HomeMy WebLinkAbout26F Oct 2026a\aTkVr**,r*rr*r*1"/a//r"t-.lr^n A
'(gt'V,rr 'ta,,'"k f,,r,nrtl
FP{07C
(Rev.1.1.201s)
a Return completed appliqation tor
APPLICATION FOR CERTIFICATE OF COMPLIANCE
FOR SMOKE DETECTORS AND CARBON MONOXIDE ALARMS
M.G.L. CHAPTER 148, SECTIONS 26F,26F112
Crty or Town 10t2212026uare:
Application is hereby made for inspection ofsmoke detectoc and carbon monoxide alams as required by
[rassachusetts General Law, Chapter 148, Seclions 26F, 26F1/2 and 527 CMR 1100 Section 13.7
NOTE: SUAM|T APPLICATION TO LOCAL FIRE DEPARTMENT HEADQUARTERS
Location of Property '106 Pine Slreet
Owner of Property Donald and Wendy Minnich
Numberof Dwelling Units Signature of Applicant
10122t2026 8y:
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, 26F12 expkes sixty (60)
days after issuance by head of the Fire Depadment.
FIRE DEPARTMENT'S COPY
I
_t-
Yarmoulhport
lnspection/Testing completed on: