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FP.O07C
(Rev. 1.1.2015)
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APPLICATION FOR CERTIFICATE OF COMPLIANCE
FOR SMOKE DETECTORS AND CARBON MONOXIDE ALARMS
M.G.L, CHAPTER 148, SECTIONS 26F,26F1N
oak).. 09125t2026City or Town Yarmouthport
Application is hereby made for inspeclion of smoke detectors and carbon monoxide alarms as required by
I\,lassachusetts General Law, Chapter 148, Sections 26F, 26F112 and 527 CMR 1:00 Section 13.7.
NOTE: SUBMIT APPLICATION TO LOCAL FIRE DEPARTiIENT HEADQUARTERS
Location of Property 37 Minah 0r
Owner of Property Mildred Sullivan
Number of Dwelling Units 102 Signature of Applicant
lnspection/Testing completed on 0912512026 By:a
Fee: (M.G.L. Chapter 148 Sec. 10A)$50.00 Fire Chief
Note: Any certificate issued in accordance u/ilh provisions of M.G.L. Chapter 148, Sections 26F, 26F1l2 expires sixty (60)
days affer issuance by head of the Fire Oepartrnent.
FIRE DEPARTUENT'S COPY
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