Detector 5 Fixed Temp Heat Detector Low Pressure
Duct Smoke Detector 1 Waterflow 5 Carbon Monoxide
6.4 Notification Appliances
Attach supplementary appliance test sheets for all notification appliances.
8 Hom/Strobe Speaker/Strobe 10 Low Frequency Sounder
10 Strobe Speaker Beacon
Hom Mini Hom Bell
6.5 Interface Equipment
Attach supplementary interface component test sheets for all interface components.
Circuit Interface/Signaling Line Circuit Interface/Fire Alarm Control Interface
6.6 Supervising Station Monitoring
Description Yes No Time Comments
Alarm signal_ Cl ❑ 9:00 AM _
Alarm restoration ❑ 2:00 PM
j
Trouble signal [] ❑ 10:00 AM
Trouble restoration CI ❑ 2:00 PM
Supervisory signal CD ❑ 11:00 AM
Supervisory restoration Cl ❑ 2:00 PM
6.7 Public Emergency Alarm Reporting System
Description Yes No Time Comments
Alarm signal ❑ ❑ NOT MONITORED
Alarm restoration F-1 ❑ NOT MONITORED
Trouble signal ❑ ❑ NOT MONITORED
Trouble restoration ❑ ❑ NOT MONITORED
. .........
Supervisory signal ❑ ❑ NOT MONITORED
Supervisory restoration ❑ ❑ NOT MONITORED
NFPA 72
SYSTEM RECORD OF
Fire Alarm&
Security Integration INSPECTION AND TESTING
Report No: 1802-0908
7 NOTIFICATIONS THAT TESTING IS COMPLETE
Monitoring organization Contact: CENTRALARM Time: 2:00 PM
Building management Contact: Time:
Building occupants Contact: Time:
Authority having jurisdiction Contact: Time:
Other, if required Contact: Time:
8 SYSTEM RESTORED TO NORMAL OPERATION
Date: Friday, February 09,2018 Time: 14:00
9 CERTIFICATION
This system as specified herein has been inspected and tested according to NFPA 72, 2013 edition,Chapter 14.
Signed: " - �'"`� �"= Printed name: TONY MARTELLO Date: 02/09118
Organization: Tocco Fire Alarm&Security Integration Title:INSPECTION TECHNICIAN Phone:978408-5313
Qualifications(refer to 10.5.3):
10 DEFECTS OR MALFUNCTIONS NOT CORRECTED AT CONCLUSION OF SYSTEM INSPECTION,
TESTING,OR MAINTENANCE
1
10.1 Acceptance by Owner or Owner's Representative:
The undersigned accepted the test report for the system as specified herein:
Signed: Printed name: _ _ _ Date:
Organizatior Title: Phone:
NFPA 72 INTITIATING DEVICE
SUPPLEMENTAL RECORD OF
0
Fug Aga &
Security Integration INSPECTION AND TESTING
Report No: 1802-0908
Inspection/Test Start Date: Friday, February 09,2018 Start Time: 8:00 AM
Inspection/Test Completion Date: Friday, February 09,2018 Completion Time: 2:00 PM
1 PROPERTY INFORMATION
Name of property: HARBORLIGHT COMMUNITY
Address: 43 BOSTON ST. SALEM MA 01970
2 INITIATING DEVICE TEST RESULTS
DEVICE ZONE or LOCATION RESULT DEFICIENCY
POINT ITEM#
MANUAL STATION 1001BASEMENT PULL STATION
MANUAL STATION 1002 FL1 FRONT PULL STATION
MANUAL STATION 1003 FL1 HALL PULL STATION
MANUAL STATION 1004 FL1 REAR PULL STATION
MANUAL STATION 1005 FL2 REAR PULL STATION
MANUAL.STATION 1006 FL2 FRONT PULL STATION
MANUAL STATION 1007 FL3 FRONT PULL STATION
MANUAL STATION 1008 FL3 REAR PULL STATION
SMOKE DETECTOR 1011 FL2 REAR SMOKE DETECTOR _
SMOKE DETECTOR 1012 BASEMENT SMOKE DETECTOR
SMOKE DETECTOR 1013 FL3 REAR SMOKE DETECTOR
SMOKE DETECTOR 1015 FL1 REAR SMOKE DETECTOR
SMOKE DETECTOR 1016 FL2 FRONT SMOKE DETECTOR
SMOKE DETECTOR 1017 FL1 FRONT SMOKE DETECTOR
SMOKE DETECTOR 1020 FL3 FRONT SMOKE DETECTOR
C/O SMOKE COMBO 1025 FL1 HALL SMOKE/CO DETECTOR
C/O SMOKE COMBO 1026 FL2 REAR SMOKE/CO DETECTOR
C/O SMOKE COMBO 1027 FL2 FRONT SMOKEICO DETECTOR
C/O SMOKE COMBO 1028' FL3 REAR SMOKE/CO DETECTOR
C/O SMOKE COMBO 1029 FL3 FRONT SMOKE/CO DETECTOR
C/O SMOKE COMBO 1030 FL1 REAR SMOKE/CO DETECTOR
WATERFLOW 1031 SPRINKLER WATERFLOW
TAMPER 1031 SPINKLER TAMPER
SYSTEM RECORD OF COMPLETION
This form is to be completed by the system installation contractor at the time of system acceptance and approval.
It shall be permitted to modify this form as needed to provide a more complete andlor clear record.
Insert A11A in all unused lines.
Attach additional sheets, data,or calculations as necessary to provide a complete record.
Form Completion Date: 2/9/2018 Supplemental Pages Attached:
1. PROPERTY INFORMATION
Name of property: HARBORSIDE COMMUNITY
Address: 43 BOSTON ST.SALEM MA 01970
Description of property: 3 STORY APARTMENT BUILDING
Name of property representative: KRISTEN CARLSON
Address: PO Box 507 Beverly,MA 01915
Phone: 978-922-1305 Fax: E-mail:
2. INSTALLATION,SERVICE,TESTING,AND MONITORING INFORMATION
Installation contractor: TOCCO CORP
Address: 26 COOK ST SUITE A.BILLERICA MA
Phone: 978-663-0292 Fax: E-mail: INFO@TOCCOCORP.COM
Service organization: TOCCO CORP
Address: 26 COOK ST SUITE A,BILLERICA MA
Phone: 978-663-0292 Far: E-mail: INFO@TOCCOCORP.COM
Testing organization: TOCCO CORP
Address: 26 COOK ST SUITE A,BILLERICA MA
Phone: 978-663-0292 Fax: E-mail: INFO@TOCCOCORP.COM
Effective date for test and inspection contract:
Monitoring organization: CENTRALARM
Address: 994 Candia Rd.Manchester,NH 03109
Phone: 800-639-4068 Fax: E-mail:
Account number: 7000-5848 Phone line 1: Phone line 2:
Means of transmission: AES RADIO
Entity to which alarms are retransmitted: SALEM FIRE DEPARTMENT Phone: 978-744-1235
3. DOCUMENTATION
On-site location of the required record documents and site-specific software: IN PANEL
4. DESCRIPTION OF SYSTEM OR SERVICE
This is a: ®New system ❑Modification to existing system Permit number:
NFPA 72 edition:
4.1 Control Unit
Manufacturer: SEIMENS Model number: FC901
4.2 Software and Firmware
Firmware revision number:
4.3 Alarm Verification ®This system does not incorporate alarm verification.
Number of devices subject to alarm verification: Alarm verification set for seconds
Copyright®2012 National Fire Protection Association.This form may be died for irxiividuat use otter that for resale-it may not be copied for Commercial sale or distribution.
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SYSTEM RECORD OF COMPLETION (continued)
S. SYSTEM POWER
5.1 Control Unit
5.1.1 Primary Power
Input voltage of control panel: 120V Control panel amps: 5
Overcurrent protection: Type: BREAKER Amps: 20
Branch circuit disconnecting means location: HP Number: 1
5.1.2 Secondary Power
Type of secondary power: BATTERIES
Location,if remote from the plant:
Calculated capacity of secondary power to drive the system:
In standby mode(hours): 24 In alarm mode(minutes): 5
5.2 Control Unit
❑ This system does not have power extender panels
❑ Power extender panels are listed on supplementary sheet A
6. CIRCUITS AND PATHWAYS
Pathway Type Dual Media Pathway Separate Pathway Class Survivability Level
Signaling Line A
Device Power N/A
Initiating Device A
Notification Appliance A
Other(specify):
7. REMOTE ANNUNCIATORS
Type Location
8. INITIATING DEVICES
Addressable or
Type Quantity Conventional Alarm or Supervisory Sensing Technology
Manual Pull Stations 8 ADDRESSABLE ALARM
Smoke Detectors 13 ADDRESSABLE ALARM
Duct Smoke Detectors 0
Heat Detectors 5 ADDRESSABLE ALARM
Gas Detectors 5 ADDRESSABLE SUPERVISORY
Waterflow Switches 1 ADDRESSABLE ALARM
Tamper Switches 1 ADDRESSABLE j SUPERVISORY
Copyright®2012 National Fire Protection Association.This form may be died for individuai use other than for resale.It may riot be copied for ow nercial sale or distribution.
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SYSTEM RECORD OF COMPLETION (continued)
9. NOTIFICATION APPLIANCES
Type Quantity Description
Audible 10 LOW FREQUENCY SOUNDER
Visible 10 STROBE ONLY
Combination Audible and Visible 8 HORN STROBE
10. SYSTEM CONTROL FUNCTIONS
Type Quantity
Hold-Open Door Releasing Devices
HVAC Shutdown
Fire/Smoke Dampers 8
Door Unlocking
Elevator Recall
Elevator Shunt Trip
11. INTERCONNECTED SYSTEMS
® This system does not have interconnected systems.
❑ Interconnected systems are listed on supplementary sheet
12. CERTIFICATION AND APPROVALS
12.1 System Installation Contractor
This system as pecified herein has been installed according to all NFPA standards cited herein.
r—
Signed: Printed name: TONY MARTELLO Date: 2/9/18
Organization: TOCCO CORP Title: TECHNICIAN Phone: 978-408-5313
12.2 System Operational Test
This syst50r!��
g to all NFPA standards cited herein.
Signed: Printed name: TONY MARTELLO Date: 2/9/18
Organization: TOCCO CORP Title: TECHNICIAN Phone: 978408-5313
123 Acceptance Test
Date and time of acceptance test: 2/9/18 2:00 PM
Installing contractor representative:
Testing contractor representative:
Property representative:
AHJ representative: fi
Copyright 0 2012 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.
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