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FP{07C
(Rev. 1.1.2015)
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APPLICATION FOR CERTIFICATE OF COMPLIANCE
FOR SMOKE DETECTORS AND CARBON MONOXIDE ALARMS
M.G.L. CHAPTER,I48, SECTIONS 26F, 26F1N
City or Town Yafinoulhport oate.. 09t25t2026
Application is hereby made for inspection of smoke detectors and carbon monoxide alarms as required by
Ivlassachusetts General Law, Chapter 148, Sections 26F, 26F112 and 527 CMR 1r00 Sectron 13.7.
NOTE: SUBMIT APPLICATION TO LOCAL FIRE OEPARTMENT HEADQUARTERS
Location of Property 22 Blueberry Path Village
Owner of Property nancy Rytrna
Number of Dwelling Units 456 Signature of Applicant
lnspection/Testing completed on o9t25t2026 By:.u6'
Fee: (M.G.L. Chapter 148 Sec. 10A)$50.00
Note: Any certificate issued in accordance with provisions of M.G.L. Chapter '146, Sections 26F, 26F1l2 expires sixty (60)
days after issuance by head of the Fire Department.
FIRE DEPART]IIENT'S COPY
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Fire chief
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