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FP{07C
(Rev. 1.1.2015)
a Retum completed applicalion to:f
City or Town West Yarmouth Date 09t04t2026
Application is hereby made for inspection of smoke detectors and carbon monoxide alarms as required by
lvlassachusetls General Law, Chapter 148, Sections 26F. 26F112 and 527 CMR 1:00 Section 13.7.
NOTE: SUBMIT APPLICATION TO LOCAL FIRE DEPARTMENT HEADQUARTERS
Location of Property
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(gl'.
Owner of Property HeidiArchibald
Number of Dwelling Units
lnspeclion/Testino completed on 09t04t2026 By
Fee: (M.G.L. Chapter 148 Sec. 10A)
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APPLICATION FOR CERTIFICATE OF COMPLIANCE
FOR SMOKE DETECTORS AND CARBON MONOXIDE ALARMS
M.G.L. CHAPTER 148, SECTIONS 26F, 26FI/2
121 Camp Street Unit 103
1 Signature of Applicant
$50.00 Fire chief
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Note: Any certificate issued in accordance with provisions of M.G.L. Chapter 148, Seclions 26F,26F1n exptes sixty (60)
days after issuance by head of the Fire Department.
FIRE DEPARTMENT'S COPY