HomeMy WebLinkAbout26F Sep 20265-\c%, Vo-,-*rrr,"o/rrl "/ a//r**.lr*m
V./y /r-/rr,r, n7 k |/o , r, nrrtl
FP{07C
(Rev. 1.1.2015)
+ Return completed applicalion to:
APPLICATION FOR CERTIFICATE OF COMPLIANCE
FOR SMOKE DETECTORS AND CARBON MONOXIDE ALARMS
M.G.L. CHAPTER 148, SECTIONS 26F, 26F1N
South Yarmoulh Date ogt03t2026
Application is hereby made for inspection of smoke detectors and carbon monoxide alarms as required by
Massachusetts General Law, Chapter 148, Sections 26F,26F112 and 527 CMR 1:00 Section 13.7.
NOTE: SUBMIT APPLICATION TO LOCAL FIRE DEPARTMENT HEADQUARTERS
\
f
Location of Property 87 Highbank Rd
Owner of Property Jayne Cash
Signature of Applicant
lnspection/Testing completed on 09t03t2026 By:r Utr--
Fee: (i.4.G.1. Chapter 148 Sec. 10A)$50.00
Note: Any certificate issued in accordance with provisions of M.G.L. Chapter 148, Sections 26F. 26F'12 expires sixty (60)
days after issuance by head ofthe Fire Department.
FIRE DEPARTMENT'S COPY
City or Town
1Number of Dwelling Units
Fire chief
-