HomeMy WebLinkAbout26F Oct 2026a\agkVr-r-*""".r/il"/o'//",m"1*rcm
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+ Retum completed application to:
APPLICATION FOR CERTIFICATE OF COMPLIANCE
FOR SMOKE DETECTORS AND CARBON MONOXIDE ALARMS
M.G.L. CHAPTER I48, SECTIONS 26F,26F112
South Yarmouth oak).. 10123t2026
,tFP407C
(Rev. 1.1.2015)
City or Town
Application is hereby made for inspection of smoke detectors and carbon monoxide alarms as required by
I\,lassachusetts General Law, Chapter 148, Sections 26F, 26F1/2 and 527 CMR 1:00 Sectron 13.7.
NOTE: SUBMIT APPLICATION TO LOCAL FIRE DEPARTITTENT HEADQUARTERS
Location ot Property 105 Capt Chase Road
SLrllvan
Numbor of Dwelling Unib Signature of Applicant
lnspection/Testang completed on:10t23t2026 8y:vL.
Fee: (M.G.L. Chapter 148 Sec. 10A)s50.00 Fire Chief
Note: Any certificate issued in accordance with provisions of M.G.L. Chapter 148, Sections 26F, 26Fl12 e)Aires sixty (60)
days afier issuance by head of the Fire Department.
FIRE DEPARTMENT'S COPY
-3.-
Owner of Property