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FP407C
(Rev. 1.1.2015)
APPLICATION FOR CERTIFICATE OF COMPLIANCE
FOR SMOKE DETECTORS AND CARBON MONOXIDE ALARMS
M.G,L. CHAPTER .I48, SECTIONS 26F, 26F1N
City or Town oale.. 1olo1t2o26
Application is hereby made for inspection of smoke detectoIs and carbon monoxide alarms as required by
Massachusetts General Law, Chapter '148, Sections 26F. 26F112 and 527 CMR 1:00 Section 't 3.7.
NOTE: sUB IT APPLICATION TO LOCAL FIRE DEPARTT{ENT HEADOUARTERS
8 Barkley Street
Owner of Property Patrick McElligafl
Number of Dwelling Units Signatur€ of Applicant
10t0112026
I
lnspection/Testing cornpleted on By
Fee: (M.G.L. Chapter'148 Sec. 10A)ss0.00 Fire Chief
Note: Any cedificate issued in accordance with provisions of M.G.L. Chapter 148, Sections 26F. 26F112 expires sixty (60)
days after issuance by head ofthe Fire Depadment.
FIRE DEPARTMENT'S COPY
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i Retum completed application to:
South Yarlnouth
Location of Property
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