HomeMy WebLinkAbout26F Oct 2026a\a7k Vr-r* "/o/k*r.l*rt 'A(gJ',Vtly /r'/o,,,,nfrtt,aatl
FP{07C
(Rev. 1.1.2015)
a Return completed application to:
APPLICATION FOR CERTIFICATE OF COMPLIANCE
FOR SMOKE DETECTORS AND CARBON MONOXIDE ALARMS
M.G.L. CHAPTER 148, SECTIONS 26F,26F112
Date 10t16t2026Cily or Town
Application is hereby made for inspeclion of smoke deteclors and carbon monoxide alarms as required by
l\,,lassachusetts General Law, Chapler 148, Seclions 26F, 26F1/2 and 527 CMR 1:00 Sectron 13.7
NOTE: SUBMIT APPLICATION TO LOCAL FIRE DEPARTITTENT HEADAUARTERS
Localion of Property 11 Pamet Rd
Linda Cahoon
10116t2026 8y |-
Fee: (M.G.L. Chapter 148 Sec. 10A)s50 00
t
Owner of Property
Number of Dw€llirE Un'O t Signaturo ot Applicant
lnspection/Testrng completed on:
Fire Chief_
Note: Any certificate issued in accordance with provisions of M.G.L. Chapter 148, Sections 26F, 26F1/2 erpires sixty (60)
days aner issuance by head of the Fire Depadment-
FIRE DEPART]IIENT'S COPY