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Home My WebLink Aboutsprinkler and alarm test report Apr 2024YARMOUTH FIRE DEPARTMENT FTRE SPATNKLER & EIRE ALARII |EST REPORT INTEGRITUS HEALTHCARE WINDSOR & REHAEILITATION CEIITTER IYAI'E OF PREI'ISES: ADDRESS: |ELEPHO EIU BER: 265 NORTH MAIN STREET. SOUTH YARMOUTH. MA DIRECTOR OF @fr|nol PA ETS A flUIICUTORS SIA T>BY BAITERTS S''OTE DE'ECTORS HEAT DE|EAORS PULL STATIO S BELLS/HOR S SPRT KLERS TA'TPER S'JIrcHES qRBOIt "O OXTDE SERWCE CorfirEfils: .oK .. oK /- )/1 SERWCE SERWCE SERWCE SERWCE SERWCE SERWCE SERWCE SERWCE SERWCE SERWCE OK 7.1. _oK _oK I OK OK _oK OK -/ H-/ 4- .l ,lt _oK z4 I MICHAET K.T,IAHANEY HAUET I;PECTED WINDSOR NURSING & REHABITITATION CENTER OI AIID THE AEOYE TESTEO IIE'15 ARE WORIAfrG PROPERLY ACCORDI G TO 'IA'TUFACruRERSRE@I"IE DAiIOfrs TflSPECTORS STG AruRE: COI'PAIIY 'IAIIE A D ADDRESS:MKM FIRE TECHNOLOGTES. I C. Z+263-5924r7+263-59An 2 TABER STREEI. FAIRHAVEN. FORM 1993 RECETVED BY YARI1OUTH EIRE DEPARTEEflT: 02719 7l' 7r\T./\ MATNTFNAN'F 4 ?4 t/ - 4. ,<,t DAfE: tTE COPY: MKM OffiCE , ELLOW COPY: Customer PINK COPY: Fire Dept MKM TEST INSPECTION AND SERVICE DIVISION $g9[ ffi & 2 TABER STREET FAIRHAVEN, MA 02719 774 - 263 -592 4/774 -263- 5930/ EHAIL : m kmfrE Echnologas@con cast. rE t SPR Iil KL ER,/ FTRE A LA R I' SYSTET' ilISPECTTOil REPORT ***In rrentory of LL Erian Sulliuaa. Sqnd47 FD y******In mcrnorrt of drlcf S@ttqsofl of the SmeBeq ,4A llre R€5,c/rre Oqartmdrt***** *fn memorl of Firellghhr Russ Hor.t of thc t!6u Aadbr4 l,U Fire Rg5'ctto Dwftrnqrt** * TNTEGRTruS HEALTHaRE CUSTOMER IIAME: ADORES: COI,ITACT: TELEPHq(E: DATE OF INSPECNON-, Of TNSPECEON: RErcRT*: WINDSOR NURSING & REHABIT CENTER 265 NORTH MAIN STREET YARMOUTH . MA 02654 FACILITY DIRECTOR FORTY.FIVE (45) 2202q ACCOUNT #: WNH/S Fl13-4 ONE OF FOUR 6.t4\ Emember 9,/17ffiffi EIRE D EPARTMEI|I r COiTTACTED : ETRE DEPARTMENT TELEPHOIYE #: FIRE DEPAR TME4IT CONTACT: ERE DEPARTMENT HAIUI,IG ADDRESS: CEIV 7RA L STA EOI! CO N TA CTED : CEIIIIRAL STANON TELEPHONE *: YARMOUTH FIRE RESCUE DEPARTMENT 508-398-2 72 FIRE P NTION BUREAU 96 OLD MAIN STREET-SO. YARMOUTH.MA 026& CAPE COD ALARM COMPANY 800<68 FOR CENTRAL TION ONE WET SPRINKLER ALARM FOR ENNRE FACILITY T & LMTION:COMMUNICATOR/PRIMARY & SECONDARY PHONE LINES TO ; TYPE OF SySTEM/S: MA'|ER/RADTO tuX DIALERS LOCATED AT INDIVIDUAL P EL / FIRE ALARM AND CARBON E PANELS EIRE AtARt4 CONTROL qANEL - MAKE/MODEL/LOC4AOA|:FIRELITE MS92OOUD FOR FIR ALARM P LOCATED AT lST FLOOR MAIN E E FOYER IIIOTE***PUT JUMPER IN TERMIIIAL ELOCK DIRECNY ATTACHED TO AURM REUY FOR OOOR OJ948LE**INOTE***ruR SILEIYT TEST DI,4BLE NAC CTRCUITS 1 IHROL\GH 4*** NOIE'/COMMENTS: ITISPtrTORS NAME: PRESIDENT: UCEI$E #5: MICIAEL K. IIAI] ETM SpRItgQER CO T44CTOR *N7102 / tA S?N\WLER -tOUENEmrA l *OO36g/RtpE IStAt@ sPRIt*lER @ |RAAOR #N@358 / RH@E EUND SaRIflKLER JOUNEY1TUN #R10006714A ERE &ARn COTVTRAAOR *835C,/ ,/t ERE AURM tEOlMCAtt #1*3D / rA SrcURITy SyS- fEtls #001512 / M./l DEP BACKFI-OW fESfER #4376 / l,lEW El,lGLA lD WAIW WORKS &qO( f,OW REPAIR #2562 265 NORTH MAIN STREEI SOUTH YARMOUTH, MAWINDSOR NURSING REHAB PAGE 1 FD Y343 FIRE TECHNOLOGIES, INC. .888.658.FrRE (3473) SPRINKLER/FIRE ALARM SYSTEM INSPECTON REPORT DEWCE TYPE FACP AIVNUN FS WFPS OEB 73 ITV W6 DCEP ftTNIV b. Date c. Report Filgd? DESCRTPTIOAI FIRE ALARM PANEVRADIO BOX REMOTE ANNUNCIATOR WATER FLOW IND SWITCH WATER FLOW PRES SWITCH OUTSIDE ELECTRIC BELL TAMPER SWIICH WET PIPE VALVE INSPECTORS TEST VALVE WATER MOTOR GONG DOUELE CHK BACKFLOW STD PUMPER CONNECTION a. Model: Y EJ NAEN t]Y[INAENE TOTAL OTY OTY TESTED ACTIY'TEorz RESET OK? 1 1 1 1I zI 1 1 1 _1 THIS IIYSP Y Y NAtr]N E Y NAEN E Y NAEN E Y NA EN [:] Y NAEN D Y NAEN f] Y NAEN E Y NAEN E Y NAEN N Y NAEN E Y NAEN E Y S PRITY KL ER S YS TE M I N FORMA TIO tV 1. CETERAL a, Is the building or praiis€s presently ocxup'ted? b. Is the occupa ncy class Sarhe as previous inspection? c. Are all applicabb systems in service and in normal condition? d. Are all applicable systerns the same as the previous inspection? e. Is the building cornpletely covered with automatic sprinkleB? f. Are all new additions or buildings also sprinklered? g. Is all storage/debris properly stored away from sprinkbr heads? h. Was the property free from fire since the last inspection? I. Are areas covered by wet sprinkler piping properly heated? 2. rAilKS. putq?s. EnRE OEpr. CdVnECnOilS b. Are fire departnent pumper connections in satMactory condition, couplings free, cap6 present, check vafues not leaking? 2 1/2" Siamese located outside East to right of Main Entrance 3. WET SYS|E t a. Are cold ryoi+fFf Ialves i1 t[e proper open/closed position? b. Are anti-fteeze systems irt oFralirp condition? c. Are alarm valves, waterflow indiiators and retarding chambers in working order? Number of wet systems: Make/Model: 4. ALARTI' a. Water motor ggng test satisfactory? b. Electric device (bell, hom, strobe) test satisfactory? c. Supervisory algfm service test satisfacory? a. Date internal qxam ucted : JULY 13,2022 b. Next schod m? JULY.2O27 4b. FIRE Y NA NA YENAE [I rue5ru 3f:]NADN ENAEN NNAEN ENAEN N NAEN NNA[f N E NAf]N E N N N NAE NAE NAE N N N E nufactu rer:Ames Size: 4" inch Results ofTests: PAAS Results: Serhl #: 01386 FNLYE 26s NORTH [tlAIN SrB sorryf Y4BMaffitfWINDSOR NURSING REIIAF infernql 71 PAGE 2 N Frr litA NAENENAENE NAE]N ENAEN NNAEN f]NAEN ENAIIN flNAEN ENAEN DNAEN ENA-]N E E L/ /,_ /j+-r- T oNE (1) GEM 4" WET ALARM VALVE IN BASEMENT SUPPLY ROOM .888.658.FrRE (3473) 5 PR I NKL E R S YSTEN TN rcAUA TIOIY 5. SPRIflKIERS ATID PIPilrc a. Sprinkler heads in good condition, not obstructed and corrosbn free? b. Are all sprinkler heads less than 50 years old? c. Extra sprinkhr heaG, sprinkler wrerrch and catinet readily available? d. Is the condition of sprinkler piping, drain valves, hangeE, pressure gauges, open sprinkler headg strairrers, satisfactory? e. Are all sprinkler heads of the proper temperature rating? f. If present. is the system hand hose grid in grood condition? g. Are any existing autornatic sprinkler heads presently listed in any manufacturers literature regarding recalls or volunta ry replacet nent? h. Are there any 3/4' or smaller endlines present on piping grd? If yes approximate o/o of system: 0olo SMINKLER/FIRE ALARM INSPECTION REPORT NA NA NA E FIRE TECHNOLOGIES, INC. Y Y @Ba EEfl Ea N N N N N N N N d STGTI NONOYESYESOSY NA NA NA NA NA NA NA NA N N N 6.YALYES a. Are all sprinkler systern main control valves and all other related sprinkler valves in tie appropriate open/cbsed posiuon? b, Are all sprinkler systern control valves sealed or supervised in the appropriate open/closed position? c. Are all valves in good condition? CITYCONNECTION: arY 2 rYaE SUPERYISED OPEN IOCK 7. WATER FLOW TEST RESULTS a. City/Municipal water supply PSI: b. Was water fbw test performed and resuhs satisfactory? TEST PIPE LOGTTON:" MAIN DRAIN TO ESTIC CONNECI-ION IN AD]ACENT M o-b5 2 DICAL TEST PIPE ORIFICE SZE: STA77C PRESSURE BEFOR E: RESIDUAL PRESSUR E DURITIIG: STATlC PRESSURE AFTER: GOOD RECOVERY? Y E] OWIN NV'S UTTUZED? MAIN DRAIN VALVE OK? MD COND.? ALARM ACTIVANON 77ME II! SEC? RNAffNE d *ENE N 2" INCH N -nfa.* * *fnspettors fe5t Co0nection frrJi.lc pade tRoom #A-t,s* NOTES/COMIVIENTS: ft*NKt Fir.e Tahnologies, In . b,{,€5 tlris inopccbbn oo t te fact that ,rre pr5ant syrbm/s vqe brstztted arrd approtd bf ,rre AH, for t E occuwncf lor whkh h wor dqigncd.r, * STAIE OF MA LIFE SAEETY ADDMONS: a. Were sprinkler s]6Hn @ntml valv6 workd and tuw? y b. Have sprinkler sys@m ptusure gouges fun catibntd/rcplad? y Date of Glifuafun/Replacdnent: luly e 2022 Nert: July 13, 2027 c. Have sttkes with info bet fud on or nei,r gaug6? y d. Have sysbn ri*r bg/s ben u4atd aN pstd awmpriatety? y e. Tm6mission of abrm to central shtfun? y Ef]E NA NA NA NA NA N N N N N 265 NORTH MAIN STREET SOUTH YARMOUTH, MAWiNDSOR NURSING REHAB PAGE 3 NAffNE q{a q Speciatizing in Inspection, ,lesting and StLaiatenance of Water Gdse[ lFire Srotectrbn an[ _A utomatic lFire r4tarm Slstems WIIIDSOR NURSING & REHAB CEI\TTER. Yarmouth Fire Dept: 508-398-2212 265 North Main Street South Yarmouth, MA 02664 Maint 508-39-3514 Bo Cape Cod Alarm: 800468-8300 Test: Jan, Apr, Jul, Oct DEVICE APR ]UL ocr FIRE ALARM CONTROL PANEL l-Firelite MS-9200 UD FACP Located in Basement Boiler Room OK OK***Breaker for FACP in Electrica ler Room EMPB #35*** 2-72V 18 Am Hour Located near FACP Basement Boiler Room otd FACP OK OK***New Batteries 0*r* Fire Alarm Panel eO ut 25.8 25.0 AUTOMATIC FIRE ALARM CONNECIION 1-D I Dialer to Ca Cod Alarm Central Station Acct. #6-0206 OK OK S nal Transmitted to Central Station?YES YES REMOTE ANNUNCI,ATORS 1-Firelite Front Main Entrance OK OK ADDRESSABLE SMOKE DETECTORS 1-D001 - Easement Hallw OK 2-D@2 - Basement Hallw OK 3-D003 - Basement Hall OK 4-D004 - Basement ffice OK 5-D005 - Basement Hallwa OK 6-D006 - Basement Ha OK 7-D007 - Basement Hallw OK 8-D008 - Basement Hal OK 9-D009 - Basernent OK 10-D010 - ls Roor Elevator Machi Room Recall Present OK 11-D011 - I't Floor Hall Oubide Patient Room A-1 OK 12-D012 - l't Floor Hallw OK 13-D013 - lc Flmr Hal Outside Patient Room A-7 OK 14-D014 - l't Floor Near A Win Nurses Station OK 15-D015 - 1* Flmr Hallway Near A Wing Nurses Station OK 16-D015 - I't Floor Hallway Outside Patient Room A-12 OK l7-D077 - 1't Floor Hallway Outside Patient Room A-16 OK 18-D018 - lst Floor Hallway Outside Patient Room A-18 OK 19-D019 - 1{ Floor Hallway Oubide Patient Room A-20 OK 20-D020 - l't Floor Hallway Oubide Patient Room A-24 OK 21-D021 - 1st Flmr Wndsor Dining Hall OK PAGE 1 OF 3 IE Outside Patient Room A-5 Itlt JAN I t i tt F DEVICE JAN ]UL ocT ADDRESSABLE SMOKE DETECTORS continued 2-D022 - 1't Floor Windsor Dini Room h OK 23-D023 - l't Flmr Windsor Dinin Room OK 24-D024 - l't Floor Windsor Dinin Room OK 25-D025 - 1st Floor Main Dinin Room OK 26-D026 - 1't Floor Main Dinin Room OK 27-D027 - 1.t Flmr Main Din Room OK 28-D028 - 1'r Floor Hall Outside Diet Kitchen OK 29-D029 - 1st Floor Main OK 30-D030 - 1't Floor Admissions Office H h OK 3f-D031 - lst Floor Hallwa Outside Kitchen OK 32-D032 - 1.t Floor Elevator No Recall Present OK 33-D033 - l't Floor Hallwa Outside Patient Room B-24 OK 34-D034 - lst Floor Hall Oubide Patient Room B-22 OK 35-D035 - 1't Flmr Hall Outside Patient Room B-18 OK 3GD036 - l't Floor Ha Outside Patient Room 8-16 OK 37-D03 7 1 FI Hallwa Outsade Patient Room B-12oor OK 38-D038 - 1st Floor B Wi Hallwa OK 39-D039 - l't Floor B Wi Ha Near Nurses Station OK 40-D040 - ln Floor B Wi Hallwa Near Nurses Station OK 41-D041 - 1.t Floor Hallw Outside Patient Room B-7 OK 42-DU2 - lst Flmr Ha Outside Patient Room B-5 OK 43-D043 - l't Floor Hallwa OuEide Patient Room B-1 OK 44-DU4 - ln Floor Hallwa Near A Rear Exit OK 45-D045 - 1't Flmr Hallwa Near A Bath Hal OK.+6-D050 - Basement Mechanical Above FACP OK ADDRESSABLE HEAT DETECTORS 1-D046 - Basement Boiler Generator Room OK ADDRESSABLE DUCT SMOKE DETECTORS 1-D080 - Kitchen Roof To Unit Dini Room Ceili net ADDRESSABLE MANUAL PULL SIANONS 1-M061 - Basement 2-M062 - Basement 3-M053 - ld Floor A Wi Rear Exit 4-M054 - lst Floor Main Area 5-M065 - 1't Floor Kitchen 6-M065 - l$ Floor A Win Street Side 7-M067 - 1"t Floor A Win 8-M068 - 1$ Flmr A Wi 9-M069 - Windsor Room 10-M070 - 1st Floor B Win l1-M071 - 1n Floor Elevabr Lob l2-M072 - I't Flmr B Win Street Side AUTOMANC FIRE DOOR RELEASE MAGS 1 -Basement Hall Oulside Em Break Room 2 OK 3 4-Basement Hal Oubide Administration Office z OK 1st Floor Hal5 Oubide Patient Rooms #A10 & #A9 2 OK OK78-1't Floor Hall Outside Patient Roor6 #A16 & #A17 2 PAGE 2 OF 3 APR 13-M073 - 1't Floor Dininq Room ----r---f___l I] I l I -l = ---t = T_--t I rT___l tt L APR ---t + DEVICE AUTOMATIC FIRE D@R REI.EASE MAGS continued 10-1't Flmr Hall Outside Patient Rooms #A24 & #A25 OK 11 12-1< Floor Main Dini Room OK 13 14-1" Floor Hallwa Outside Patient Rooms #824 & #825 2 OK 15 16-1't Floor Hall Outside Pati Rooms #818 & #819 2 OK 77 18-1't Floor Hall Outside Patient Rooms #89 & #810 Z OK D SUAL NOTI DEVICES 1-Basement Laund Room 2-Basement Hal Outside Em Break Room Chime & Visual 3-Basement Hal Outside Adult Care SeMc6 hime & Visual 4-Basement Hal Outside Thera Office Chime & Visual 5-1d Floor Ha Outside Patient Rooms #86 & #88 Chime & Visual 6-1.t Hall Outside B Wi Clean Util Room Chime & Visual 7-1.t Hall outside Patient Rooms #821 &#823 chI &vis ame 8-1'r Floor Kitchen Horn & Strobe 9-l* Floor M in Dinin Room Strobe On OKI1't Cei Room #A24 Horn &OK 1 Ha I Patient Room #A17 & Strobest OK H Ortside A Wi Room & Shobest Floor Hallwa Outside Patient Rooms #A8 &A6 H &Strobeslorn OK SPRINKTER SYSTEM IPMENT _SPRINKLER RT 30 Minute Batte Back-u Test No AC Power OK Load Test on Ba After VOLTS _)( VOLTS _,OK 1-Kitchen Ansul Alarm to FACP OK l-Smoke r Sensiti Test Com 4-12-23 Next:2028 w@rflTrEil @ETrerrer Noted Prouem/Defi ciencies/Comql?nb /1)a TTL([ut 4/t /, "x ,4 Technifien Narne S Sisnature P|FE I OF 3 2 TAB$R STRFET, FAIRHAVEN, MA O?7IO Date 77 4.263.5924 or 774.263. 5930 or mkmfi retechnologies@cqfncast.net =lr IqK OK t- I I I tl Er___l I r-_r---t foK -. /YAt44 w &-q .9pecuf*ing in tnspection, (ening and *ldint nai.e of 'I lhtel .thsed,Iie :ilote.uon nni:Lutotutit ,Fie Ahrm SJstens rcmembe, 9111 - 343 Bo WINDSOR NURSING & REHAB CEIi'TER 265 North Main Street South Yarmouth, MA 02664 s08 394-3514 NOTES/COMMENTS: Yarmouth Fire: (508) 398.22L2 Cape Cod Alarm Company 800-468-8300 Account #: 6-1032 TERLY APRIL 2024 DEVICE APR DEVICE 1-Silent IFP-50 Control l%nel @ Front Main OK Entrance Room1CMD Basement Laund OK CMD Basement Furnace Room CMD BasenEnt Boiler Room OK2-72 Hour in Panel Cabinet CMD Kikhen Area OKLoad Test Results: 1 -HourVolb OK 2 -,' Vdb /.^ AmpHour OK Install - 2023 NEfl 2026Date of **rThese particular devices a**+Cape Cod Alarm Company re not tied into the main fire alarm control ponel.++* 800-468-8300ta * Account #61-032 r rltct2)Zz- y' t )lo\t-/t\Ey u/i//t //4,/ra//- a, -ms/ Technician Nanxe & Signature PAGE 1 of 1 2 TABER STREET, FAIRHAVEN, MA 02719 Date of E)Gmination 774.263.5924 or 774.263.5930 or mkmfiretechnologiB@comcdt.net I - APR CARBONE MONOXIDE CONTROL PANEL CARBON MONOIDE DETECTORS OK BATTERIES