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APPLICATION FOR CERTIFICATE OF COMPLIANCE
FOR SMOKE DETECTORS AND CARBON MONOXIDE ALARMS
M.G.L, CHAPTER 148, SECTIONS 26F,26F1N
City or Towtl Date. 09/09/2026
Application is heroby made for inspeclion ofsmoke detectors and carbon monoxide alarms as required by
lrassachusetts General Law, Chapter 148. Sections 26F, 26F112 and 527 CMR 'l:00 Section 13.7.
I{OTE: SUBirlT APPLICATION TO LOCAL FIRE DEPARTMEI{T HEADQUARTERS
Location of Property 19 Wallham Circle
Owner of Property Hayes Family lnvestment Trust
Numb€r of Dwelling Units Signature ol Applicanl
lnspection/Test ng completed on:09t0912026 By:
Fee: (M.G.L. Chapter 148 Sec. l0A)s50.00
Note: Any certificale issu€d in accordance with provisions of M.G-L- Chapter 148, Sections 26F, 26F112 expires sixty (60)
days after issuance by head of the Fire Department.
FIRE DEPARTIIIENT,S COPY
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