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THE COMMONWEALTH OF MASSACHUSETTS
s _ ........... OF .............................................................................
BOARD OF HEALTH
APPLICATION FOR A PERMIT TO OPERATE A SWIMMING POOL
Application is hereby made for a permit to operate a public, semi-public, or wading
pool. This pool is to be operated according to the minimum standards for swimming
pools set forth in Article VI of the Sanitary Code of the Commonwealth of Massachusetts,
OWNER ALLIED REALTY TRUST ( � �' TEL. NO. (. h 17 ) 9 6 2- jq_U
fa i V1 f
LOCATION LOT 10 B
TYPE OF POOL h 4 j$ ", ""E LENGTH e WIDTH r
VOLUMEr it c'
SKETCH (A detail plan must be filed with original application)
SIZE: SWIMMING AREA NON SWIMMING AREA DIVING AREA
SOURCE OF WATER
DISPOSAL OF SEWAGE AND WASTE WATER .,
TYPE OF FINISH CSCUM GUTTER
DECK: TYPE AND WIDTH C'
rSNj SKIMMERS:
WEIR LENGTH
TREATMENT SYSTEM (Kind
of filters etc)
-
DISINFECTION METHOD (Method, type, capacity etc) --
5'
DATE
t,
(Permits expire on Dec. 31) $75.00 yea ;11_foi
F �
FO 1707 HOBB6 8 WARREN. INC. „mss
(508)261-7366
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