Untitled t
FIRE Iipu on afCebute EecroanSt et
bb Main S[reet
Chicopee,Me 01020
(414)594-9710
Imm594-9966
www.t,ebul..om
14,
SYSTEM RECORD OF COMPLETION
Mid loan to be canylend by ere system b allatkn wMaC«at ae bane nr system amaptaice and appmver
dahell he pemtieed to modify end form ad needed t,provide a more complew mNo,de., o.d
Weed WAk arlunusedlines.
Aaerh addRlonaf eheaa,deb,or mkulab.as nacaaasry w;enM.a canpleb..M..
Fom Compbaon0ew: Numberof Supplemental Pages Attached:
t. PROPERTY INFORMATION
Name of properly: >r u.i.�ei /1// �'
AMeun: a/ Al.n/-L a.+. A fl,J Mme. s f o!rt'
Oa pnan of Flopesty: Ra },
Name of p.opnay mpmaaebtive:
Add..:
Pheoe: Fe, E-msil:
2 INSTALLATION,SERVICE,AND TESTING MONITORING INFORMATION
ladeallnion ..mabr 1e¢f� �. a/!r✓
Amraa: fp,;j F.rf!✓�. ('-G,�epJ17 A- /�/D �i.
Fhoor ql.q .' Yr,1 n�� Fac 3ae &.nl:
sev;cenrgaaias an: Flee DC Ze / s4>r eine
Addrn:: 6L MA4.J St /74 li- ..tee. j;Vo � . a.zt �. C'
Phone: 4'�9./- 77/� Fac yr &mal:
Taring agenimtioa:
AM.
ph. Fu: &mail:
Eflevnee date to net and impatian omasm
Mooltoring orgmnahon:C. 2iwd S'e e..e f
Add.-
Pham: Ta/T—/u7/2 F. &mail:
'.. Acdadrabmber 8'9Vd Nwendebal: Fharcnumber2
Meana of vamniuion. S C
Ea,ty w wldeh awn a re; dan.mnad:At t Fboee: 37 7 —/D'?d
S. System Documentation //
Do-site locaaonof,be.,uitcd rcwsddowmemsaM aim-apeifie soft4
ware: r -
4. DESCRIPTION OF SYSTEM OR SERVICE
This is ew Va. J Modilicam to existing rystem Femsb Number.
NFFA]2 edition: 2013
4.1 Cartrol Unit T
Manufaneae.: W r/d-�S Model neeabm: rt 13 loo a
42 Software and Firmware I'
Finnwatone,don..b . T ,
4J wlarm 4erlDcaOae ' rystem done net ioearpenue aWm eadfiution.
Number of&e kms subject w slam verification: Alamvedficasionsetfm seconds
NIM re 0.e Wd
Life Safety, Security and Communication$+stems
ISO 9001:200810002152 and UL UUJS 56438
M4 Lie 1194C•CT Lic 106016•SSCO 000515
31(S-
SYSTEM RECORD OF COMPLETION(contr wito
5. SYSTEM POWER
5.1 Control Unit
5.1.1 Primary Power
I,ryin vokage ofcwtrol pave!: /,PLO )/9L)- cormol pmiclmnpr:
Ovaanwcprowmi,r: lYpo: ak ce' . Amps: ..Z C:
timvch Cvmitdmoo ciugmesu%lonlioo: ,gsy Number /�eY �7
5.1.2 Sewata,Power /
T ( n
Ypc&f ..odniy Power: SIA�r;Gl I-Y.�IL /)L,-c o
/ .-&
LDCavon,ifremob fmm the Pian[:_ �"�»e c �/},s;,
Celculrted capacity ofsvondary power b dr`iveilie ryuem:
to standby mode ikon ): .2 } In aknn modc(miwtw): �
5.2 Control Unit T
❑This vem dov not have powv cvwdv pavclz
owv ezbrdapaac6 mo ltskd on aupplenwntary shat A.
S. CIRCUITS AND PATHWAYS
Dual Media Separate
Pathway Type Pathway Pafkwrys Cku Sa Loot
Slpwling Lion 0
Devi.Paw. jJ y
Intimates Devices
Noeficavov Applixnors
Other(spvify)
T. REMOTE ANNUNCIATORS
A1
8.
INITIATING DEWCES
Addrsmbkor Akre or SwmS
Typo Q000Ny Coaw.boal S.P" .y Tbchcoloy
S.A.Du.mn &Loget
Docs Smoke Dclwbra �$ _
Heat Dnemors
Gar DMCmrs
Wm rfl wSwibh.
Swlr bas - 1 d
1mAnn2nra
Llfe Safety,Secwity and Comm-tcaboa Systems
/SO 9001:2008 10002152 and UL UUJS 56438
A"Lic 1194C•CTLic 106016•SSCO 000525
SYSTEM RECORD OF COMPLETION(cwflnuee)
9. NOTIFICATIONAPPLMNCES
Type gamtlq Dceriptiom
Audible
Vaible �SM s �A I�RC.Md4.'
Combimatiov Au bland Viable 22_ F/✓��5 {.'gym��s
10. SYSTEM CONTROL FUNCTIONS
TYPe Quantity
Hold-Opm D=Reka®mg Dews
HVAC Shmdeeo
Fi rsoke Denipm
Door UWo&ial
Elevate,Rend
Elevator Shun Trip —_..
I
11. INTEE CONNECTED SYSTEMS
7Tha system docs rot have imIOICeoIXd41 syaems
❑lmumomxud systema me linea m supplememary shed
12 CERTIFICATIONS AN D APPROVALS
121 System Installation Contractor.
This teas .twed'Krdn,
hub =iv llMucoNiogtoallbi"Astmsdarddss ciiWiteeie.
Signed Pdmn®Tc'�<.� e tt l ]aw,� Dau:
Ogemimbm: C' 11de: aC ewa0
122 System Operatlonel Test:
Thusyeem ass if ei 'hest de monSeg Well NFPA stmdarda Cited bereim
c /
sietta: adatmamkV�:v�r..J� sdd ,>/!s Date:G / 9�
O,gevivdom: '4:•r A>><: SI/.str. Title: Pmoe:
121 Ameptance Test:
Dab matime nr.enepranm teae 9-7 /dam �/.'?�
IMallwg Cantrectm,cpreamtanve:
Tctmg Cwm m,,ePresev04ve
Pmpcay,Wmsamative:
AHJ npresnutive:
NPPAT3p3of3
Life Safety,Security and Communication Systems
ISO 9001:200810002152 and UL UUJSS6438
AM Lic 1194C•CT/rc 106016•SSCO 000525
FIRE Division o1 CebWm
aEle Mi. Corp.et
bb Main Street
Chimpee,Ma 01020
0 nO (4 )594-7116
IIII'11Y1J1 Fu(41313)594-9666
www.cebula.com
POWER SYSTEMS
SUPPLEMENTARY RECORD OF COMPLETION
Thio Ism M e supplemerrt fo Me System Remdol Com➢bf4x,. V Iddon Hstema end wmponnos s auflc
mpowersysiernc Matin ,,row gwsvnos UPS systems rcnroro bdou,syssems oroMer cwrybx powreyamms
Tom loan b be ccrnpond by dr system indNlallon mrbartor et the ante a/sysson acceptance and approval.
It sh"eopermftlMb modaythtl W nee091 M provin amore complete arlror doormcord
/ � �IJrW/�,,/WAN aN unused fins
Fame Comosdon Daley NumbnoFSupplemnr1RPsges Anacbad:�_
1. PROPERTY INFORMATION // ,,
NameafprVsa, �-@.
Address .2 r O ac� e f A/e:� .rrn�f iv.a1 /f/rl• O/O L a
2. SYSTEM POWER
2.1 control Unit
2.1.1 Primary Power
Inputvoltage of mnholpanel: rt.;—a vlyd Comeclpanlrops:
Ovenorrcneprouro.n'. Asn': d-6
uti
Loan(ofprimery Supply panel burd) 13,.rOL P )L. �A9
Discormetng mean location: Pa-.sae 1�1 [• —'/ -�"'l
2.1.2 Engine-Driven Gescralaou � /^
Lvionofgenerroc ,
Locarim offucl swrage: Type of Fed:
2.1.3 Ualnceruptabie Prinary Pewee /
Fgmpmmt powered by a UPS syromi N/f1"
I aorw of UPS Hstem:
Calculated uprtiry of UPS batteries m drive the syrtcm compamh camandto it
In shndby esode(bora} Io ilrm mods(mmmesy
2.1.4 Batteries
Laatioa�i/fOVC !/3NL1 '1)pe:�flNamioel volm6a. �'� Amdhovr nung:yl, �
', Ca1NIerM capacity ofbasrerin addve the Hrem:
II
so"
mode(hours): 24 In drm mode(minmes): .4
'.. NBacleries arc corked with dew a(mmufumre ❑Battry cdculaliossaresmched
2.2 In-Building Fire Emergency Voice Alarm Communleetlon System or Maes Notification System
2.2.1 Primary Power I I n
IoputwIu,cofEVACSorh Spancl: N /l- EVACSorM Spaoclampe:
Overcmrentprdectiov: Type: Amps:
I fion(ofmimery supply yoe@coof):
Diacomedng man bmGps:
sePPnnv.l an
Life Safety, Security and Communication Systems
ISO 9001:100810001151 and UL WJSS6438
MA Lic 1194C-CTLic 106016•SSCO 000525
POWER SYSTEMS(rnntlnuadJ
2 SYSTEM POWER(contlnpodf
2.23 Eepne-Driven Generator )
Locationofgcromm':
Luationoffuel uwa,c, Typcaf Fucl:
2.23 Unin[mrwptoble Primary Paws
Equipment powesN by a UPS aysmm:
Location afUPS system:
CalwlstM capacity of UPS batteries m drive the sysion cumponemts connected In it
In standby mode(bourn): In.lases mode(mimeses)',
21.4 Batkries
Location: N�i�- Type: Nommulaimagr. .4mpheursati.,
Cdalaud capuity c flummics to drive the synem:
In standby mode(hours) Indmmmode(eires :
2.2 Notification Appliance Power E Isnder Penalty
❑This system does rot have pow=Wonder pe Js.
2.2.1 Primary Power
Ivput valueotpowa exlemda pamel(c):�.2(7 Power extsadmpondampa:
rcnm �D
Oveentpronction: Type: &A- A , Qom' « Amps, a0
Loatian(of Prhnary supply pmdboard): /STG >-7L _0'Al
Disconsctin'means locance swe et 1"'>" 37
23.2 Eayimr-Drives Genres.,
Locanonof generemr. /J //�
Locatia t of fuel stare's: Typo efFeal:
241 Uninterruptable,Primary Power
Equipment powered by a UPS system: �
lACRlan Of UP$tyRmn:
l ioauad capacity urUPSbaue.ies to drive the systen=io ousua cvsnooed no it
In standby mods,(hmsa):_ _. _ _._ Io alum me&no mtes):
21.4 Batfmla
C D I
Lactim iS'N P.9vK / Type: b / Nwoival voltage: {.,2— AmpNom mting:�
Ca4vWcd capacity afhatheries so done the
In stmdby condo(hours), .2— Indannmadc(mfmJa):
See Main System Reardof Comple onforaddidon4information,c tiriiwdonsmdappvo h.
tannyrpv
Life Safety, Security mid Communication Systems
ISO 9001.200810001151 and UL UUJSS6438 -
Md Lic 1194C•CTLic 106016•SSCO 000525
I
FIREA D s prt ofCeba a Elee6 a iCorp
fib Main
e Street
Chicopee,Ma 01070
710
OEM
(413)594-77
Faa 1413)594- 710
9866
.cannm.eam
NOTIFICATION APPLIANCE POWER PANEL
SUPPLEMENTARY RECORD OF COMPLETION
This fom,is a se voeent b Me Syslern Record a Compklianll in Jedw a lief N*pas and knobees
of rofifraribn appdsnnv power ertembrpanels
Thiel ,,to be completed by M.syEfemmhalanan cmdracbr at no fen.ofsystem aooeptann.and appmual
N Krell be ponnnVetlft,modify Mis l as needed to ve,,da a more Mmehes ana0d,dwrraceld
lnyerf IJ/AIn all unuEed Grres
q
Form Camplegdn Dab: Ai. /� Number of Supplemenlel Pages Aewhad: J
1. PROPERTY INFORMATION �/
Name ofp neafty: SPre Y' ,eC e_ AIC _
nmduE: � f aR n-„ld�.e DR.}UL �✓oxeuiAMDFa-�✓ /H/9 .6 /aha
2 NOTIFICATION APPLIANCE POWER E%TENDER PANELS
Mate Pad Madel Lawtlae Alv Bavad P.; SM.
�3 d- E u a < ontc Ckt 3
See Main System Rem.A of Co mpletion for addih...I idbrmali.q car fn.fi—add approve lE
Life Safety,Security and Communication Systems
ISO 9001:200810002152 and UL UUJS 56438
MA Lic 1194C•CT Lic 106016•SSCO 000525