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FIRE AND SAFETY INSPECTION REPORT
ADDRESS OF INSPECTION;
E YARMoUTH PoRT
! OWNER D MANAGER E TENANT oTHER (explain)
DATE PHONE
OWNERS MAILING ADDRESS:
An inspection of the 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 beinq filed.
days. Failure to do
Original - Owner / Tenant Yellow Copy - Fire Department
Title
FBP 99 ]
YARMOUTH FIRE DEPARTMENT
96 OLD MAIN STREET
SOUTH YARMOUTH, MA 02664
PH.: 508-398-2212 / F AX: 508-7604861
NAME:
E SOUTH YARMOUTH ! wEsr YARMoUTH
TIME:
NAME:PHONE:
I u
Signed: (
Copy Received By: