HomeMy WebLinkAboutfire alarm inspection report 2009Ga/e, Gad,4/an rru G*., 9no
eol Old.%oanlotqz fraad
Eliao, ga.r*oel/4 JbtaaaA4aalA, o e a f ,c
ALARM INSPBCTION REPORT
Occupancy: WindsorSkilledNursing
265 North Main Street
South Yarmouth , MA 02664
Site Contact: John Gray
Telephone (508)394-35 l4
Alarm System is a (X) Fire System ( ) Security System
Alarm System Reports to (X) Cape Cod Alarm Co., Inc.
( ) Other: Local
The Alarm System at the above location was tested, and all parts ofthe above system
were found to be, or conected to be operational,
Comments:
Date Tested; 10113109 Bv: Thomas Lese\.t
signr,rr., A-/"N-
MA Contractors License # 1592C
*lnsnllinq, Senvicinq end Monironinq o[ Srcuniry, Finr, nnd CCTV Sysrrms*
lro8l r98.6fl6 " (800) 468,8100
Fnx: Officr (r08l 198.1666 * Fnx: Crrrnnl Srnrion (t0B)760,2012
MA Licrnsr No. lI92C
Inspection and Testing Ileport
Property: Windsor Nursing Home
Transmission Type:
( ) Mcculloh
( ) Multiplex
(X) Digital
( ) Reverse Polarity
ORT( ) Master Box _
Qty of
t2
Inspection Schedule
( ) Weekly
( ) Monthly
(X) Quarterly( ) Semi-Annually
Other: Annuall()
Panel Manufacture: Firelite
Location: Boiler room
Number of Circuits: Addressable
Last date system had any service performed: 10/13109
Last date that any software or configuration was revised
Alarm Initiating Devices and Circuit Information
Model Number: MS 9200UD
Circuit Styles: Addressable
Software Rev.:
Manual Stations
Ion Detectors
Photo Detectors
Duct Detectors
Heat Detectors
Water flow Switches
Supewisory Switches
Other: Ansul system
Comments
N/A
45
Circuit Styte
Addressable
_Addressable,
_Addressable_
_Addressable_
_Addressable-
_Addressable_
_Addressable_
Pass
I
I
I
Transient Suppressors
Remote Annunciators
Notifi cation Appliances
Audible
Visual
Speakers
Voice Clarity
()
(x)
(x)
(x)
cx)()
()
Fail
()
()
()
()
()
()
()
N/A_
N/A
I
l
Inspection and Testing Report
Property: Windsor Nursing Home
Initiating and Supervisory Device Tested and Inspections
Loc. & SA,l Device Visual Functional FactoryType Check Check Setting
nkler Rm Water flow (X) (X)IA
Sprinliler Rm Tamper (x) (x)(x) (x)
N/A
N/A
Meas.
Setting
-N/A-
-N/A_N/A
(x)
(x)
(x)
()
()
()Boiler Rm Heat Det.
Ansul Switch - Tested b1, others
oke Detectors - See attached Detector Sensitivity Report.
Emergency Communications Equipment
ual Funclional
Phone Set
Phone Jacks
Off Hook Indicator
Amplifier
Tone Generator
Call In Signal
System Performance
S CommentsN/A_
N/A
N/A
N/A
N/A
N/A
()
()
()
()
()
()
()
)
)
)
)
)
)
)
(
(
(
(
(
(
(
Interface EquipmentVisual Functional Simulated Operation
Specifo _N/A
Specifo _N/A
Specifr _N/A_
Specify _N/A
Special Hazard Systems() ( )() ( )Specifo _N/A
Secondary (Stand-by) Battery
_2_ Storage Battery: Amp-Hr Rating _12_ Calculated
Calculated capacity to operate system in hours:_ 24 _ 60 _
Engine -driven Generator Dedicated to Fire Alarm System:
Location of Fuel Storage:
()
()
()
()
()
()
)
)
)
(
(
(
()
()
Type of Battery( ) dry cell( ) nickel cadium
(X) sealed lead acid( ) lead acid ( ) other
Pass Fail
Inspection and Testing Report
Property: Windsor Nursing Home
Emergency or standby system used as a backup to primary power supply, instead ofusing
a secondary power supply:
( ) Emergency system described inNFPA 70, article 700
(X) Legally required standby described in NFPA 70, article 701( ) Operational standby system described in NFPA 70, article 702, which also meets the
performance requirements ofarticle 700 or 701.
Prior to Testing
Notifications Are lvlade
Monitoring Entity
Building Occupants
Building Management
Other:
AHJ notified of any impairments
Control Panel
Interface Equipment
Lamps/LED's
Fuses
Primary Power Supply
Trouble Signals
Disconnect Switches
Ground Fault Monitoring
Secondary Power
Battery Condition
Load Voltage
Discharge Test
Charger Test
Specific Gravity
Bells
Horns
no
System Tests & Inspections
yes
(x)
(x)
(x)
()
()
)
)
)
)
)
(
(
(
(x
Visual Functionalcx) (x)cx) (x)(x) (x)(x) (x)(N/A) (X)00 (x)(N/A) (N/A)(x) (x)(x) (x)(x) (x)(N/A) (x)(N/A) (x)(N/A) (x)
() ()
Comments
Alarm Indicating Appliances and Circuit Information
Qfy of Circuit Style Qty ofStrobes 3
Speakers
Hom/Strobes 1
N/A
Circuit Style
Class B
Class B
Number of indicating circuits: 2 Are circuits supervised? (X) yes ( ) no
Chime/Strobes 12 _Class B_
Inspection and Testing Report
Property: Windsor Nursing Home
Supervisory Signal Initiating Devices and Circuit Information
Qty Circuit Style
Building Temp. N/A N/A
Site Water Temp N/A N/A
Site Water Level _N/A_ _N/A_
Fire Pump Power _N/A_ _N/A_
Fire Pump Running N/A N/A
Fire Pump Auto Position Nla- N/A
Fire Pump/Pump Controller Trbl. N/A N/A
Ceneraroi ln Auto Posirion -N/A N/A
Switch Transfer -N/A- -N/A-Cenerator Engine Running Nla N/AOther -N/A- -N/A-
Signaling Line Circuits
Quantity and style (see NFPA 72, table 3-6.1) ofsignaling line circuits connected to
N/A
Location (panel no.)Boiler Room I-abeled: BMPB
Disconnecting Means Location:
Special Procedures: _None_
Comments:
On/Off Premises MonitoringYes No
Alann Signal (X ) ( ) Supervisory Signal
Alarm Restoral (X ) ( ) Supervisory Restoral
Trouble Signal (X ) ( )
Notifications That Testing Is Complete
Yes No Yes
Building Management CX) ( ) Building Occupanrs (X )
Monitoring Agency (X) ( ) other (specify) ( )
Yes
cx)(x)
No
()()
No
()
()
System Returned to normal operation on l0/13/09 at ll:15
system: Qty. _N/A_ Style(s)
Stem Power Supplies
Primary (main): Nominal Voltage _110v Amps _20_
Overcurrent Protection: Type _Circuit Breaker , Amps 20_
None
The following did not operate corectly: