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Based on a tour of the Dorchester General Hospital facility, it was determined that
approved materials capable of limiting the transfer of smoke were not provided for the annular spaces of the duct penetrations of walls enclosing the Mechanical Room on the Third Floor. (19.3.2.1, 8.2.4.4.1)

Based on a tour of the Memorial Hospital at Easton facility it was determined that appropriate repairs are required to replace the missing detector head for the smoke detector installed in the chute room at the Birthing Center - Fifth Floor - East Building. (19.3.4.1, 9.6.1.4) Also, all fire alarm, detection and suppression system devices which have been disconnected and discontinued from service throughout the building shall be removed so as not to be obvious to the public, or shall be inspected, maintained, and returned to approved service. (9.6.1.4, 4.6.12.2)

Based on a tour of the Dorchester General Hospital facility, it was determined that approved automatic sprinkler protection was not provided for the O. R. Locker Room toilet - Third Floor; for the Blood Draw Room in the Lab - Ground Floor; and for the ED Linen Storage Area - Ground Floor in accordance with NFPA 13. (19.1.1.4.5, 18.3.5.1)

Based on a tour of the Memorial Hospital at Easton facility it was determined that the approved automatic sprinkler protection was not extended into the new storage area adjacent to the exit access corridor on the Fourth Floor - East Building in accordance with NFPA 13. (19.3.5.3, 9.7.1.1) Additionally, appropriate repairs must be completed to the O. S.& Y. control valve on the system side discharge pipe of the fire pump to eliminate the leak from this valve. (19.3.5.2, 19.7.6, 4.6.12.1)

Based on a tour of the Dorchester General Hospital facility, it was determined that appropriate repairs must be completed to damaged sprinkler head escutcheons and adjacent ceilings to ensure the proper placement, position, and protectin of sprinklers throughout the building in accordance with NFPA 13. (19.7.6, 4.6.12.1)

Based on a tour of the Dorchester General Hospital facility, it was determined that appropriate verification was not provided to indicate the installation of approved devices to shut off the fuel to all cooking appliances beneath the hoods in the Kitchen upon activation of the fire protection system for the hood. In addition, appropriate verification of the operational status of the kitchen hood extinguishing systems shall be verified in accordance with NFPA 96. (19.3.2.6, 9.2.3)

Based on a tour of the Dorchester General Hospital facility, it was determined that
approved materials capable of limiting the transfer of smoke were not provided for the annular spaces of the duct penetrations of walls enclosing the Mechanical Room on the Third Floor. (19.3.2.1, 8.2.4.4.1)

Based on a tour of the Memorial Hospital at Easton facility it was determined that appropriate repairs are required to replace the missing detector head for the smoke detector installed in the chute room at the Birthing Center - Fifth Floor - East Building. (19.3.4.1, 9.6.1.4) Also, all fire alarm, detection and suppression system devices which have been disconnected and discontinued from service throughout the building shall be removed so as not to be obvious to the public, or shall be inspected, maintained, and returned to approved service. (9.6.1.4, 4.6.12.2)

Based on a tour of the Dorchester General Hospital facility, it was determined that approved automatic sprinkler protection was not provided for the O. R. Locker Room toilet - Third Floor; for the Blood Draw Room in the Lab - Ground Floor; and for the ED Linen Storage Area - Ground Floor in accordance with NFPA 13. (19.1.1.4.5, 18.3.5.1)

Based on a tour of the Memorial Hospital at Easton facility it was determined that the approved automatic sprinkler protection was not extended into the new storage area adjacent to the exit access corridor on the Fourth Floor - East Building in accordance with NFPA 13. (19.3.5.3, 9.7.1.1) Additionally, appropriate repairs must be completed to the O. S.& Y. control valve on the system side discharge pipe of the fire pump to eliminate the leak from this valve. (19.3.5.2, 19.7.6, 4.6.12.1)

Based on a tour of the Dorchester General Hospital facility, it was determined that appropriate repairs must be completed to damaged sprinkler head escutcheons and adjacent ceilings to ensure the proper placement, position, and protectin of sprinklers throughout the building in accordance with NFPA 13. (19.7.6, 4.6.12.1)

Based on a tour of the Dorchester General Hospital facility, it was determined that appropriate verification was not provided to indicate the installation of approved devices to shut off the fuel to all cooking appliances beneath the hoods in the Kitchen upon activation of the fire protection system for the hood. In addition, appropriate verification of the operational status of the kitchen hood extinguishing systems shall be verified in accordance with NFPA 96. (19.3.2.6, 9.2.3)