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APPLICATION FOR CERTIFICATE OF COMPLIANCE
FOR SMOKE DETECTORS AND CARBON MONOXIDE ALARMS
M.G.L. CHAPTER 148, SECTIONS 26F,26F1N
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(Rev. 1.1.2015)
City or Town
Application is hereby made for inspeclion of smoke detectors and carbon monoxide alarms as required by
lrassachusetts General Law, Chapter 148, Sections 26F, 26F112 and 527 CMR 1:00 Sectron 13.7.
NOTE: SUBMIT APPLICATION TO LOCAL FIRE OEPARTMENT HEADQUARTERS
Location of Property 3 Danbury Way
Owner of Property Mary Beth Molloy
Number of Dwelling Units Signature of Applicant
lnspection/Testing completed on:09t25t2026 By
Fee: (M.G.L. Chapter 148 Sec. 10A)$50.00
Nole: Any cedificate issued in accordance with provisaons of M.G.L. Chapte |48, Sections 26F, 26Fl12 exptes sixty (60)
days after issuance by head of the Fire Department.
FIRE DEPARTIIIENT'S COPYJ-
a Return completed applicalion to:
Fire chief-