HomeMy WebLinkAboutSmoke and Co2 Compliance - Smoke/CO2 Compliance Permit - 25 ABBOTT STREET 9/20/2019 �„ C�/yLC� -(QG�I?i�rc%cYi'7�/,I1P�7Li�fG r2�C.�G'GCIiJ6CGG�� :trl
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APPLICATION FOR CERTIFICATE OF COMPLIANCE
FOR SMOKE DETECTORS AND CARBON MONOXIDE ALARMS
r M.G.L. CHAPTER 148, SECTIONS 26F, 2 1/2 /
City or Town / , Date:
Application is hereby made for inspection of smoke detectors and carbon monoxide alarms as required by Massachusetts
General Law,Chapter 148,.Sections 26F, 26F?h and 527 CM 31, et seq.
NOTE:SUBMIT APPLICATION TO LOCAL FIRE DEPARTMENT HEADQUARTERS
Location of Property
Owner of Property °' r
d e.� o,
Number of Dwelling Units Z_Sig ature o Applicant '
Insnection/T'estina completed on: s° Vk 7 By
a
p
r
FP•0070 Return ocnlplated application to:
(Rev,1.1.2015)
APPLICATION TIFI TCOMPLIANCE
FOR SMOKE DETECTORSMONOXIDE
M.G.L. CHAPTER 148, SECTIONS 26F, 26F112
City or Town Crate: a6—
b
Application is hereby trade for inspection of emoke detectors and carbon monoxide alarms as required by
Massachusetts Genera(Law,Chapter 148, Sections 26F,26F112 and 527 CMR.1:00 Section 13.7.
MOTE:SUBMIT APPLICATION TO LOCAL FIRE DEPARTMENT HEADQUARTERS
Location of Property P h o n
Owner of Property t
-ci�= -_ . -- ---"IF 7-
Number of Dwelling Units I Signature of Applicant
InspeotionfTesting completed on: By: w
sp d
Fee:(M.G.L,Chapter 146 Sec, 10A)-- Fire Chlef
Note:Any certificate issued in accordance with provisions of M,G.L.Chapter 148,Sections 26F,26F172 expires sixty(60)
days after issuance by head of the Fire Department,
FIRE DEPARTIVIENT'S COPY