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a Return 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 Date.09/10/2026
Application is hereby made for inspeclion of smoke detectors and carbon monoxide alarms as required by
Massachusetts General Law, Chapter 148, Sedlons 26F,26F112 and 527 CMR 'l:00 Section 13.7.
NOTE: SUBMIT APPLICATION TO LOCAL FIRE DEPARTMENT HEADAUARTERS
t
Location of Property 449 Long Pood Drive
Owner of Property Ellen Batch
Number of Dwelling Units
Fee: (M.G.L Chapter 148 Sec. 10A)
Signature of Applicant
09110/2026 ,UA-
Flre Chiefs50.00
Note: Any certificate issued in accordance with provisions of M.G.L. Chapter ,|48, Sections 26F, 26F112 expires sixty (60)
days afrer issuance by head of the Fire Deparlment.
FIRE DEPARTMENT'S COPY
South Yannouth
1
lnspection/Testing completed oni By: