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........... 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 Keith Properties, Inc.
TEL. NO. 339-3583
LOCATION 9 Francis Ave., Mansfield (Mansfield Depot .IZ)
TYPE OF POOL Residential LENGTH 4 0' WIDTH 20' VOLUME 30,000 ga 1.
SKETCH (A detail plan must be filed with original application) SKETCH ON BACK
SIZE: SWIMMING AREA 20' x 4 0 ' NON SWIMMING AREA 1600 s a . 'DIVING AREA - 0 -
T ft.
SOURCE OF WATER
Town
DISPOSAL OF SEWAGE AND WASTE WATER
Town
TYPE OF FINISH vinyl,printed SCUM GUTTER
DECK:
TYPE AND WIDTH Cement Slab
(On Back)
TREATMENT SYSTEM (Kind of filters etc )
SKIMMERS: WEIR LENGTH
Hayward DE -3600 earth filters
DISINFECTION METHOD (Method, type, capacity etc.) Chlorinating sticks, Plus to
increase ph, Minus to decrease ph, Shock, Algaecide concentrate Water
clarifier, ca e and Iron remover.
CHEMICAL TREATMENT (Feeders, capacity, quantity etc.)
Automatic Chlorinator
W�4�IN
DATE ` C>
(Permits expire on Dec. 31) $75.00 yearly/pool (508)261-7366
FORM 1707 HOBBS & WARREN. INC.
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THE COMMONWEALTH OF MASSACHUSETTS
(°
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 Keith Properties, Inc. TEL. NO. 339-3585
LOCATION 9 Francis Avenue (The Village at Mansfield E)epot)
TYPE OF POOL Vtinyl L-shaped LENGTH 48WIDTH 24' VOLUME55 , 000 aal .
SKETCH (A detail plan must be filed with original application)
SIZE • SWIMMING AREA 36' x 24' NON SWIMMING AREA 12'x36' DIVING AREA N/_L_
SOURCE OF WATER Town Water
DISPOSAL OF SEWAGE AND WASTE WATER Town
TYPE OF FINISH Vinyl Print SCUM GUTTER N/A
DECK: TYPE AND WIDTH24' concrete SKIMMERS: WEIR LENGTH 2 s �mmerG
slab
TREATMENT SYSTEM (Kind of filters",etc)
two (2) Sand Filters/Jacuzzi MFM24 Flo r
DISINFECTION METHOD (Method, type; capacity etc) GPM 7 5 Backwa s G n
CHEMICAL TREATMENT .(Feeders, capacity, quantity etc) --
Hayward chlorine Feeder/Tabs/CH 200
REMARKS
SI
DATE
$75.00 yearly/pool
(Permits expire on Dec. 31)
FORM 1707 HOBBS & WARREN. INC.
(508)261-7366