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LORING HILLS POOL-POOL - ESTABLISHMENTS LORING HILLS POOL 2-DD a City of Salem, Massachusetts Board of Health << 120 Washington Street, 4th Floor, Salem, MA 01970 Public13ea1lth Prcvevt Pvmo,<.P(olecl. Tel. (978) 741-1800 Fax. (978) 745-0343 Kimberley Driscoll health@salem.com Larry Ramdin, MPH, RENS, CHO Mayor Health Agent PUBLIC POOL HEALTH PERMIT Permit# PO-17-8 License For : Pool (seasonal) Date of Print 5/16/2017 Granted To: East Coast Properties LLC Permit Issued 5/16/2017 Address: East Coast Salem MA 01970 Properties -400 Highland Ave Ste. 11 Permit Expires 9/4/2017 Location of Establishment: LORING HILLS AVENUE Permit Fee $140.00 Restrictions: Vinnin Square Recreation Facility Late Fee 200 Loring Hills Avenue $0.00 Notes: This permit or license is granted in conformity with the statues and ordinances relating thereto, and expires on 9/4/2017 , unless sooner revoked or suspended. Larry Ramdin, MPH, REHS, CHO Health Agent 4 . t J CITY OF SALEM, MASSACHUSETTS BOARD OF HrAL:rt4 120 WAST IINGTON S'1R13I±T,41r FLOOR KIMBERLEY DRISCOLL Ttu-(978)741-1800 RECEIVED FAX(978)745-0343 MAYOR Iramdin@salem.com MAY 112017 LARRY RANIDIN,RS/REI-IS,CHO,CP-FS CIN OF SALEM HF'.tu.Trr AGFN'f BOARD OF HEALTH 2017 x209A APPLICATION FOR PERMIT TO OPERATE A SWIMMING POOL LOCATION OF POOL 200 LORING HILLS AVENUE NAME OF APPLICANT EAST COAST PROPERTIESS LLC TEL# 978-741-2003 MAILING ADDRESS 400 Highland Avenue, Ste 11, Salem MA 01970 CERTIFIED POOL OPERATOR Name: ANDREW J. ANSELMO Cert4Pl-182673 TEL# 978=852-4001 DATES OF OPERATION(if not annual):MEMORIAL DAY WEEKEND (5/27/17) thru LABOR DAY SUNDAYS thru MONDAYS - 10 AM - 8 PM DAYS &HOURS OF OPERATION:, TYPE OF POOL Public Semi-Public Special Purpose FEE: $210.00 for year round pools $140.00 r seasonal$40.00 Non-Profit (Please pay total with one check pay ab a to the City of Salem) This permit is not transferable and must be reissued upon change of ownership. In accordance with the State Sanitary Code,before any renovations,improvements,or Equipment changes are made,all plans for such must be submitted to and approved by the Salem Board of Health. Pursuant to MGL Chap r 63 Section 49a,I certify under the pains and penalties of perjury that I,to my best knowledge and belief,have fil11ste retu s and d all state taxes required under the law., 1 Ad %i� 3 S natu a Date S#or Federal Identification Number Revised 5/23/11 poolappl Ldoc Check#Date v Pf0, OD RECEIVED MAY 112017 CITY OF SALEM BOARD OF HEALTH CPbSR C'erttfi.- - ^ t , . nw � j �y�ff Certit '� Id r� � p i Y J1 tt • CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREET,4"'FLOOR PI1blicHealth TEL. (978) 741-1800 FAX(978) 745-0343 KIMBERLEY DRISCOLL Iramdin(a�salem.com LARRY RAMDIN,RS/RP:I-IS,CFfO,CP-1'S MAYOR HGAI;fR A(;13N'C \ / ( r.SWIMMINGPOOL INSPECTION REPORT NAME: V 1 h h ;A d care, I`zt o- 4;nh VA r ji{y /7DATE: 05' 1_6/21).1 TIME IN: },, ADDRESS: �� L,nv na i�� S fFyv.nUa /PHONE:1 —WI-20TIME OUT:1U3 CERTIFIED POOL OPERATOR: Ahlaw n 5,1 ,49 Regulations 105 CMR 435.000 :Minimum Standards for Swimming Pools, State Sanitary Code, Chapter V Regulation -Complianjee Number Yes o Title and Description 435.03 Bathhouse: Separate sanitary dressing facilities and water closet for each sex which are well lighted, drained and ventilated- Showers with hot and cold water—Sanitary drinking water— toilet paper, soap at sink and in showers (shatter proof containers), paper towels and waste receptacle 435.06 Water Circulation and Filtration: Over-all recirculation and purification system designed recirculates and filters the entire volume as follows: • Swimming Pools—Once every eight hours • Wading Pools—Once every four hours • Special Purpose Pools (Spas)—Once every half hour Maximum design filtration for filters: • High rate sand filter— 15 gpm/ft' -20 gpm/ft' (NSF filters) • DE filters—2 gpm/ ft' It Cartridge filters—0.375 gpm/ft' Automatic hypochlorinators required feed-rate capacity: at Outdoor Pools—Three pounds of chlorine per 24 hours per 10,000 gallons • Indoor Pools—One pound of chlorine per 24 hour per 15,000 gallons 435.08 Inlets and Outlets—All special purpose and wading pools shall install an emergency shut off switch which is accessible, working and prominently marked 435.12 Water Depth Markings—Marked on pool deck and on vertical pool wall. Four-inch contrasting color stripe dividing shallow and deep ends including ledges and steps 435.21 Permit Requirements and Pool Records—Permit posted in conspicuous location. Maintain initialed records including daily attendance, amounts and types of chemicals used daily, chemical and bacteriological tests, dates and times of emptying, cleaning, and back-washing and hours of operation of purification equipment 435.22 Health Regulations, Signs—No employee working at swimming, wading or special purpose pool shall have a communicable disease. Operator shall enforce the following for bathers: All bathers shower before entering pool -Clean bathing suits—No communicable diseases (fever, cough, cold, inflamed eyes, nasal/ear discharge)—No open sores, skin diseases or bandages—No glass • Signage at entrance of pool enclosure or in dressing room—"All persons are required to take a cleansing shower bath before entering the pool. No person with a communicable disease is allowed to use the pool'. • Additional signage for special purpose pools—"Do not use under these conditions: Alone- Under the influence of alcohol, anticoagulants, antihistamines, vasoconstrictors, vasodilators, stimulants, hypnotics or tranquilizers—Consult physician if person is elderly, pregnant, suffers from heart disease, diabetes, high/low blood pressure—Water temperature above 104°F— Observe reasonable time limits—No oils and body lotions" Easily readable large dial clock SWIMMING POOL INSPECTION REPORT Regulations 105 CMR 435.000 Minimum Standards for Swimming Pools, State Sanitary Code, Chapter V NAME: Vith h t o e ` DATE:12 6� Regulation I Complia ce Number I Yes I Ao I Title and Description 435.23 Lifeguards— Lifeguard certifications—Warning sign stating(if no lifeguard is required by Board of Health)"Warning—No lifeguard on Duty"and"Children under age 16 should not use swimming pool without an adult in attendance and "Adults should not swim alone"in four inch letters. Clothing—Lifeguards shall wear red or bright orange bathing suits, shirts or jackets with guard printed in 4-inch lettering. Lifeguards shall direct their attention to area assigned 435.24 Safety Equipment—One ring Buoy for each 2000 ft2,One rescue tube and rescue hook Lifeguard staffed pools shall have readily available a backboard with straps 435.25 First Aid Equipment and Emergency Communication—Provide a standard Red Cross first aid kit—Working, convenient, immediate, toll-free communication system with emergency medical s ices, local/state police, fire department available to staff and public at all times with structioas for use 435.29 Chemical Standards—Test for residual disinfectant and pH conducted four times a day(once during peak load), Alkalinity and calcium test conducted weekly. Ranges are: • Residual Chlorine 1.0—3.0 PPM Combined Chlorine 0.0—0.2 PPM • Bromine 2.0—6.0 PPM • pH 7.2—7.8 PPM • Alkalinity 50— 150 PPM 435.30 Water Testing Equipment—Provide a DPD test kit for measuring chlorine/bromine and appropriate kit for measuring pH, alkalinity and cyanuric acid—Reagents shall not be more than one year old—Provide accurate, unbreakable thermometer for special purpose pools 435.31 Water Clarity—Water shall be clear(black disc on bottom of pool, clearly visible from sidewalks of pool at all distance up to ten yards) 435.32 Water Quality Maintenance— Special purpose pools shall be drained, cleaned and refilled a minimum of once every 14 days 435.33 Maximum Operating Temperature for Special Purpose Pools—Water temperature not more than 104°F—Water temperature shall be tested when residual disinfectant and pH are tested 435.34 Closure of Pool—Operator shall immediately close pool until pool water conforms to 105 CMR 435.28 through 435.31 standards 435.38 General Sanitation—All pools, bathhouses and grounds shall be maintained in good repair, safe and sanitary manner. Remarks, Results and Action Taken: Swimming Pool Wadi /Kiddie Pool Spa Type: Type: Free // Free Free Free Free Chlorine b Chlorine Chlorine Chlorine Chlorine Combined _� Combined Combined Combined Combined Chlorine Chlorine Chlorine Chlorine Chlorine Bromine Bromine Bromine Bromine Bromine PH � oV pH pH pH pH Alkalinity Alkalinity Alkalinity Alkalinity Alkalinity Calcium Calcium Calcium Calcium Calcium Hardness Hardness Hardness Hardness Hardness SWIMMING POOL INSPECTION REPORT Regulations 105 CMR 435.000 Minimum Standards for Swimming Pools, State Sanitary Code, Chapter V NAME: fn av- R"regf tl Y DATE: ZD 4 Remarks, Results and Actions: Type: T pe: Type: Free Free Free Chlorine Chlorine Chlorine Combined Combined Combined Chlorine Chlorine Chlorine Bromine Bromine Bromine pH pH pH Alkalinity Alkalinity Alkalinity Type: Calcium Calcium Calcium YP Hardness Hardness Hardness Type' Type Pool Pool Pool Volume g Jl—'09f COO Volume g Volume g end Sand Sand DE Filter Type E Filter Type DE Filter Type Cartridge artrid a Cartridge Filter Size ft' �jO Filter Size ft= Filter Size ft' Minimum Minimum Minimum Flow Rate gpm rAct=ua Flow Rate gpm Maximum Maximum Flow Rate gpm Actual w Rate gpm Flow Rate gpm ot��Aq:jv- le)wtl AQeAs �10" I�L fypz aL4t nJ� 1VLve,J,4 h Qv C f> 19P ry f,S Passed Inspection: YesV MO ❑ Re-Ins a ate: Inspector's Signature: Person In Charge: , City of Salem, Massachusetts 4 Board of Health 10 120 Washington Street, 4th Floor, Salem, MA 01970 PublicHeaIth Prevent.Pramow.Protect. Tel. (978) 741-1800 Fax. (978) 745-0343 Kimberley Driscoll Iramdin@salem.com Larry Ramdin, MPH, RENS, CHO Mayor Health Agent PUBLIC POOL HEALTH PERMIT Permit# PO-16-11 License For : Pool (seasonal) Date of Print 5/24/2016 Granted To: East Coast Properties LLC Permit Issued 5/24/2016 Address: East Coast Salem MA 01970 Properties -400 Highland Ave Ste. 11 Permit Expires 9/30/2016 Location of Establishment: LORING HILLS AVENUE Permit Fee $140.00 Restrictions: Vinnin Square Recreation Facility Late Fee 200 Loring Hills Avenue $0.00 Notes: This permit or license is granted in conformity with the statues and ordinances relating thereto, and expires on 9/30/2016 , unless sooner revoked or suspended. • s J�� CITY OF SALEM, MASSACHUSETTS ® tl(S BOARD OF HEALD 1 120 WASI-IING'rON STRFT31',4" FLOOR PubhCHt~Alth Prevent.Promote.Protect. TEL.(978)741-1800 FAX(978)745-0343 lramdin(o�salem.com IQMBERLEY DRISCOLL LARRY RP.MDIN,RS/REFTS,CHO,CP-FS MAYOR HEAurH AGENT APPLICATION FOR PERMIT TO OPERATE A SWIMMING POOL LOCATION OF POOL 200 LORING HILLS AVENUE, SALEM CYNDY ANSELMO NAME OF APPLICANT VINNIN SQUARE RECREATIONAL TEL 978-747-2001 MAILING ADDRESS 400 HIGHLAND AVENUE, SALEM MA 01970 EMAIL ADDRESS CYNDY @ECPLLC.net CERTIFIED POOL OPERATOR 01-182673 Name: ANDREW J. ANSELMO Cert#: TEL# 978-852-4001 DATES OF OPERATION(if not annual): MEMORIAL DAY to LABOR DAY DAYS &HOURS OF OPERATION: 7 days a week — 9 AM to 8 PM TYPE OF POOL Public Semi-Public ,r Special Purpose FEE: $210.00 for year round pools $140.00 for seasonal$40.00 Non-Profit (Please pay total with one check payable to the City of Salem) This permit is not transferable and must be reissued upon change of ownership. In accordance with the State Sanitary Code,before any renovations,improvements,or Equipment changes are made,all plans for such must be submitted to and approved by the Salem Board of Health. Pursuant to MGL Cha ?anpaid C,Section 49a,I certify under the pains and penalties of perjury that I,to my best knowledge and belief,have file al tax ret all state taxes required under the law. /32-0086006 Sign ure Date SS#or Federal Identification Number Revis 20/13 poolappl l.doc Check#Date .N "InP IN ... .. Yh NA PIE QPA ABrd—Mlo I Hayward industrial Drive 12HANWARUPolowroducts' clemmons,NC 27012 A Hayward Industries,lnc.Company 335-712-9900 www.haVwardnet.com CERTIFICATION OF COMPLIANCE Contains: WG1048E or WG1048EW Description: 8" Round Suction Outlet Cover Ratings: Floor: 125 GPM Wall: 72 GPM Open Area: 8.1 sq-in Certified to Comply with Section 1404 of the Virginia Graeme Baker Act(VGB)Pool& Spa Safety Act Test Results can be obtained from:www.Haywardnet.com and/or htto://www.nsforg/Certified/Pools/ Manufactured: After December 20, 2008,by Hayward Pool Products in Jiangsu Province,China and Clemmons,NC Divisions of Hayward Industries,Inc. 620 Division Street, Elizabeth,NJ 07207,Phone 908- 355-7995 Date of Mfr: The Lot Number shown on the product label contains the Year& Month of manufacture. The first number represents the year(ex 8 =2008)and the second character the month(A=Jan, B=Feb,H=Aug,I is skipped, J=Sep, etc) Tested to ANSI/ASME 112.19.8-2007 (addendum 8a-2008)per Section 1404 of the Virginia Graeme Baker Act(VGB)Pool& Spa Safety Act. Certified by NSF International,789 N. Di oro,Road,Ann Arbor,MI. 48105 1(800)-NSF-MARK. �n�, t74-n)"oLjA/ � 1 Date of Installation: / c, ®SLS ISWG1048COC Rev B . 6" SPACING BETWEEN MOUNTING HOLES USED ON FOLLOWING SERIES: • 00 00 WG1030AVPAK2 SP1030AVPAK2 - ' 0000000 WG1048AVPAK2 SP1048AVPAK2 000000S WG1049AVPAK2 SP1049AVPAK2 073/4" .p 0000000,. 0000 00000 WG1051AVPAK2 SP1051AVPAK2 SUCTION OUTLET 0000000000 WG1052AVPAK2 SP1052AVPAK2 COVERWG1048E 000000 WG1053AVPAK2 SP1053AVPAK2 000000 WG1054AVPAK2 SP1054AVPAK2 000 000 WG1153AVPAK2 SP1153AVPAK2 000 00 WG1154AVPAK2 SP1154AVPAK2 G VLL)LIIVE HAYWARD'Pool Products corvmOLs One source. Every po61. s _ ' CommonwealfhofMassaehusetts ?lF v'a` S 1/ a tl -. �x-F_:p ® "City of Salem,ft;6 `� � '}� = c wBand f H a f° Kllllbefl y Dfi3f�11 �� so 120 Washington St eet,4thFlooa t M8y0�� °� a a x SALEM,MA ky N11970 - S imiWng Pool Seasongal DATE PRINTED x 05/2212013r r s 10 04 } I = Villa eat Vmnin Square Pool y` ESTABLISHMENT NAME: g 9 t � , • ^m 17- File Number BHF-200".v at Vmmn S ware/1il1,Fama 92 ;Village� 4 "SOO,W Cummings,Park 6, " c SALEM 1 MA01970 ,: ' d 5 �, •'u+„ 'g �� Af a -$,� w # x` #& gist' - a :p 'LOCATED AT ;_ a �� 14w $ f SALEM,1v1A 01970 ,w -11 # Permrt Type -A"Permit No� Permrf Issued Perodt Expires e�%_ {Fee Ilestncdons/Notes - E SWIMMING POOL BHP 2013 0421 May 25;2013 _Sep 9,2013'� �$140 00 y P s 3Total Fees : 3140.00Wilt Aix yt ^� a 3�• ,mob `�.a � ,y� r , Nr 'i ^fiw' 1-.1-361 -gym _,t, Y a x m� f4 +4, ' `$ vw�t _ riga 1 40 :;r r 5 - ` s '$s yya � '� 3.. e . f" prj PERMTT EXPIRES September 9;`2013 s 3 gx �� Board of Health o- ' A15 I i a ` W 4 � L"t":s .y v _ .cam "� 05 x x �m g` s 3' ry 4 V`ys4Y�•,— Y Fj f. Al * .. '�' '':6 ' ,a. �'FP �m ��'". .' "A' A. .`' .. �r CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREET,4TM FLOOR KTEL.(978)741-1800 IMBERLEY DRISCOLL FAx(978)745-0343 MAYOR Iramdin@salem.com LARRY RAMDIN,RS/REHS,CHO,CP-FS HEALTH AGENT ._APPLICATION FOR PERMIT TO OPERATE A SWIMMING POOL LOCATION OF POOL_ 200 LORING HILLS AVENUE, SALEM VINNIN SQUARE REC FACILITY NAME OF APPLICANT _1'EL# 972-741 2nn3 MAMINGADDRESS EAST COAST PROPERTIES, 400 HIGHLAND AVE_ SALEM MA CERTIFIED POOL OPERATOR 01 -182673 Name: nndrpw 7 An!;e1mo- Cert#: TEL# 978_859_4001 DATES OF OPERATION(if not annual): MEMORIAL DAY to LABOR DAY DAYS &HOURS OF OPERATION: 7 days a week — 10 AM — 9 PM TYPE OF POOL Public Semi-Public _,qv Special Purpose FEE: $210.00 for year round pools $140.00 for seasonal$40.00 Non-Profit (Please pay total with one check payable to the City of Salem) This permit is not transferable and must be reissued upon change of ownership. In accordance with the State Sanitary Code,before any renovations,improvements,or Equipment changes are made,all plans for such must be submitted to and approved by the Salem Board of Health. 4fiffed MGL Chapte C, ton 49a, I certify under the pains and penalties of perjury that I,to my best knowledge and belief, have a tax return an id a s ate taxes requiredender the law. Date SS#or Federal Identification Number Revised 5ell1 poolappl l.doc Check#Date 9 CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREET,4."FLOOR KIMBERLEY DRISCOLL TEL. (978) 741-1800 MAYOR FAA(978) 745-0343 lramdin@salcin.com salcm.com LARRY RAMDIN,RS/REHS,C1 10,(T-FS HrAt;ai AGI NT Swimming Pool Inspection Report Pool:VIL1AWL A? 1Vrc1DWIA SOA%b Date: S-21: 0 Address Phone: Operator: Max Bathing Load: In accordance with 105 CMR 435.00 Minimum Standards for Swimming Pools;State Sanitary Code Chapter V. Annual Permit Posted ✓ Health and Showers signs Posted ✓ Health: no sick employees,no sick bathers, bathers take showers,spitting prohibited,no glass. Lifeguards: Present — Certification Red/orange suit —_"Guard"printed on jersey _Sun block avail. Voice Amplifier _Elevated seat ✓ Emer.Communication:phone at pool `�Phone instructions _Emergency numbers _v—Phone in unlocked area safety Equip: for each 2000,sq.feet _✓Rescue tube or ring buoy(with rope) _✓Backboard with collar and straps _First Aid: Equipment area (35) l"band-aids 110)30 gauze _IZ(2)5x9 surgipads V112)antiseptic wipes _/(1)8x 10 Surgi _L4 )2"soft roller bandages ✓Scissors _(2)3"Soft roller bandages :Zrweezers V(I)'/2 roll hypoallergenic tape , ,"kescue blanket ::v5cle packs �ocket mask sterile isotonic eyewash ✓ Disinfection (OA Chlorine S_5 pH 7.2—7.8 Residual free 1-3,Combined 0-0.2 _Bromine _pH 7.2—7.8 Residual 2-6 (ppm)(mg/1) ✓ Records Kept: ✓ Water tests _Chemicals Used L/8ackwashing ✓Attendance Hours of operation Depth Markings Sidewalk and inside pool ►'1_Diving Boards rigidly constructed,properly anchored,braced for heaviest load,no splinters or c cracks,non-slip surface,not over 10' above water level and at least 13' unobstructed headroom Nk1 Bathhouse: Separate dressing and sanitary facilities for each sex,adjacent to pool,well lighted, drained,ventilated, impervious construction,one shower and one toilet per 40 bathers,hot and cold water, soap provided, no common cups,towels,combs, pool adequately enclosed,approved drinking water facilities Notes: R f : OY 7ci' rv,gPlti�bvL " 1�A� hdt� Gtll.tr f Received Inspected by: T / Commonwealth of Massachusetts 4 i City of Salem Board of Health Kimberiey Driscoll 120 Washington Street, 4th Floor Mayor SALEM,MA 01970 Swimming Pool Seasonal Permit DATE PRINTED: 05/25/2012 ESTABLISHMENT NAME: Village at Vinnin Square Pool File Number:BHF-2004-000192 Village at Vinnin Square/Jill Fama 500 W. Cummings Park#6050 SALEM MA 01970 LOCATED AT: SALEM, MA 01970 Permit Type Permit No. Permit Issued Permit Expires Fee Restrictions/Notes SWIMMING POOL- BHP-2012-0445 May 25,2012. Sep 29,2012 $140.00 SEASONAL Total Fees: $140.00 PERMIT EXPIRES September 29, 2012 Board of Health nn �1 Page 1 �4 + CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREET,4TH FLOOR KIMBERLEY DRISCOLL TEL.(978)741-1800 FAX(978)745-0343 MAYOR Iramdin@salem.com LARRY RAMDIN,RS/REHS,CHO,CP-FS HEALTH AGENT 2012 "41:APPLICATION FOR PERMIT TO OPERATE A SWIMMING POOL LOCATIONOFPOOL 200 LDRTNa HIT.T,S AVF.NTIF. VINNIN SQUARE RECREATIONAL NAME OF APPLICANT FACILITY TEL# 978 741 2003 C/o EAST COAST PROPERTIES MAILING ADDRESS 400 HIGHLAND AVENUE, SALEM MA 01970 CERTIFIED POOL OPERATOR 01 -182673 Name: ANDREW J. ANSELMO Cert#: TEL# 978 852 4001 DATES OF OPERATION(if not annual): MEMORIAL DAY to LABOR DAY 7 days a week DAYS &HOURS OF OPERATION: MONDAY - FRIDAY - 4-1 AM - 7 PM SATURDAY - SUNDAY 10 AM - 8 PM TYPE OF POOL Public Semi-Public XXX Special Purpose FEE: $210.00 for year round pools $140.00 for seasonal$40.00 Non-Profit (Please pay total with one check payable to the City of Salem) This permit is not transferable and must be reissued upon change of ownership. In accordance with the State Sanitary Code,before any renovations,improvements,or Equipment changes are made,all plans for such must be submitted to and approved by the Salem Board of Health. PuauaMGL Chapter 63C,Section 490,I certify under the pains and penalties of perjury that I,to my best knowledge and belief,have filx retur an paid all state taxes required under the law. /' � ,/�,��✓ "l'lrP�lltJ(0 S Hato ✓ Date SS#or Federal Identification Number Revi 5/23/]1 poolappl Ldoc Check It Date CITY OF SALEM, MASS ACHUSE1'TS BOARD OF HE:ILTH 120 WASHINGTON 31'REE'I' 4"r FLOOR �� `CSL. (97$)',•41-1800 F_AY.()78)745-0343 KTMBLRLI,Y DRISC011, h'atxxdina saletn.com LARRY R,\AIDIN,RSf RI'TIS,G 10,CP-FS MAYOR Iil'?N;TII A(_76;N'f i ' t Swimming Pool Inspection Resort Pool• )I1 �e, at VIhnIIn Date: 4agl "fi Address Phone: Operator: Max Bathing Load: In accordance with 105 CMR 435.00 Minimum Standards for Swimming Pools•State Sanitary Code Chapter Y. Annual Permit Posted Health and Showers signs Posted Health: no sick employees,no sick bathers,bathers take showers,spitting prohibited,no glass. (� Lifeguards:Present _Certification —Red/orange suit _"Guard"printed on jersey _Sun block avail. Voice Amplifier _Elevated seat _Emer.Communication:phone a pool �1 —Phone instructions - inA'�Po}15 _Emergene nu hers _Phone in unlocked area rJr � Safety Equip:for each 2000,sq.feet _Rescue tube or ring buoy(with rope) _Backboard with collar and straps First Aid: Equipment area J(35) 1"band-aids (10)3x3 gauze (2)5x9 surgipads (12)antiseptic wipes (1)8x10 Surgi (2)2"soft roller bandages Scissors (2)3"Soft roller bandages Tweezers (1)Yz roll hypoallergenic tape Rescue blanket _�ice packs Pocket mask sterile isotonic eyewash _Disinfection _ chlorine •Q pH 7.2–7.8 Residual free 1.3,Combined 0-0.2 _Bromine ?�pH 7.2–7.8 Residual 2-6 (ppm)(mgll) Records Kept: _Water tests _Chemicals Used ^Backwashing _Attendance _Hours of operation AK Depth Markings Sidewalk and inside pool Diving Boards rigidly constructed,properly anchored,braced for heaviest load,no splinters or c cracks,non-slip surface,not over 10' above water level and at least 13' unobstructed headroom _Bathhouse: Separate dressing and sanitary facilities for each sex,adjacent to pool,well lighted, drained,ventilated,impervious construction,one shower and one toilet per 40 bathers,hot and cold water,soap provided,no common cups,towels,combs,pool adequately enclosed,approved mg watertrihties Notes: _ yM1p tiv Yyt j1 a i (25m3 Iy1 ; PMUt i '3+r t Y_' T4 Received by:_ Inspected by: t Commonwealth of Massachusetts City of Salem Board of Health Kimberley Driscoll y1� 120 Washington Street,4th Floor Mayor SALEM,MA 01970 Swimming Pool Seasonal Permit DATE PRINTED: 05/24/2011 ESTABLISHMENT NAME: Village at Vinnin Square Pool File Number:BHF-2004-000192 Village at Vinnin Square/Jill Fama 500 W. Cummings Park#6050 SALEM MA 01970 LOCATED AT: SALEM, MA 01970 Permit Type Permit No. Permit Issued Permit Expires Fee Restrictions/Notes SWIMMING POOL- BHP-2011-0446 May 28,2011 Sep 6,2011 $140.00 SEASONAL Total Fees: $140.00 PERMIT EXPIRES ISeptember6, 2011 Board of Health Page 1 CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREET,4"'FLOOR TEL.(978)741-1800 KIMBERLEY DRISCOLL FAX(978)745-0343 MAYOR DGREENBAUMQSALEM.COM DAVID GREENBAUM,RS ACTING HEALTH AGENT 2011 APPLICATION FOR PERMIT TO OPERATE A SWIMMING POOL LOCATION OF POOL 200 LORING HILLS AVENUE VINNIN SQUARE RECREATION NAME OF APPLICANT FACILITY TEL# 978-741-2003 MAILING ADDRESS 400 HIGHLAND AVE. , STE 11 , SALEM MA 01970 CERTIF� POOLJOPE EOMO 01 182673 Name: REW Cert#: TEL# 978-852-4001 DATES OF OPERATION (ifnotannual): Memorial Day to Labor Day DAYS & HOURS OF OPERATION: 7 days -- Mon—Fri — 11 AM — 6 PM Sat—Sun 10 AM — 6 PM TYPE OF POOL Public Semi-Public Special Purpose FEE: $210.00 for year round pools $140.00 for seasonal$40.00 Non-Profit (Please pay total with one check payable to the City of Salem) This permit is not transferable and must be reissued upon change of ownership. In accordance with.the State Sanitary Code, before any renovations, improvements,or Equipment changes are made,all plans for such must be submitted to and approved by the Salem Board of Health. Pursuant to MGL C pte 63C, Section 49a, I certify under the pains and penalties of perjury that 1,to my best knowledge and belief,have fligg all state tax turns a d paid all state taxes required under the law. 5 X11 11 32 0086006 Oture Date SS#or Federal Identification Number Revised 10/6/10 poolappl l.doc Check# Date 7O East Coast Proortles, LLC 40 MDIMmO Avenue,9M,t t LiYMn.MA 01970 - (a1re1 741.2MS ` CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREET,4".FLOOR TEL. (978) 741-1800 KIMBlRLF_'Y llRISCOLL FAX(978) 745-0343 MAYOR lramdita(@sadeiii.com LARRY ItAMDIN,16/RGI-1S,CI-10,C11-15 HFA:rI-IAc;FNT Swimming Pool Inspection Report Pool: VACISte, 0TVIhVIiVI Date: S( ,I hU Address Phone: Operator: Max Bathing Load: 1n accordance with 105 CMR 435.00 Minimum Standards for Swimming Pools;State Sanitary Code Chanter V. Annual Permit Posted Health and Showers signs Posted Health: no sick employees, no sick bathers,bathers take showers, spitting prohibited,no glass. Lifeguards: Present _Certification _Red/orange suit _"Guard"printed onjersey _Sun block avail. _Voice Amplifier —Elevated seat �Emer.Communication:phone at pool _Phone instructions _Emergency numbers Phone in unlocked area V Safety Equip: for each 2000,sq. feet Bescue tube or ring buoy(with rope) ackboard with collar and straps FirstAid: Equipment area V_�(35) 1"band-aids t/0)3x3 gauze I/(2)5x9 surgipads12)antiseptic wipes 1)8x10 Surgi f2')2"soft roller bandages cissors �/O z roll)3"Soft roller bandages V Tweezers ✓ 1 hypoallergenic ypoa lergenic tape Rescue blankete packs Pocket mask sterile isotonic eyewash Disinfection —Chlorine .90 _pH 7.2-7.8 Residual free 1-3,Combined 0-0.2 _Bromine SopH 7.2-7.8 Residual 2-6 (ppm)(mg/1) 1/ Recor s Kept: Water tests -hemicals Used �ackwashing _Attendance ✓ Hotyrs of operation Depth Markings Sidewagand inside pool Diving Boards rigidly constructed,properly anchored,braced for heaviest load,no splinters or c cracks,non-slip surface, not over 10' above water level and at least 13' unobstructed headroom Bathhouse: Separate dressing and sanitary facilities for each sex,adjacent to pool,well lighted, drained,ventilated, impervious construction,one shower and one toilet per 40 bathers,hot and cold water,soap provided,no common cups,towels,combs, pool adequately enclosed,approved drinking water facilities Notes: `� h G/1ryisins ) - oroAzxl 5m,1, CI vlzs vel 121 OAf I Received by: Inspected by: ,_ -- - �r- - _ .j • .-. �.y .,� w,. ti A:.-.- .�:✓11,.'. ,.�'�,r�,.-.i.....y._y.e"S nw,T ^ "-+....d+' '4• Inspection of U � � �-E�P U� UI1/I it, ��) Date 4;A.?kl Time Name Address Owner Tel. No. Type of Inspection Inspector ( ' ) Remarks and Violations are listed below: -)n f�11 , Sri} n,n(vx r, ,tel �tirx5 ctr cY rr Ne �"}( �n( 0 rVlr C,4 U, PrP yl'lf�r J � — � ` /-)tr ,1,:�..P }I � :�;�` () �r �( ii�t? I� Vt-t � IC` � 'F-41. t7�:1✓ FOS, l�-� ` I ' E , ,iID, T -7')( `�(-d-CTH H , + ir-( WC, iccc " : 4 ,r, 11�Y1 � '1fr> rr -(=�r,x r-��r) ol� ) . v1I � �Y} C ✓S'�� M Report Received by: 14/16 1 41i . .,..,. .� �JF'.a�r:.,f:•�,. � .... -, -,.: ��_,�... .- ,�� _. .... _,� r.._ ..v.. ... )�w.,.�,.r• ,.�.. _^° _✓.gip• -_ v - i` ^'Sd Vl+^^l J� • 7,e Inspection of V i �� {� �� Ui�l>> li"1 e Date // i Time Name' Address Owner " Tel. No. Type oflnspection � Inspector ( ' I Remarks and Violations are listed below: ' ✓)— r t , 'Wi 34 411 , f •, . I1ytI ✓l r ,� t ', rf5 lCi *" - . t j r tel, t r(• i 0 c +�' "`,U�-I ( i'� ( � �•C � �1 �,�(-� �- i Srt � P'l�r, . Q + ��l �fl-.�"".7f t � -/ /l Report Received by: ..i✓4" ! '' Commonwealth of Massachusetts City of Salem Board of Health 120 Washington Street,4th Floor Kimberley Driscoll SALEM,MA 01970 Mayor Swimming Pool Seasonal Permit DATE PRINTED: 05/26/2010 ESTABLISHMENT NAME: Village at Vinnin Square Pool Fite Numba:BHP-2004-000192 Village at Vinnin Square 1 Jill Tama 500 W.Cummings Park#6050 SALEM MA 01970 LOCATED AT: SALEM,MA 01970 Permit Type Permit No. Permit Issued Permit Expires Fee Restrictions/Notes SWIMMING POOL- BHP-2010.0431 May 26,2010 Sep 10,2010 $140.00 SEASONAL Total Fees: $140.00 PERMIT EXPIRES Septemherl0,2010 Ise - - -- Board of Health Page 1 !✓h Inspection of 1� fX�f� rt ' U Iyi;yl ,-)D I Date _ 1 aS 1 Time v Name Address Owner Tel. No. Type of Inspection Inspector i 1 Remarks and Violations are listed below: An n rxoIng iapec-bot) ,: -j AI_S 0,-3oI uxk� CorcluC*j ctyl � li( 11ni,t)1h`tolP(P nc-+ei V1,)CI C k hcno M 'S+rgnS ("Dwke I7-P-Dr1 0Cd0l-tq - QNn"TP v t Ag r ✓ ��« c,t� in 54kv>1r�no,r C�ver� . LQ- 1' - ''_ 6(3 lh I ISt P►'J6nr)57,, b,-.nl 7)1,7m .-)n �bfh000m or kt outi 1, w4l 7,g z�i .skcx, r obruh Tor -o nr10 o jou k1ay c)-,:2c)-,:23,( 0 nm Cruel pprk "� 010 to I 1 ' 6�� hcerne Jo�elm r oCCi cA .-�k Report Received by: , Inspection of `� r�1(X`'f' CCS' �1I1mlo Doz,I Date � QT—Time t Name Address Owner Tel. No. Type of Inspection Inspector ( ' I Remarks and Violations are listed below: J �1cr I ( iy { ��;,r ) ( i�, rECI l r t vC�5 S�ywP) • ✓ �rfe (At In !�kVY, , li 'i t taCe v(�Priy-r h-ni " ` �i sh an 4 otheo')m r b�LYT� Cd Of AV ACID lNt(� ro ?jl1 SV1-�wP,V Ot StC�Q �r C� If 1vtdP 4C1� 7rt �-Ptld (,)rlc �r� y �(�€_t ��C�Y(c�Grc.e `+of -�i Gid �I �• ✓ U ! alt re �t,Jr� � rC L 0 lCtCC I r) A IC. x .D�/ Owl .''r d otw-(t { 1yy\-e by 11 V ' Report Received by: r CITY OF SALEM BOARD OF HEALTH — 120 WASHINGTON STREET 4TH FLOOR, SALEM, MA 01970 ` AWIhI"N�T1Y�Pn_gZr.. ON RFPrJRT Pool: 11`t ck-'e Ctt yIV�V}lrVl Date: j a? (o Address: Phone: Operator: ntlNi O7 Max. bathing load: In accordance with 105 CMR 435.000 Minimum Standards far Swimming Pools; State Sanitary Code: Chapter Y �-ANNUAL PERMIT POSTED HEALTH and SHOWER SIGNS POSTED -HEALTH: no sick employees, no sick bathers, bathers take showers, spitting prohibited, no glass. (�} -LIFEGUARDS: Present -certification _-red/orange suit _ -"guard" printed on jersey -sunblock avail. _-voice amplifier _- elevated seat -EMER COMMUNICATION: phone at pool ✓ -phone instructions _- emergency numbers �-phone in unlocked area SAFETY'EQUIP.: for each 2000 sq- feet - rescue tube or ring buoy (with rope) 041?r�backboard with collar and straps - FIRST AID : equipment area A/ -(3S) 1" bandaids AZ-(10) 30 gauze _%/-(2) 5"x 9" surgipads V-(I) 8x10 surgi ,/ -(2)2" soft roller bandages - scissors ✓-(2) 3" soft roller bandages Se uJ to - tweezers -(1) 1/2" roll of hyperallergenic tape 5 a rim - rescue blanket - ice packs _A/-(12) antiseptic wipes coin A/ - pocket mask -(I) sterile isotonic eyMe , V1- DISINFECTION chlorure pH 72 - 7.8 Residual: combined 0-0-2 - bromine pH 72 - 7.8 Residual: 2-6 (PPM) ,m9/1) JS water tests ✓ chemicals used t/ - backwashing aQ `6�..„C1-rats - attendance hours of operation krt1z�} cr�41I - DEPTH MARKINGS sidewalk and inside pool baroam DIVING BOARDS: rigidly constructed, properly anchored, braced for heaviest load, no splinters or cracks, non-slip surface, not over 10' above water level and atleast 11, t unobstructed headroom. BA rI-I HOUSE: scperatc dressing and sanitary faciliocs for tach sox -adjacent to pool, wcWhghtcd.dramcd, j ventilated,impervious eonstnxdon,one shonru and one toilet per 40 bathers,hot and cold watci.soap ptov,dcdno common cups, towels, combs pool adequately crtclosed approved drinking water facilities received by: — —_---_ ^_� inspected by' d. CITY OF SALEM, MASSACHUSETTS BOARD OF FIEAum 120 WASHINGTON S-I REET,4"'FLOOR. TFL.(978) 741-1800 KJJ BM ERLEY DRISCOLL FAX(978) 745-0343 MAYOR IMANONI @S Ai rm COM 1ANF I'MANCINI AcriNG 1-If M.iIi AcF.N r Swimming Pool Inspection Report Pool:y�nnsh <_Ur OS Date: Slaa )O0. Address �� t�•m�y4_ Phone: Operator: t5jti,n Ccf'st Z,!?t Max Bathing Load: 7n accordance with 105 CMR 435.00 Minimum Standards for Swimming Pools:State Sanitary Code Chanter P. Annual Permit Posted Health and Showers signs Posted Health:no sick employees,no sick bathers,bathers take showers,spitting pprohibited,no glass. Lifeguards:Present Certification Red/orange suit _"Guard"printed on jersey Sun block avail. Voice Amplifier —Elevated seat Emer.Communication:phone at pool [Phone instructions ✓ Emergency numbers J Phone in unlocked area ✓ Safety Equip:for each 2000,sq.feet Rescue tube or ring buoy(with rope) N A Backboard with collar and straps First Aid:Equipment area (3 5) 1"band-aids _u/(10)30 gauze A/(2)5x9 surgipads (12)antiseptic wipes (1)8x10 Surgi y/(2)2"soft roller bandages Scissors i/ (2)3"Soft roller bandages Tweezers ✓(1)V2 roll hypoallergenic tape i/ Rescue blanket ice packs Pocket mask _.Z sterile isotonic eyewash Disinfection _Chlorine Mies _✓pH 7.2–7.8 Residual free 1-3,Combined 0-0.2 _Bromine _pH 7.2–7.8 Residual 2-6 (ppm)(mg/1) Records Kept: Water tests ✓Chemicals Used --)p Backwashing Attendance :2 Hours of operation Depth Markings Sidewalk and inside pool p Diving Boards rigidly constructed,properly anchored,braced for heaviest load,no splinters or c cracks,non-slip surface,not over 1.0'above water level and at least 13'unobstructed headroom ✓ Bathhouse: Separate dressing and sanitary facilities for each sex,adjacent to pool,well lighted, drained,ventilated, impervious construction,one shower and one toilet per 40 bathers,hot and cold water,soap provided,no common cups,towels,combs,pool adequately enclosed,approved drinking wat r facilities Notes: s n S GCoV Received by: Inspected by: _ mcu 1 Nee 4 4b: wemt6ept) Dr. Lin $ Commonwealth of Massachusetts City of Salem Board of Health Kimberley Driscoll 120 Washington Street,4th Floor Mayor SALEM,MA 01970 Swimming Pool Seasonal Permit DATE PRINTED: 05/21/2009 ESTABLISHMENT NAME: Village at Vinnin Square Pool File Number:BHF-2004-000192 Village at Vinnin Square/Jill Fama 500 W. Cummings Park#6050 SALEM MA 01970 LOCATED AT: SALEM, MA 01970 Permit Type Permit No. Permit Issued Permit Expires Fee Restrictions/Notes SWIMMING POOL- BHP-2009-0465 May 21,2009 Sep 30,2009 $140.00 SEASONAL Total Fees: $140.00 PERMIT EXPIRES ISeptember 30,2009 Board of Health Page 1 .f CITY OF SALEM, MASSACHUSETTS BOARD OF HHkun-i 120 WASHINUION STREET,4''FLOOR TEL.(978)741-1800 KIMBERLEY DRISCOLL FAX(978)745-0343 MAYOR 1DIONNr(,@SAt.rNi.COM J ANET DIONNE, SENIOR SAN11:k1RIAN 2008 APPLICATION FOR PERMIT TO OPERATE A SWIMMING POOL LOCATION OF POOL 0D :^ ' $ Abe NAME OF APPLICANT '1(EEv e f L11 12ee, TEL# ?y/- �FJ02- 90�`I x a3- .S MAILINGADDRESS Ch /T�nl2•`Gtr! / /yGJer �`r/ 7�_-4-,-r 6-66 Lt)eul- G/0m.i+,-h,9s Su.fc ('6s6 CERTIFIED POm/9 O/ 9o/ OL OPERATOR Name: /7 "Z/i J Cs - --/'oCert#:b 1-,204 EL# aS& - '7 25/ DATES OF OPERATION (if not annual): Aa_r, _2J, .2 o d 2 00 S DAYS&HOURS OF OPERATION: /�0)1 - f'l' C/ // qrn �fJ�z TYPE OF POOL �T/- )'"S6'AC( /b aM 7L6 flus, Public / Semi-Public _T Special Purpose FEE: $210.00 for year round pools $140.00 for seasonal$40.00 Non-Profit (Please pay total with one check payable to the City of Salem) This permit is not transferable and must be reissued upon change of ownership. In accordance with the State Sanitary Code,before any renovations,improvements,or Equipment changes are made,all plans for such must be submitted to and approved by the Salem Board of Health. Pursuant to MGL Chapter 63C,Section 49a,I certify under the pains and penalties of perjury that I,to my best knowledge and belief,have filed all state tax returns and paid all state taxes required under the law. C� G4 a� enf S / �� oZ " bb � - (aoo6 gigrigire Date SS#or Federal Identification Number - Revised 8/14/07 poolapp.wpd Check# Date 40n I 1 i "fi•/,•:+'(fr• : ii, : . ii'i V:•::.;r;•;-:. ,1, 1 ri, 1-•i Fa,4,.•d;;, . .Nii..,.1.1,•c1::K`•i�i�'.•.::.••ve�•..:••J•rrr4.;•'.:•Fv,':•:••a4A.•.-.;• %ii{'':''d'•0,ii 0'9 Irf I•Q fofi e' liil e' f' �iifi !•R iNl O'Q Hfp o Q fief,•�H11 4 R f1 f, I l,ry 4 ffa/ Iff1 0 �1lf1 I!Q,fiH 9'p�li,l f•pR,.Hfiem�rifi.!!p�"Y"'VY pQlii, If•Q,li,r f!p\ lilt P p0 •.V\ / f:!!. If.9 b,. 1,.! 11 .,1 Yt .,l1t 1 , ,9 . 1 I. ':d� 11 ..B , 1+1 "!2, Hf •,Ap,iH1.�pn 11{1 Ip"ti1H �}V{11'!�HlI P= �Hnr.!® 4/Hf✓.� tllil pa 41A11 f }IHI,q .ie+ll,. piti4l1 , toll., doll; Qotf 111•. H{I r:.I,......1 I a / .:. 1 1 +:; ! •�a ••�! +l. 11 1 ,. ..+ 1 f••. I.i 1 f4. . .�f1.4.F.. .`4ti1+. JI4h1 aylir P. �1 H9�=. .,+1} 1;., ..if!.11,. .. i11 H . 1.1/91W --elfil ,V i4t11'. 11 H'1: �1,IPH,; ",IMHM., =iP+H 9MHY 9 411{'. 1},11"t, {It. P., ,„ " •:w v. 1 s + .a;•. 4 J � . i 1" 1 1 .I:.:H1 J °4Jofit{fiit'��stt{{tf�it�{tt�lt{Ht Lz � •it I'' \ r II Certified x ool / Spa OperatorP — my �(il ��141 l��e •?� if r as an Operator of Aquatic Facilities ll're 1 CPO° Registration No. 01 -206770 is hereby Certified and Registered 1 ,. by the a NATIONAL SWIMMING POOL, F ND ION LI -_ on 31'29/07 DATE CERTIFIED ' ® rl r��l INSTRUCTOR ®9 �L'i •1R'Q� 1) 11�� •; ,.. —_�t}i . r,, lllllr�s, ISI �,, II .:� II ,,,: II ,< •, 11 .., It „�, II r i u „ la ,h s ,,, .r., s4,. { <, d .I ",+lllkll,°,INIHI,- IMI1114,tIJIH �.,,.1M.Mf+ .J+J1111�+.�41iL>I!!•r'<,JIJIHI: ,MIH itt i 1 I t cz I 1 f 4 4 1 1 E r- *s + �-et 1 'rel + >s r -+ l: �a.�:.� �. >11JNi. ,eHHI r/14/1 hr',{�/../11/1�y�],..HHk nl!{+1/� .�1H,,.rS ,:+PH{t ;11tH �1144f. .f){4H+, ,�H4f+a •)1441 �• IHr fi4414y .J 11414, e9/{4f/ ti,il y}HH4,�� y5/441 a� 1441 ,HH,. , 4N. .„ 1{N c. Hel„ ,•„ 111:::•:' V'v H,l..�-4HH..�..+HP1\Y�41r Ht Vi:)lHH��,4Hrlw „Hii�e�•//rilm�jf4HN�m lH4r+ p/JfiH m✓iHH,S F'VIrH !VPPH 66S4He+\ !-Irr H'!! 4HfV1 l.4iPi!p{I ml.++ri+iql 0i�i lilrigf 4irifi141,q�i,4pi{,yl >i"llliSh' \6'{J1di' m®i 'l'14'1! m�r'•a,�III 1„IhO gh dm 1111 b,lm iirl aVa 4411 p�m li{i O.e 4f i+ L.m 4u1�Q.!s 4111 l.1 41111\.e+lli+�,0 4ilirl„!{i4N��{li��i!�.6 4�1i1i+�•�1i�ip1.;�iiHil o•g+i{i+r"•6+i4r, �•� iii .�i'.� iii 1.6 4�,i a•!i,i �•� i,r l•�a, �•� iii ,d ill ::a••d..� .: ,�....�i.0•.....i,r...,..,i.,,i,....,,,fi o....if.o...,ir.o:.,!.gyp. .•.•._mf...:.,mf.......a.:.«,._.i._.i..:....._:i.......a....u..a.....r....:.:..,a_...:...__s_,.`.:....,..e..,..:...:..!..•.......:.............:.........:• .,....... ....s,.l u Inspectionof \ HQt<-P Ctt Date Tl:} Time _v Name Address Owner j� Tel. No. -G Type of Inspection_ C .`1�! Inspector E7,J n I Ct 1,1( r y cf ( ' ) Remarks and Violations are listed below: ()I� -C), QJ)iM 000l ire , r, P�+r-�� . � c��, ��uo-+t.,6 ar�� Grp e r � r , o(-s ��SrlaP ��GYYI� � + C.P2 mash Ic, iC)a c.L5 n 1 C CIU CY)M d on(S Y k l da-)C -If) OQ7I (01 , �arli�C�riah Report Received by: ` C- Inspection of -�ilr)te{' +T \,�1i)n[O N i4^, ,N Date '`ce Time Name- Address Owner' Tel. No. Type of Inspection 4 ,`ii' Inspector ( � 1 Remarks and Violations are listed below: �e3 XYk � f> Y J I i l of ' J J t 1�. �t t f r IrY 1,77,N S l (! a-r 4r> --)I �r7n4Jri, Yt Report Received by: i Commonwealth of Massachusetts « e City of Salem Board of Health IGmbedey Driscoll 120 Washington Street,4th Floor Mayor SALEM,MA 01970 DATE PRINTED: 05/23/2008 ESTABLISHMENT NAME: Village at Vinnin Square Pool File Number:BHF-2004-000192 Village at Vinnin Square SALEM MA 01970 LOCATED AT: SALEM, MA 01970 Permit Type Permit No. Permit Issued Permit Expires Fee Restrictions/Notes SWIMMING POOL- BHP-2008-0466 May 23,2008 Dec 30,2008 $140.00 SEASONAL Total Fees: $140.00 PERMIT EXPIRES December 30, 2008 Board of Health A Page 1 CITY OF SALEM, MASSACHUSETTS f.d l Boeao , Hrtt , 120 WG ASIIINPONS711f 11,,4"'FLOOR Tei.(978)741-1800 KID4BERLEY DRISCOLL FAx(978)745-0343 MAYOR -:1'- l:com JOANNE:SCO 1-1, HISAJA H Ac;FNT 2008 APPLICATION FOR PERMIT TO OPERATE A SWIMMING POOL LOCATION OF POOL J00 Lot—.end J- ll S U C V i 11 2g �4 ;A n>N 5 ✓�r 1 - 5 Cj - a2 (, 3 S NAME OF APPLICANT I�rc c a �tv Fccs I; TEL# 4C/0 I>C MGr1 G,r Prw pe.�+`Itj MAILINGADDRESS5oo t,0, Com -!13 PK'F S uf`ll-L GO50t Wu6e- v. m 0 , 90 ( CERTIFIED POOL OPERATOR Name:_ N4lei 14- q r u Cert#:C TEL# 8572--20y-4151'y 6a-15!5 9,(. DA'Z'ES OF OPERATION (if not annual): Q( I a yam? D a J�� 7Yvn bL r DAYS & HOURS OF OPERATION: TYPE OF' POOL Public Semi-Public Special Purpose FEE: $210.00 for year round pools $140.00 for seasonal$40.00 Non-Profit (Please pay total with one check payable to the City of Salem) This permit is not transferable and must be reissued upon change of ownership. In accordance with the State Sanitary Code,before any renovations,improvements,or Equipment changes are made,all plans for such must be submitted to and approved by the Salem Board of Health. Pursuant to MGL Chapter 63C, Section 49a,I certify under the pains and penalties of perjury that 1,to my best knowledge and belief,have filed all state tax returns and paid all state taxes required under the law. Ilk dIl' f s / ZSlcel 3d- - 00 - Gvo 6 Sigire V Date 9S#or Federal Identification Number /�. a C2. Revised 8/14/07 poolapp.wpd Check# Date�579116)35a 31s UO �ly° CITY OF SALEM BOARD OF HEALTH — 120 WASHINGTON STREET 4TH FLOOR, SALEM, MA 01970 ON— SWn-nfiNG POOL INSPE oN REPORT Pool: Vl �1nnin Sea :Nb Date: Address: PhonI -`bZ q)_29 < 23a Operator: Chv c.lt Car-WA no/-o - Max. bathing load:_ _ - _ _ in accordance with 105 C1JR 435.000 Minimum Standards jor Swimming Pools, Sicte Sanitary Code Chapter V ria - ANNUAL PERMIT POSTED �ALTH and SHOWER SIGNS POSTED HEALTH: no sick employees, no sick bathers, bathers take showers, spitting prohibited, no glass. f - LIFEGUARDS: Present _- certification - red/orange suit - "guard" pnnted on Icrscy _ sunblock avail. - voice amplifier _ - elevated seat L,X - EWER CO�CATION: phone at pool — one instructions ✓ - emergency numbers hone in unlocked area t,Z SAFETY E�I .: for each 2000 sq. feet rescue tube or rung buoy (witli rope) - baca d with colla and straps _- Fli<JT AI1J e- '1 pment ui ea -(35) 1" bandaids 10) 30 gauze 2) 5"x 9" su gipad< -(1) 5x10 surgi F2) 2" soft roller bandages - scissors /_((�2) 3" soft roller bandages V - tweezers e/-t l)_1/2" roll of hype Iergcive tape rescue blaakct ice packs packs (12) antiseptic wipes pocket mask f) sterile isotonic eye wash /ASINFE-C T]ON -1 C-,). chlorine pl-1 7.2 - T8 Residual: lice 1-3, combined 0-0 bromine pH 7.2 - T8 Residual: 2-6 (Ppm) (RK3,/1 1'I'("ODDS kc; t �- water tests ✓ - chemicals used - t><ic:kwashing - attendance to A"'-�("`` hours ofolxration 1)h:P l 11 MARKINGS .adc%v:dk and inside pool DIVING 130ARDS iir,ully coh;Irnrirti, prohcrly anchurcd, hria.d fol hcavlc:-1 luau, no splinter of cracks, now �;lil, e,nf:,t-c_ not ovci 10' above watrl levt.l ;+nd itlra"d ! ; unobstructed hcadrooin V/117A F I-IIjOI)S1'. >cpuaI, di,r,inr ani ;an,(a,y Iaahlio Ins cad,so adaea„ ,o pool. well 1 1,J d,:1 v,wdated. unperv10n5 consnue,ron,unr ;howu and one Imi'l Ixi AO buhws, ho, and cold ��a,p. eoa7,p""'i'd np cnnmion cpp, to"'k, con,h. pool mlrqunicly<ndo;ri zpw1111l dimkmg w�,c- h(11111"ccc cd by�� " I /�� nsfxacd by 'AM (7671',17J�/-'Iftlro w kms, A . tJoa ZSW twtwll�f� = 3s �X a.51= IC' 3 . S � �rnw► t +� G = lZzS- 300 = 92r fiZ = � dei►, � s��. � dep►h < s �+ . a. 9257f42 Izzs f4Z 3s' Soof�Z I 1 r 3U� 3V* ?o �/- 0°° ° e City of Salem, Massachusetts 10r - � q Board of Health _. 120 Washington Street, 4th Floor, Salem, MA 01970 PublicHealth Tel. (978) 741-1800 Fax. (978) 745-0343 Prevent.Promote.Protect. Kimberley Driscoll Iramdin@salem.com Larry Ramdin, MPH, REHS, CHO Mayor Health Agent PUBLIC POOL HEALTH PERMIT Permit# Po-15-10 License For : Pool (seasonal) Date of Print 6/3/2015 Granted To: East Coast Properties Permit Issued 5/15/2015 Address: 400 Highland Avenue SALEM MA 01970 Permit Expires 9/7/2015 Location of Establishment: 6 LORING HILLS AVENUE Permit Fee $140.00 Restrictions: Loring Hills Condominium 6 Loring Hills Avenue Late Fee $0.00 Notes: This permit or license is granted in conformity with the statues and ordinances relating thereto, and expires on 9/7/2015 , unless sooner revoked or suspended. A 1 CITY OF SALEM, MASSACHUSETTS '> BOARD OF HEALTJ I 120 WASHINGTON STREE;1',4T FLOOR KIMBERLEY DRISCOLL TEL.(978)741-1800 FAX(978)745-0343 MAYOR LRAMDINQa SALEM COM LARRY RAMDIN,RS/RENS,CHO,CP-FS HF.AI,rH AGENT 2011 APPLICATION FOR PERMIT TO OPERATE A SWIMMING POOL LOCATION OF POOL 6 Loring Hills Avenue NAME OF APPLICANT_Loring Hills Condominium Unit#1 Trust TEL# 978-741-2003 MAILING ADDRESS-400 Highland Avenue, Ste 11, Salem MA 01970 CERTIFIED POOL OPERATOR Name: ANDREW J.ANSELMO Cert#: CPO-251439 TEL 4978-852-4001 DATES OF OPERATION(if not annual): Memorial Day, 5/15/15 thru Labor Day—9/07/15 DAYS &HOURS OF OPERATION: Monday thru Sunday 10 Am to 8 PM TYPE OF POOL Public Semi-Public x Special Purpose FEE: $210.00 for year round pools $140.00 for seasonal$40.00 Non-Profit (Please pay total with one check payable to the City of Salem) This permit is not transferable and must be reissued upon change of ownership. In accordance with the State Sanitary Code,before any renovations,improvements,or Equipment changes are made,all plans for such must be submitted to and approved by the Salem Board of Health. Pursuant to MGL C ter 63C, Section 49a, I certify under the pains and penalties of perjury that I,to my best knowledge and belief,have Meal stat tax tur s and paid all state taxes required under the law. Si at re Date SS#or Federal Identification Number Revised 5/23/11 poolappl Ldoc Check#Date G� ��0 ;I !IIII ili.;11111'1 IIIh1' 11!1, l 11 jh'` I': Ilp'+ I ,ry'n r!i'I �I I I I I LII II l:i ' � II 'If hl r�p p ✓ �� ' p.•• - ;Ira{ir,�f,{ ,� r91�Nr rirdm:IYvYm'�t,'i° tr ..5 'kiriliin�,qIdu� 9I 1I�I wIvNlA�m ini4+rr:dI ll�'�I 1m�'IiV",''yIk Ir�'�'snlMi p.. �4C � INoMl1 WL 11I , r+Sh♦iti�r vl III OLD Ma'n�� A kI,Y��;,Jl�';i. l+� Y + ,�I� ,P�'� 4'k«,' y .� �• ."� ( f, f 11111111, 11111 II, 11111^i 11'11111. 'L� '11'� IIghllil 111, a 11' IIIIIII IIIIpI 11111.i VIII I I � 1' IIIIIAfI' I I' 'II r' I r • f L r ',, 111'111 ill 11 :I,1��yy1I111,III i 11; II,i1,V iI�I��I, I ll:h l��illl'I'.IIII'I ITVy � 11111:1,111, �1 Ili„ Il,all!Ilgl,l111 Ill��l'II IIII �1�louq' III1i lt'.IIIIIII'ilLJuak!• III, �; 'I I'I IIIi '.IIII � �II II IN_d .Pll,� l, '"� I'�I'iI�II,�11111� 1,,II,N ',I Iu� r'•.� y i,l' I;I�� ,,I'IIII��II 'I ll�ll;l�u. ®`" 'I�,,II� IIIIIII I �II II�.I'� cati otl tot lew) • V� rlu '�. ,..v Y1m T�IItM1 x ah !r,IP, b.J ('mw �'{ Cj �'F v' b+i:. 1!tm' PS�m j;; iV �•' as an Operator of Aquatic Facilities r- 00 0 V — ltifa'1'IONALSVtfi1M1�1G 00LFOUa4TN� �_ , Lrr' Ci VIII I1II N, Ioou ull I,o II it iIlI:-�.'1I II 111,IIII 1.111%111 IIII,., .. 11 III� �IIIIlil1'. IIIIIIIIIIII' ,III Ife IrIII(IIIIIII. I I�IIII�', IIIIIII II IIIII'I'IIIIL Il i1IIIIII^ I' . f IIIIIII ,11 ',III I�I Ili lli,l I -11 III II II' II.i 11;.111 III IIII;III IIII�IIIr � .. (� I'I IIsi Illy i I IL. i, ,I IIII VIII;. I�P,aI of .�Iilllllll '.I,�IIIIIUIIIIIII�,II��IiIl1� IIII11dIIiIIIIII�II � � II IIII I I w. VIII I, �I II 1111 IIII`'�I II 111!1' IIII�Il i on Da .�� 6,'2C a a� f Certification uRiber: . 0002 .k439 �- z z t Expires •Rarchµ6 ,202� r° ' ° _ s..: .' • ° i I +,�7 i I - p' I a! W� I IIG,'ma t�Nn 4 iuT s^�) /+i �'� .rwf� Y 8 otierlk R 1610e49h. 2!1 ), LL 0I as mlla' chocki =T_ rr Healt Bodtss Chief Executive Officer •; Hea Pbols. 1w I _ � A ...•�• :.E .. .y ..yam �� CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH ,. 120 WASHINGTON STREET,4�"FLOOR KIMBERLEY DRISCOLL T$L. (978)741-1800 MAYOR FAX(978) 745-0343 Immdin@salem.com LARRY RANIDIN,RS/RENS,CHO,CP-PS o HEALTHAGENT -Swimming Pool Inspection Report Pool: 14S121_J La 1�1 L` 1 (As-t_ l Date: S, 12,1 Address 242� LAR_. + 4 i vet ANA Phone: Operator: Max Bathing Load: In accordance with 105 CMR 435.00 Minimum Standards for Swimming Pools:State Sanitary Code Chapter V. Annual Permit Posted � 2 Health and Showers signs Posted Health: no sick employees,no sick bathers,bathers take showers,spitting prohibited,no glass. N1� Lifeguards: Present _Certification _Red/orange suit _"Guard"printed on jersey ✓ —Sun block avail. —Voice Amplifier _Elevated seat Enter.Communication:phone at pool Phone instructions _Emergency numbers Phone in unlocked area Safety Equip: for each 2000,sq.feet ✓Reccue tube or ring buoy(with rope) Backboard with collar and straps _first Aid: Equipment area (35) I"band-aids ✓U 0)3x3 gauze r/ (2)5x9 surgipads _(I2)antiseptic wipes V✓(1)8x10 Surgi �/(2)2"soft roller bandages Scissors ✓'(2)3"Soft roller bandages /7 Tweezers 1)%:roll hypoallergenic tape w/Rescue blanket _Ice packs �--Pocket mask "sterile isotonic eyewash ✓ Disinfection k,"Chlorine pH 7.2-7.8 Residual free 1-3,Combined 0-0.2 Z. . Bromine _pH 7.2-7.8 Residual 2-6 (ppm)(mg/1) 117rds Kept: _Water tests Chemicals Used t/Backwashing ✓Attendance Hours of operation Dep_th Markings Sidewalk and inside pool Diving Boards rigidly constructed,properly anchored,braced for heaviest load,no splinters or c cracks,non-slip surface,not over 10'above water level and at least 13'unobstructed headroom ✓Bathhouse: Separate dressing and sanitary facilities for each sex,adjacent to pool,well lighted, drained,ventilated, impervious construction,one shower and one toilet per 40 bathers,hot and cold water, soap provided,no common cups,towels,combs, pool adequately enclosed,approved drinking water facilities Notes: 51 VV_ '7LL4Vn�t)tlL- � LjJ Received / Inspected by: 7 W4 w v w .5, 6'"w A a'r r^ r 5 rr" 4 t,-, �.�"" t7"°iae r6 ra ..; 'z'' v tR. �'¢ §r ^� .4•Lro } Yy sw rl .} �* s .� ��i. h t F'�y t,'S kr � aY 4 y. Rk�. u » :b� 4 " . 9e ai r ".;¢.r :L „. � Lp' t 4' 53.4v .yj'a''£, e o "KRP, b x„ "�+c�J.r;� `..r)ar` d' n ,:{."k4' a .. 5, a� '�s' "�e ” 4, +�.+, .x '"" e 'w .w�`'u Na r n,[ F $,+qt:y. �t�'�' ,+�'F '` v. itPF,',znd^ City of4$alem Massachusettsµ 5u,�H.:; s�,'y, tia Ahrs"ali ML41 "y ea Y^r ♦ e} '' , x .I .,:�R T+ C ,� k"y �"y�-1°y„�+�Al y '�' � r (L'`:.l t`F '1 �: �A✓N'�`ta*�'t�V� C4r �+wazln �" Ta+, .0.. � '�"�`lM• .� � r +4�; p' ;,r cu � Ft1�4P..°:% �itl�4a •,r� 8. xr -,`$� d, � . ( •6a S .X} '" r{'E,fi'�tt _ry'Yr>'4 °•.. $y {u"r ;^h, 3rP 's' . ?§4fY#$"s. .'L„ .w�t a.`. Board of ealth r4 ."� ""aaX�"fi vY"ar +y. y,9r.°...gq�y,, a, ' `si + �t, 4•' r.} , ` . a �F ° `?,, a,M � }x �Au.;• h��r ,,. 'a w� a � t � ar h . ��.rnw� ds�r'�,z��.:U�t` c$� t.49s 9 ,'F Tf. G��a,'kiYx � `},f `a" elf' �.�+Y w'�3�n+ �efi'.y "E .7Pa x�r"r fi�"ls :. u, Washington Street 4th lour Salem; MA07970 ,rr r� PublicHeAlth� s+ r; «'_ a �, $ ,t,;N+� +741 18U0 F x - 978 745-0343., �} e '- IGmbedeyDriscoll )k ca`<'. � Ir2lfiChn Sia@111'COfTI" " r. * uLarryRamdm'RS/REHS CHb`CPFS+`t � �c +.;+ 0f. `rw .firs .. R''��FF f` cm ..p�x f 9 ,.d v ,.3 �1< .3"� { ,' uh ass P xrp x s s„ kw�r r "tel ne. 3""e .0 9x s l .as n :.r.:b w":.1 .'�a`� v,r'1sfa 3. s Health./�8fltS `„ � '�n�.FCa ��`� :' ��T%Ul}�} $�}�+�1�'4 ��,�•� �v.F:",+hN`,,,,�e�' ��,�b �•�'fi'�', 411 `tj..:¢ :°S 1 + + �.� f {•s<, a, as sk: ,e Y e )n `4d:;? 9 t9°'S "�`4'' �f L ° _ � '�� a i t 1 r:;C' _ : u 5 r;. c �l+r � d� 5 f �, t> �✓ >�� i ..r{ t+.r x n � %4X n,.zro ..�9, y �rt!�s i F+� � T ,Yh,.,4 s� 1' w,,.ixe fS{ r'+n' "�4'sYc ,t�� r�k b e P� �', fF , xx S,'`�'fkya, 'k ^13.. s +'¢F 'M s¢ {•: d u i' .' a y§ Date Of Pflnt i £ OP'�kag pele�MISS! Nd LLC .„ "rra„ ,t{`�" n... : n `• ',aa < ,..,., u ` a ''`: H' k " .� w i r£ z5122/2014,y. „ " v€ gl a .� a x . ' ,r ,.yl ��'i,m 'f5°�4 4 s .~*it a ffm ,,,vv## - 3'3{.+f3"5p., tf "y�" ".+..im t 1�F...•. ,.=d. rur �,c.s a x5 .i.,' v,{gW �i ,-% ., p. 4ga fi 9id5•�nbc d $ rrh } d'" ",}'5 i d c `� a t n:{ '" d"4.r k•a� tkri` '}'n ~,"g xyS. p 3 i 3f "p N k k4 " t r„i d;ry sw., Pennitlssued., v �' �£ . wnl h.7v.§�z ckka'„ . r ..... s _ a + „r eE '� k.°'. t . �.- �, ,y .r rti r a, t ,�'s'., Address "Ea t Coast ,, � 2 , ,,� t Salem s MA 01970} a 5122/2014 . 4 � pf . .. } w # ' d S ' :i x a✓ t< t� d ,�k`.. e” s ` Y S taw $ e t a5- f:sf ropert�es 400 „ ', „ fez " ; ,. , a i x Si F ,r. i, „R.,7y sK4 C•C�, { g ;ti } �.r ', s}^' r' rou r Fn ^ + g fi . e H�ghldnd AVB Ste 1:1 w ti* A Permlt;EX IreS "f k „E,u' Ck�'J :• '„ y`Y a+�'{Dc.;, p tw' rry�,*riia" y .- h r�' , J .' �� ; `y",a aP t��'r ,p( :✓ t' + a,,r.YxvwY aa.+k ��`�e"`{tiv p #. �� ,`N >•:<� a�� 5' aYk ,� �. 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'� t rkiM:: ; m �a'Y At ". fsFr F$ „' G}.h' #'; Sv+'�, +.°r ;.. �f �$°3 r ,✓4.�` �tN, G fi ?F w �. .,fir �` a�5<t' r iaW < n� yp'+ v�4 $�.DO 1 9 w tly 9 nsF"" Sz is y q.d' r t Nff V2 ''m e `9" k f c ,} ,u, uitl rv'£ v £ ,e 4 ✓ `al Y kr`�£ 1 5 +*`s X J of?�M {4 £`i E V4��2 .. a i x aS vy n '�. r s ;Nio a x y ar n m Rro iX y $I. ` 1'1a, trL�. NQt@$ p ,M J: +AF`. y 5 ,.{i. v { uh M1s �`y dr"v("r Irl Y ,p,y'r d rs'?.t„ A. 'xti'� ,° iM a� b }"s. "� y�y { R s} r N. `4" ........ `r ! Yrce i f I Is -t+ Ni"�Y r '�R,.�° i��c> F t`„ �. . r f r "*- a i I, , n' ,� '`Ms�.,; {af'N'"'t,•'"', kT'2, irYt' `n.6n r,p"! Nxi. -h"i. vt":x,sy.+r'u :gym. 'ia, d? �t:N ktwa vy i a,. fi tsar a,xsr ,M ,'r , ;"$V .skf Ta,. This permit or,license is granted in'confomnty'vnth,the. tatues and o finances relating.thereto;and:expires on 4/30/2015;unless sooner.0 revoked or suspended , hg ' .tea i r�'iTt"° s a w"' ..Y Fa n'`1J rf,y F`m 4{fi � 4 31 v�r ' i� Y �b"� ''r Ad,�` �. V A.+'Y 4"ftl� } �£\ ��G'•+3 NiY 4 Av�M� '$. 4/Y�� „ �ry�r � � `' d 1�' Y i�/. r,91 r 1 5wi��Yy t < Y ) c r ! �•.. )'".* 'H S+ s, • � y ' r b ,.5 ;§.fir«.a..,.a�.. ,., )'It,�,c. ,,:. :"uk .aw;"nm*.kt».,'tfl.�x.:n —0—h?C-..,exa17M;.1.w�+. „ava.N&lr.�w .,.«,t,rr>,a.,rys ® CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREET,4"'FLOOR KIMBERLEY DRISCOLL TEL.(978)741-1800 FAX(978)745-0343 MAYOR LRAMDIN(1)SALEM.COM LARRY RAMDIN,RS/REHS,CHO,CP-FS HEALTH AGENT 2014 APPLICATION FOR PERMIT TO OPERATE A SWIMMING POOL LOCATION OF POOL 200 Loring Hills Avenue Salem NAME OF APPLICANT Vinnin Square Rec Facility TEL# 978-741-2003 MAILING ADDRESS 400 Highland Avenue Salem MA 01970 CERTIFIED POOL OPERATOR Name: Andrew J.Anselmo Cert#: 01-182673 TEL#978-852-4001 DATES OF OPERATION(if not annual): Memorial Day to Labor Day DAYS& HOURS OF OPERATION: 7 days a week—l OAM—9 PM TYPE OF POOL Public Semi-Public x Special Purpose FEE: $210.00 for year round pools $140A�for seasonal$40.00 Non-Profit (Please pay total with one check pay to the City of Salem) This permit is not transferable and must be reissued upon change of ownership. In accordance with the State Sanitary Code,before any renovations, improvements,or Equipment changes are made,all plans for such must be submitted to and approved by the Salem Board of Health. Pursuant to MGL Chapte ,Section 49a, I certify under the pains and penalties of perjury that 1,to my best knowledge and belief,have filed a stax rem t and aid all state taxes required under the law. 5/05/14 Federal Id Number: 32-0086006 Sign I' re Date SS#or Federal Identification Number Revised I poolappI Ldoc Check 4 Daze ��jT �✓j,� � Commonwealth ofMassachusetts City of Salem ` * Board of Health 120 Washington Street,4th Floor Kgmbedey Driscoll SALEM,MA 01970 Mayor Swimming Pool Seasonal Permit DATE PRINTED: 0511812010 ESTABLISHMENT NAME: Loring Hills Condo Pool File Number:BHF-2004-000199 East Cost Properies 400Ilighalnd Ave Ste. 11 Salem MA 01970 LOCATED'AT: SALEM, MA 01970 Permit Type Permit No. Permit Issued Permit Expires Fee Restrictions i Notes SWIMMING POOL- BHP-2010-0424 May 28,2010 Sep b,2010 $140.00 SEASONAL Total Fees: $140.00 PERMIT EXPIRES September 6,2010 Board of Health Page 1 CITY OF SALEM, MASSACHUSETTS `.- ✓'�/ BOARD OF HEALTH 120 WASI IINGTON STREET,4" FLOOR TEL.(978)741-1800 KIMBERLEY DRISCOLL FAx(978)745-0343 MAYOR DGREENBAUM@SA1.EM.COM DAVID GREENBAUM, ACTING HEALTH AGENT 2010 APPLICATION FOR PERMIT TO OPERATE A SWIMMING POOL LOCATION OF POOL 6 LORING 'HILLS AVENUE NAME OF APPLICANTLOR ING HILLS CONDO TRUST TEL# 978-741-2003 MAILING ADDRESS 400 HIGHLAND AVENUE , SALEM MA 01970 CERTIFIED POOL OPERATOR 01-182673 Name: ANDREW J. ANSELMO Cent#: TEL# 978-852-4001 DATES OF OPERATION (if not annual): MEMORIAL DAY to LABOR DAY DAYS&HOURS OF OPERATION: 9 AM — 8 PM MONDAY thru SUNDAY TYPE OF POOL Public . Semi-Public Special Purpose FEE: $210.00 for year round pools $140.00 for seasonal$40.00 Non-Profit (Please pay total with one check payable to the City of Salem) This permit is not transferable and must be reissued upon change of ownership. In accordance with the State Sanitary Code,before any renovations,improvements,or Equipment changes are made,all plans for such must be submitted to and approved by the Salem Board of Health. uant to MGL C - 63C, Section 49a,I certify under the pains and penalties of perjury that 1,to my best knowledge and belief,have file 11 state tax etums trid paid all state taxes required under the law. 5/14/10 04-2983765 S g lure Date SS#or Federal Identification Number Ap/sed 8/14/07 poolappmpd Check# Date — rromr978 745 9684 05/2112009 14:52 #269 P.0011005 EAST COAST PROPERTIES - 400 Highland Avenue.Ste. I 1 Salem MA 01970 j 978-741-2003:FAX 978-745-9684 f E-mail:EastCoostPro@ool.com I Real Estate& Property Management I ^ , FAXr DAV ID GR EENBAUM To: 1 From -- Fax__ 978.745-0343 Pages: 3 Phone: 978-741-1800 Date: 5121109 Re: HIGHLAND/LORiNG HILLS POOLS Cc: COMMENTS: Attached are copies of the paperwork regarding the pools at Highland Condominium, i end of Indian Hill Lane and Loring Hills Condominium, 6 Loring Hills Avenue. i I i i i i { I i i i i i i I � i i I i I i i i i i i j I I I i Pram:978 745 9684 05121/2009 14:53 #269 P.004/005 FAMILY POOLS & PATIO, INC. 70 South Broadway Lawrence, MA 01843 978-688-8307 To Whom It May Concern: This is a letter to verify that the pool at Loring Hills Condo on 6 Loring Hill Ave, Salem MA is compliant with the Virginia Graeme-Baker Pool and Spa safety act. On 5/18/09 a Pentair Intelliflo pump with built in suction vac release system was installed on the pool. On 5/16/09 compliant drain covers were installed with the ANSI/ASME Al 12.19.8M stamp on them verifying that they are compliant on the double drains. Any questions please call Family Pools 978-688-8307 x 14. Thank You Bill Gianopoulos Family Pools Owner �l�' From:978 745 9684 05/21/2009 14:54 #269 P.005/005 I Hayward Industrial Drive 12HAYWARlYpooiProducts Clemmons.NC 27012 A Hayward Industries,Inc.Company 336-712-9900 www.haywardneccom CERTIFICATION OF COMPLIANCE Contains: WG1048E Description: 8"Round Suction Outlet Cover Ratings: Floor: 125 GPM Wall: 72 GPM Open Area: 8.1 sq-in Certified to Comply with Section 1404 of the Virginia Graeme Baker Act(VGB)Pool&Spa Safety Act Test Results can be obtained from:www.Haywardnet.com and/or http://www.nsforg/Certified/Pools/ Manufactured:Between October 2008 and December 2008,by Hayward Pool Products in Jiangsu Province, China and Clemmons,NC Divisions of Hayward Industries, Inc. 620 Division Street,Elizabeth,NJ 07207, Phone 908-355-7995 Date of Mfr:The Lot Number shown on the product label contains the Year&Month of manufacture.The first number represents the year(ex 8=2008)and the second character the month(A=Jan,B=Feb, H=Aug, I is skipped,J=Sep,etc) Tested to ANSI/ASME 112.19.8-2007(addendum 8a-2008)per Section 1404 of the Virginia Graeme Baker Act(VGB)Pool&Spa Safety Act. Certified by NSF International, 789 N. Dixboro, Road,Ann Arbor,MI. 48105 1(800)-NSF-MARK. Date of Installation: S1 10 00 1 ISWGIO48COC FAMtk u. FPCoI-S 6" SPACING BETWEEN MOUNTING HOLES USED ON FOLLOWING SERIES: 00 00 WGI030AVPAK2 SP1030AVPAK2 000000 WGI040AVPAK2 SP1048AVPAK2 000000 WG] 049AVPAK2 SP1044AVPAK2 07 314" 0000000 0000 0000 WGlO51AVPAK2 SP1051AVPAK2 SUCTION OUTLET 00000000 WG1052AVPAK2 SPI052AVPAK2 0000 0000 COVERWG1048E 000400 WG1053AVPAK2 SP1053AVPAK2 000000 WG1054AVPAK2 SPI054AVPAK2 000 4 00 WG1153AVPAK2 SP1153AVPAK2 WGI154AVPAK2 SPI154AVPAK2 G%LDUNE HAYWARD'wolaroduets One source. Every pool. CITY OF SALEM, MASSACHUSETTS G BOARD OF I IFAI_TH § � � 120 WASHINGTON STRi rT,4'"FLOOx TEL.{97 8)741-1800 KIN MERLE,Y DRISCOLL FAt(978) 745-0343 MAYOR IMANCtNi(7vn�.ixat.con JANF I'MANCINI ACPINc, HFAi.rH AC:SI',N`r Swimming Pool Inspection Report Pool, rihtlm Date: 5lao kcl Address Phone: Operator: —Max Bathing Load: In aeeorda»ee wi h 105 CMR 435 dd Minimum Standards for Swimming Pools:State Sanitary Code Chanter R Annual Permit Posted Health and Showers signs Posted Health:no sick employees,no sick bathers,bathers take showers,spitting pprohibited,no glass. N=Lifeguards: Present Certification _Redlorange suit _"Guard"printed on jersey Sun block avail. _Voice Amplifier _Elevated seat Enter.Communication: phone at pool Phone instructions m Emergency numbers Phone in unlocked area Safety Equip: for each 2000,sq. feet Rescue tube or ring buoy(with rope) Backboard with collar and straps First Aid: Equipment area (35) 1"band-aids _✓(10)3x3 gauze (2)5x9 surgipads (12)antiseptic wipes (1)8x 10 Surgi s/(2)2"soft roller bandages Scissors _[(2)3"Soft roller bandages 411 Tweezers (1)V2 roll hypoallergenic tape Rescue blanket ice packs V Pocket mask ✓sterile isotonic eyewash Disinfection _Chlorine _pH 7.2-7.8 Residual free 1-3,Combined 0-0.2 _Bromine _pH 7.2-7.8 Residual 2-6 (ppm)(mg,0 Records Kept: Water tests _✓Chemicals Used %/ g Backwashin N]�Attendance -2 Hours of operation Depth Markings Sidewalk and inside pool Diving Boards rigidly constructed,properly anchored,braced for heaviest load,no splinters or c cracks,non-slip surface,not over 10'above water level and at least 13'unobstructed headroom r4lry/ Bathhouse: Separate dressing and sanitary facilities for each sex,adjacent to pool,well lighted, drained,ventilated, impervious construction,one shower and one toilet per 40 bathers,hot and cold water,soap provided,no common cups,towels,combs,pool adequately enclosed,approved drinking water facilities Notes: fCSs .L4 `� t K Gt iQatp (_S }rtat f`a e��no� — Received by: Inspected by: CITY OF SALEM BOARD OF HEALTH — 120 WASHINGTON STREET 4TH FLOOR, SALEM, MA 01970 ]SSWIA�ZM qGP�OO .INSPECTION REPORT Pool: Lc;: Y, l llt��S coido /ppot Date: 5/a7On Address: Phone: Operator: Max. bathing load:_ In accordance with 105 CMR 435.000 Minimum Standards for Swimming Pools,- State Sanitary Code: Chapter V V -ANNUAL PERMIT POSTED - HEALTH and SHOWER SIGNS POSTED V-HEALTH: no sick employees, no sick bathers, bathers take showers, spitting prop bited, no glass. N�A LIFEGUARDS: Present - certification - red/orange suit - "guard" printed on jersey sunblock avail- _-voice amplifier _ - elevated seat -EMER COMMUNICATION: phone at pool -phone instructions emergency numbers -phone in unlocked area A- SAFETY EQUIP.: for each 2000 sq. feet V/ - rescue tube or ring buoy (with rope) QIA - backboard with collar and straps - FIRST AID : equipment area -(35) 1" bandaids ✓-(10) 30 gauze A/-(2) 5"x 9" surgipads ✓-(1) 8x10 surgi ✓ -(2) 2" soft roller bandages ✓ - scissors ✓ -(2) 3" soft roller bandages ✓ - tweezers ✓-(I) 1/2" roll of hyperallergenic tape - rescue blanket - ice packs v/-(12) antiseptic wipes ✓ - pocket mask = -(1) sterile isotonic eye wash - DISINFECTION 5',6 chlorine pH 7.2 - 7.8 Residual: free 1-3, combined 042 bromine pH 7.2 - 7.8 Residual: 2-6 (PPM) (Mg/1) }sept 7.3 - - - water tests _ - chemicals used _ - backwashing - attendance _ - hours of operation DEPTH MARKINGS: sidewalk and inside pool 4} - DIVING BOARDS: rigidly constructed, properly anchored, braced for heaviest load, no splinters or cracks, non-slip surface, not over 10' above water level and atleasl 13' unobstructed headroom. BATI*JOUSE: sepuate dressing and sanitary facilities for each scx - adjacent to pool, wdl-hghlcd,dramed, ventilated, impervious consuucuon,one shower and one toilet per 40 bathca,hot and cold water. soap providedno common cups, towds,combs pool adrouatdy enclosed approyod cinnicing water facilities received by: _ _ inspected by:___ !M TANT MESSAGE FOR DATELl)f5lTIME JD-Lb-�P.M. M n,( OF 5-C2;�fi PHONE AREA CODE NUMBE R q/� (EXTENSION ❑ FAX �/�Y .Jti-2 `Z OO / O MOBILE AREA CODE UM6 R TIME TO CALL TELEPHONED PLEASE CALL CAME TO SEE YOU WILL CALL ASAIN WANTS TO SEE YOU RUSH RETURNED YOURR CALLL WILL FAX�M YOU MESSAGE / `��YJ �"'�'�✓ SIGNED FORM 009 MAOE .S.A. IMPORTANT MESS GE FOR DATE ` a2 'e2 '/ 9,• .M. TIME . M , OF PHONE ?' ARE DE NUMBER EXTENSION D FAX I/� l ❑ MOBILE l" ' AREA CODE N�VMBER TIME TO CALL ,TEL.EPHONEO e'PLEASE.CALL CAME TO SEE YOU WILL CALL AGAIN .WANTS TO SEE YOU "RUSH- 'RETURNED YOUR CA WILL FAX TO YOU MESSAGE I SIGNED s FORM 4aVO9 1 MARE IN U.S.A. NOTES -- --- - - - - . i IMPqRITANT MESSAGE i FOR tt// DATE M / OF PHONE. - AREA CODE NUMBER EXTENSION ❑ FAX O MOBILE AREA CODE N MBER TIME TO CALL TELEPHONED' PLEASE CALL CAME TO SEE YOU WILL CALL AGAIN WANTS TO SEE YOU .; RUSH, .. .O RETURNEE)YOUR CALL WILL FAX TO YOU - MESSAGE n SIGNED 19%ps FORM 4009 MADE IN U.S.A. NOT -S tkz aoj I �-�p=f�;er�z..CuaZ.._I��c;�,(f�svi'tS�_ CLki2_Q ._�OOK•_W��I. .11�TC.J�_ �/ _ I I CITY OF SALEM BOARD OF HEALTH – 120 WASHINGTON STREET 4TH FLOOR, SALEM, MA 01970 I J^` l SW MING POOL INSPECTION REPORT Pool: tffils..-CaDdo,<3Date: Addr Ori FPhone: Operator. �() Max. bathing load: In accordance w+itth' 05CMR435.000 Minimum Standards for Swimming Pools, State Sanitary Code: Chapter V. lY1S rd11 6/a JJ4NUAL PERT POSTED MI ' Aoe�kIEALTH and SHOVER SIGNS POSTED HEALTH: no sick employees, no sick bathers, bathers take showers, spitting prohibited, no glass. (V�- LIFEGUARDS: Present - certification - red/orange suit _- "guard" printed on jersey sunblock avail. - voice amplifier _ - elevated seat MER. CON9AUNICATION: phone at pool ✓ phone instructions —- emergency numbers phone in unlocked area VSAFETY Er.: for each 2000 sq. feet scue tube or ring buoy (with rope) �T- backboard with collar and straps - FIFIST A1i�/: �uipmeix area V - 35) 1" bandaids Z(10) 3x3 gauze Z2) 5"x 9" surgipads 1) 8x10 surgi2) 2" soft roller bandages scissors Y2) 3" soft roller bandages tweezers 1) 1/2" roll of hyper�dlergenic tape /rescue blanket ice packs _ (12) antiseptic wipes V pocket mask 71) sterile isotonic eye wash o'h /DIS0,IFECTION'30 Perkwk"cAon (�-a chlorine pH 7.2 - 7-8 Residual: free 1-3, combined 0-0.2 - bromine pH 7.2 - 7.8 Residual: 2-6 (ppm) (trig/1C) 3 RECORDS: kc t {water tests (chemicals used V backwashing , - attendance - hours of operation DEPTH MARKINGS: sidewalk and inside pool NA DIVING BOARDS: rigidly constructed, properly anchored, braced for heaviest load, no splinters or cracks, non-slip surface, not over 10' above water level and aticast I1' unobstructed headroom BAJ HHOUSE: scpcoalc dressing and sanitary faci Glia for tach scx -adjacent to pool, well-hghtcd.drained, \� ,,entilated, impervious connmcoon,one shower and one toilet per 40 bathers, hot and cold watu, soap povidcd. no common cups, towels,combs tool adcduatdy enclosed approved dnnking water facilities received by: inspected b ¢z. Commonwealth of Massachusetts City of Salem Board of Health Kimberley Driscoll 120 Washington Street,4th Floor Mayor SALEM,MA 01970 DATE PRINTED: 05/20/2008 ESTABLISHMENT NAME: Loring Hills Condo Pool File Number:BHF-2004-000199 East Cost Properies 400 Highalnd Ave Ste. 11 Salem MA 01970 LOCATED AT: SALEM, MA 01970 Permit Type Permit No. Permit Issued Permit Expires Fee Restrictions/Notes SWIMMING POOL- BHP-2008-0461 May 20,2008 Dec 31,2008 $140.00 DATES OF OPERATION: SEASONAL Memorial Day-Labor Day HOURS OF OPERATION:10:00 am to 9:00 pm 7 days a week/SEMI-PUBLIC Total Fees: $140.00 PERMIT EXPIRES December 31, 2008 Board of Health Page 1 CITY OF SALEM, MASSACHUSETTS _ BOARD OF HEALTH p� 120 WASHINGTON STREET,4T FLOOR TEL.(978)741-1800 KMMERLEY DRISCOLL FAX(978)745-0343 MAYOR )SCOTT&ALEM.COM RECEIVED JOANNE SCOTT, HU?AI.I'HAGENT MAY 162006 CITY OF SALEM 1 BOARD OF HEALTH 2008 APPLICATION FOR PERMIT TO OPERATE A SWIMMING POOL LOCATION OF POOL 6 LORING HILLS AVENUE LORING HILLS CONDOMINIUM NAME OF APPLICANT UNIT 1TRUST —TEL# 978-741-2003 MAILING ADDRESS 400 HIGHLAND AVE. , STE 11 , SALEM MA 019 70 CERTIFIED POOL OPERATOR 01-18267 978-852-4001 Name: ANDREW J . ANSELMO —Cert#: L# MEMORIAL DAY TO LABOR DAY DATES OF OPERATION (if not annual):__ — DAYS &HOURS OF OPERATION: SUNDAY — SATURDAY — 10 AM — 9 PM TYPE OF POOL Public Semi-Public Special Purpose FEE: $210.00 for year round pools $140.00 for seasonal$40.00 Non-Profit (Please pay total with one check payable to the City of Salem) This permit is not transferable and must be reissued upon change of ownership. In accordance with the State Sanitary Code,before any renovations,improvements,or Equipment changes are made,all plans for such must be submitted to pproved by the Salem Board of Health. Pursuant to MGL Chap r 63C, ection 49a,I certify under the pains and penalties of perjury that I,to my best knowledge and belief,have II state retu s and p id all to taxes required under the law. , �llLll CJ 7 01 %a c� ✓�2/ I at Date SS#or Federal Identification Number Revised 8/14/07 poolappmpd Check# Date �1 �6 Commonwealth of Massachusetts • F City of Salem Board of Health Kimberiey Driscoll 120 Washington Street,4th Floor Mayor SALEM,MA 01970 Swimming Pool Seasonal Permit DATE PRINTED: 05/25/2012 ESTABLISHMENT NAME: Loring Hills Condo Pool File Number:BHF-2004-000199 East Cost Properies 400 Highalnd Ave Ste. 11 Salem MA 01970 LOCATED AT: SALEM, MA 01970 Permit Type Permit No. Permit Issued Permit Expires Fee Restrictions/Notes SWIMMING POOL- BHP-2012-0443 May 25,2012 Sep 29, 2012 $140.00 SEASONAL Total Fees: $140.00 PERMIT EXPIRES ISeptember29, 2012 Board of Health Page 1 1 s CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREET,4" FLOOR KTEL.(978)741-1800 IMBERLEY DRISCOLL FAx(978)745-0343 MAYOR lramdin e salem com LARRY RAMDIN,RS/REHS,CHO,CP-FS HEALTH AGENT 2012 2044APPLICATION FOR PERMIT TO OPERATE A SWIMMING POOL LOCATION OF POOL 6 LORING HILLS AVENUE LORING HILLS CONDOMINIUM NAME OF APPLICANT UNTT y1 TPT1CT TEL# 978- 741 2903 MAILINGADDRESS EAST COAST PROPERTIES, 400 HIGHLAND AVE. , SALEM MA CERTIFIED POOL OPERATOR 01 -182673 Name: Anrl oa, T nnselmn Cert#: TEL# 978-859-4001 DATES OF OPERATION(if not annual): MEMORIAL DAY to LABOR DAY DAYS &HOURS OF OPERATION: 7 days a week — 10 AM — 9 PM TYPE OF POOL Public Semi-Public ,.,. Special Purpose FEE: $210.00 for year round pools $140.00 for seasonal$40.00 Non-Profit (Please pay total with one check payable to the City of Salem) This permit is not transferable and must be reissued upon change of ownership. In accordance with the State Sanitary Code,before any renovations,improvements,or Equipment changes are made,an plans for such must be submitted to and approved by the Salem Board of Health. Pursuant MGL Chapter 63C, Seekion 49a,I certify under the pains and penalties of perjury that 1,to my best knowledge and belief,have filed a t to tax returns and aid a 1 state taxes required under the law. ",75/�� J k Si#a Sa re Date SS#or Federal Identification Number Revised /1 l pIolappl Ldoe Check#Date