HomeMy WebLinkAbout26F Sep 2026^Qabe
(oy(+ Uor6 tUL
.\&k Vorr*or**o/tl. "/ o//an"l,r*m A
erV,ty r.7;,,,,, o7 'l/y', , ru,,,tl
FP{07C
{Rev. 1.r.20r5)
a Return completed application to:
APPLICATION FOR CERTIFICATE OF COMPLIANCE
FOR SMOKE DETECTORS AND CARBON MONOXIDE ALARMS
M,G.L. CHAPTER 148, SECTIONS 26F,26FlN
City or Town 09t09t2026
Applicalion is hereby made for inspection of smoke detectors and carbon monoxide alarms as required by
Massachusetts General Law, Chapter 148, Seclons 26F, 26F112 and 527 CMR 'l:00 Section ,l3.7.
NOTE: SUBirlT APPLICATION TO LOCAL FIRE DEPARTMENT HEADAUARTERS
Location of Property ll Rosetta
Owner of Property Paul & Barbara Lab.az
Number of Dwelling Units Signature of Applicant
t
lnspection/Tesling compleled on Bv,O1,,"^-09149t2026
$s0 00 Fire Chief
Note: Any certificate issued in accordance with provisions of M.G.L. Chapter 148, Sections 26F, 26F1l2 exprres sixty (60)
days after issuance by head ofthe Fire Department.
FIRE DEPARTMENT'S COPYJ-
1
Fee: (M.G.L. Chapter 148 Sec. 10A)