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~ THE COMMONWEALTH OF MASSACHUSETTS
.... 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.
OWNERCCt-e_ 1 tJ 0 LI) TEL. NO. 3 3
LOCATION % -37 frJ , /
TYPE OF POOL_LENGTH�WIDTH�y V0LU, rte!_
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 FINISSCUM GUTTER
DECK: TYPE AND WIDTH `6' )V f Yb/4_ /U ` SKIMMERS : WEIR LENGTH
TREATMENT SYSTEM (Kind of filters
�G n r
DISINFECTION METHOD (Method, type, capacity etc)
C> ti-- L -
CHEMICAL TREATMENT (Feeders, capacity, quantity etc.)
REMARKS
SIGNED
DATE
(Permits expire on Dec. 31) $75.00 per unit. (508)261-7366
FORM 1707 HOBBS & WARREN. INC.
THE COMMONWEALTH OF MASSACHUSETTS '
... 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.
LOCATION
K'P,
TEL. N0.
env :7"/
TYPE OF POOL, Ll L,, "c(, -,�L-LENGTH WIDTH __ 0 VOL JME
SKETCH (A detail plan must be filed with original application)
SIZE: SWIMMING AREA
SOURCE OF WATER
n
NON SWIMMING AREA DIVING AREA
DISPOSAL OF SEWAGE AND WASTE WATER
in
TYPE OF FINISH C �ryvk e- -Yt T - SCUM GUTTER
DECK: TYPE AND WIDTM / SKIMMERS: WEIR LENGTH
TREATMENT SYSTEM (Kind of filters `etc.
DISINFECTION METHOD Method t e ca acit etc.
�l
CHEMICAL TREATMENT (Feeders, capacity, quantity etc.)
REMARKS
SIGNED
DATE
(Permits expire on Dec. 31) $75.00 per unit per year. (508)261-7366
FORM 1707 HOBBIT d WARREN. INC.