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FP{07C
(Rev. 1.1.2015)
APPLICATION FOR CERTIFICATE OF COMPLIANCE
FOR SMOKE DETECTORS AND CARBON MONOXIDE ALARMS
M.G.L. CHAPTER 148, SECTIONS 26F, 26F1/2
City or Town South Yarmouth
Application is hereby made for inspection of smoke detectoG and carbon monoxide ala.ms as required by
Massachusetts General Law, Chapter 148, Sections 26F,26F112 and 527 CMR 1i00 Section 13.7.
NoTE: SUBMIT APPLICATION TO LOCAL FIRE DEPARTMENT HEADQUARTERS
Location of Property 8 Viking Rock Drive
I
Owner of Property Tina Costa
Number of Dwelling Units Signature ofApplicant
lnspection/Testing completed on 09t03t2026
Fee: (M.G.L. Chapter 148 Sec. 10A)$50.00 Fire Chief
Note: Any certificate issued in ac@rdance with provisions of M.G.L. Chapter 148, Sections 26F, 26F112 expires sixty (60)
days after issuance by head of the Fire Department.
FIRE DEPART]ilENT'S COPY
a Retum completed application to:
Dare 09/03/2026
1
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