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YARMOUTH FIRE DEPARTMENT
96 OLD MAIN STREET
SOUTH YARMOUTH, MA 02664
PH.: 508-398-2212 / F AX: 508-760-4861
F!RE AND SAFETY INSPECTION REPORT
ADDRESS OF INSPECTION:
n YARMoUTH PoRT SOUTH YARMOUTH
DATE PHONE:
OWNERS MAILING ADDRESS:
An inspection ofthe above captioned property was conducted by the undersigned during which the following
fire or safety deficiencies (D) or violations (v) were observed and noted for correction:
You are hereby ordered to abate or correct the deficiencies or violations within
so may result in civil and / or criminal complaints being filed.
Copy Received By
days. Failure to do
FBP 99-1
NAME:
E WEST YARMOUTH
E owNER fl MANAGER n TENANT OTHER (exptain):
TIME:
NAME:PHONE:
Signed:
Original - Owner / Tenant Yellow Copy - Fire Department
Title: