HomeMy WebLinkAbout26F Sep 2026\a7kV"*-r"*r"*r//rr/o//"r*./rr.tt
VttJ /e-/i1,,,,,'.//ortt,rutl
FP{07C
(Rev 1.1.2015)
APPLICATION FOR CERTIFICATE OF COMPLIANCE
FOR SMOKE DETECTORS AND CARBON MONOXIDE ALARMS
M.G.L. CHAPTER 148, SECTIONS 26F,26F1/2
City or Town Yarmouthport Dats.09/18/2026
Application is hereby made for inspection ol smoke detectors and carbon monoxide alarms as required by
Massachusetts Geneml Law. Chapter 148, Sections 26F, 26F112 and 527 CMR 1:00 Section 13.7.
NOTE: SUBtYllt APPLICATION TO LOCAL FIRE DEPARTT ENT HEADQUARTERS
Location of Property 6 shaker house rd
Owner of Properly
Number of Dwell ng Units Signalur€ ofApplicant
09t18t2026 By:
Fee: (M.G.L. Chapter 148 Sec. 10A)$s0.00
Note: Any cerlificate issued in accordance with provisions of M.G.L. Chapter 148, Sections 26F, 26F112 expires siny (60)
days afrer issuance by head ofthe Fire Department.
FIRE DEPART EI{T'S COPY
__-k__
a Retum completed application to: _ f
Kohr Family Trust
1
lnspection/Testing completed on:
Fire chief _