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FPI)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,26F1N
City or Town Yarmoulh port Dale 10t29t2026
Location of Property 7 Benl Bluff
Owner of Property Roosa
a
Number of Dwelling lJnils Signature of Appli
lnspection/Testing completed on 10129t2026 By
Fee: (M.G.L. Chapter 148 Sec. 10A)s50 00
Note: Any cerlilicate issued in accordance with provisions of M.G.L. Chapter 148, Seclions 26F, 26F'12 expires sixty (60)
days afrer issuance by head of lhe Fire Oepartment.
FIRE DEPARTMENT'S COPY
-3-
Application is hereby made for inspec,tion of smoke detectors and carbon monoide alarms as required by
Massachusetts GeneralLaw, Chapter 148, Sections 26F, 26F1l2 and 527 CMR 1:00 Section 13.7.
NOTE: SUBillT APPLICAnON TO LocAL FIRE DEPART ENT HEADOUARTERS
1
Fire Chief _