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FP{07C
(Rev. 1.1.2015)
a Retum completed application to:
APPLICATION FOR CERTIFICATE OF COMPLIANCE
FOR SMOKE DETECTORS AND CARBON MONOXIDE ALARMS
M.G,L. CHAPTER 148, SECTIONS 26F, 26F1N
City or Town West Yarmouth oqtMt2026
Application is hereby made for inspection of smoke delectors 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
300 Buck lsland Rd 14C
a
Owner of Property James Skinger
Number of Dwelling Units Signature of Applicant
lnspection/Testing completed on 09t04t2026
Fee: (M.G.L. Chapter'148 Sec. 10A)$50.00 Fire Chief
Note: Any certificate issued in accordance with provisions ol M.G.L. Chapter 148, Sections 26F,26F112 e\Dtes saxty (60)
days after issuance by head of the Fire Department.
FIRE DEPARTMENT'S COPY
By:Utr("
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Location of Property
1