HomeMy WebLinkAboutMansfield Host Hotel 12/31/19920
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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: ///-)/'IP-510leL -5! 0C_ . �L'm. P7rJ� TEL. -NO
ADDRESS: -3 1 11--6 ryl d'�-, l -i :5 -
TOWN: Mf9A,�6 r /_6-�7- 0 STATE: A74 ZIP: C�3
LOCATION_ OF POOL: L L- A'0 /�L �--
ADDRESS: 3 / /1% /° /d//' c -!5, r / r`
TYPE -OF -POOL: LENGTH: WIDTH: VOLUME:
MINIMUM/MAXIMUM DEPTHS: L, � (
SKETCH (A detailed pian must be filed with original application.)
SIZE: SWIMMING AREA: NON -SWIM AREA: DIVING AREA:
/�
SOURCE-OF-WATER:�', ��,r
DISPOSAL OF SEWAGE AND WASTEWAT��"'//
n
TYPE_ OF FINISHV-1 SCUM GUTTER:
DECK TYPE AND WIDTH:SKIMMERS'_ WEIR_ LENGTH:
TREATMENT SYSTEM (Kind of filters, etc.'):
DISINFECTION METHOD (Method, type, capacity, etc.):
_q y�' t� e �t/'C lr✓� f L t
CHEMICAL TREATMENT (Feeders capacity, quantity, etc.):�< i
REMARKS:
Sign
Tit]
Date
NOTE PLEASE Permit expires on December 31st yearly.
Fee is $75.00 per year, payable b.� check to
Town of Mansfield, 50 'Fest St. , Mansfield 02048
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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.
TEL. NO:'"f
OWNER _
ADDRESS
TOWN: STATE: -' ZIP:
LOCATION -OF -POOL:
ADDRESS: t n '
�.
TYPE -OF -POOL: LENGTH: WIDTH: VOLUME:
MINIMUM/MAXIMUM DEPTHS:
SKETCH (A detailed plan must be filed with original application.)
SIZE: SWIMMING -AREA: NOI-SWIM-AREA: t'vo DIVING -AREA: C
SOURCE OF WATER:�
DISPOSAL OF_SEWAG AND WASTEWATER:
TYPE_ OF FINISH: SCUM GUTTER:
DECK_TYPE_AND-WIDTH:/"'_ SKIMMERS'_WEIR_LENGTH:
TREATMENT -SYSTEM (Kind of filters, etc. ) : e 'A`&' c
DISINFECTION_ METHOD (Method, type, capacity, etc.):
CHEMICAL TREATMENT (Feeders, capacity, quantity, etc.):
REMARKS:
Signa
Title
uate i -,IL a
NOTE PLEASE Permit expires on December 31st yearly. �
Fee is :75.00 per year, payable by check to
Town of Mansf i el d, 50 West St. , Mansf i el d 02048