HomeMy WebLinkAbout26F 2026t\o7l" Vr.r-r"""r,.rU a/ o'//aur"lrr^ea A
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(Rev. 1.1.2015)
City or Town
a Return completed application to:
APPLICATION FOR CERTIFICATE OF COMPLIANCE
FOR SMOKE DETECTORS AND CARBON MONOXIDE ALARMS
M.G.L, CHAPTER 148, SECTIONS 26F,26F112
oate.09/09/2026
t
Location of Property 20 Anthony Road
Owner of Property
Number of Dwelling Units Signature of Applicant
09t0912026 By:
Fee: (M.G.L. Chapter 148 Sec. 10A)s50.00
Nolg: Any cedificate issued in accordance with provisions of M.G.L. Chapler i48, Sections 26F, 26F12 expires sixty (60)
days after issuanco by head of the Fire Department.
FIRE DEPARTMENT'S COPY
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Applicalion is hereby made for inspection of smoke detectors and carbon monoxide alarms as required by
Massachusetts General Law, Chapler 148, Sections 26F, 26F112 and 527 CMR 1t00 Section 13.7.
NOTE: SUAMlT APPLICATION TO LOCAL FIRE DEPARTMENT HEAOQUARTERS
1
lnspection/Testang completed on:t/O.-
Fire chief
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