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FP{07C
(Rev. 1.1.2015)
a Relurn completed application to:
APPLICATION FOR CERTIFICATE OF COMPLIANCE
FOR SMOKE DETECTORS AND CARBON MONOXIDE ALARMS
M.G,L. CHAPTER 148, SECTIONS 26F, 26F1/2
City or Town Ya.mouthport Date 09/03/2026
Application is hereby made for inspection of smoke detectors and carbon monoxide alarms as required by
Massachusetts General Law, Chapter 148, Sections 26F, 26F 112 a d 527 CMR 1 :00 Section 1 3.7.
NOTE: SUBMIT APPLICATION TO LOCAL FIRE DEPARTMENT HEADQUARTERS
Location of Property 4209 Heatherwood
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Owner of Property Clinton Parker
Number of Dwelling Units Signature of Applicant
lnspeclion/Testing completed on 09103t2026 By ,l
Fee: (M.G.L. Chapter 148 Sec. 10A)$s0.00 Fire Chief
Note: Any certificate issued in accordance with provisions of M.G.L. Chapler 148, Sections 26F, 26F112 expires sixty (60)
days after issuance by head ofthe Fire Department.
FIRE DEPARTMENT'S COPY
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