HomeMy WebLinkAboutEdgewood 12/31/1992I.
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THE COMMONWEALTH OF MASSACHUSETTS
TOWN OF MANSFIELD
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: ��
c��Ef�t� -
F
TEL. NO:
max_ ,>€�
ADDRESS
TOWN:
�,
STATE: °' ,s
ZIP:t'
,,s ,.
.
LOCATION_OF_POOL:
ADDRESS:
TYPE OF
POOL: i
a€t r LENGTH �a
WIDTH: 1 c.y VOLUME
MINIMUM/MAXIMUM DEPTHS:
SKETCH (A detailed plan must be filed with original application.)
SWIMMING_AREA: ',,C°;`" NON -SWIM _AREA: c ,}` DIVING AREA: "�
SOURCE_ OF WATER:
DISPOSAL OF -SEWAGE-AND-WASTEWATER:
TYPE_ OF FINISH:{ .,,SCUM GUTTER: -a
DECK _TYPE_AND WIDTH `" �,a ., SKIMMERS' -WEIR -LENGTH:
TREATMENT.SYSTEM (Kind of filters, etc.,):
fl: All__�Iclr3 a
r . p� °
DIS INFECTION_METhOD (Method, type, capacity, etc.):
CHEMICAL_ TREATMENT (Feeders, capacity, quantity, etc.):
c"
REMARKS:
Signature
Title' //'- "
t
Date 11
NOTE PLEASE Permit expires on December 31st yearly.
Fee is $75.00 per year, payable by check to
Town of Mansfield, 50 West St., Mansf field 02048