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Yarmouth
t Return completed application to:Yarmouth
FP-007C
(Rev 6/23)
APPLICATION FOR CERTIFICATE OF COMPLIANCE
FOR SMOKE DETECTORS AND CARBON MONOXIDE ALARMS
M.G.L. CHAPTER 148, SECTIONS 26F, 26F1/2
City or Town Yarmouth Date 10t20t2026
Application is hereby made for inspeclion of smoke detectors and carbon monoxide alarms as required by
Massachusetts General Law, Chapter 148, Seclions 26F, 26F112 and 527 CMR 'l:00 Seclion '13.7.
NOTE: SUBMIT APPLICATION TO LOCAL FIRE DEPARTMENT HEADQUARTERS
PLEASE iIOTE THAT ONLY APPLICATIONS WITH ORIGINAL WET SIGNATURES wlLL BE ACCEPTED, PHOT@OPIES OF APPLICANONS TIIILL NOT 8E PROCESSEO
Loc€tion of Property 109 Seaview Ave Unrl2
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Laura DoaneOwner of Property
1Number of Dwelling Uniis Signature of Applicant
lnspection/Testing completed on 10t20t2026 Lt. Oliva l.r,'-
Fee: (M.G.L. Chapter 148 Sec. 10A)$50.00 Fire Chief Enrique Arrascue
Note: Any certificate issu€d in accordance with provisions of M.G.L. Chapter 148, Sections 26F, 26F1/2 e&ires sixty (60)
days after issuance by head ofthe Fire Department.
FIRE DEPARTMENT'S COPYr
6,17 t{,.,-
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