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PICKMAN PARK SWIMMING POOL City of Salem, Massachusetts / P � a Board of Health lu „ 120 Washington Street, 4th Floor, Salem, MA 01970 PublicHeaIth 0 - Tel. (978) 741-1800 Fax. (978) 745-0343 Kimberley Driscoll Iramdin@salem.com Larry Ramdin, MPH, REHS, CHO Mayor Health Agent PUBLIC POOL HEALTH PERMIT Permit# PO-16-7 License For : Pool (seasonal) Date of Print 5/24/2016 Granted To: Pickman Park Condominiums Permit Issued 5/24/2016 Address: 6 Dewey Drive Salem MA 01970 Permit Expires 9/30/2016 Location of Establishment: DEWEY DRIVE Permit Fee $140.00 Restrictions: Late Fee $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. /J RrF-13-2016 08:58 FROM: TO:17815692657 P.2/2 i- ( { �r Y Y r CITY OF SALEM, MASSACHusm- 'S 120 WASI nNGTON STm3P_T,4T11 FLOOR TIt1..(978)741-1800 KI�lR1i.RT.f'1`I:)RL5COL1' FAX 0)78)745.0343 02,5 aR >,ramd n0mlcrn cutn 1.1x01'RAMT)TN,i15/REI is,(.11o'C'P•I+5 1-lrnl:ril;uil,Nr 201 17APPLICATION FOR PERMIT TO OPERATE A PWIMMIN9 POOL LOCATION OF P001.. r / h cc, bhouj,) ' 7� 979-OIoLQ NAME OF APPLICANT � 1 Alan TEC # - MAILING ADDRESS I 7 ( ( ' �IrII'��9f PL '9 w l�vl�r�,�� CekTrrlEDPool.o -xATOR �f�3-M3 Name I ' Ccrt#: TEL# I IfDATES OF OPERATION(if not annual): DAYS &HOURS OF OPERATION: N� i go tit 9 a/)7 — bom TYPE OF POOL Public Semi-Public T Special Purpose F FE; $210.00 for yearround pools 140. r seasonal$40,00 Non•Proflt (Please pay total with one check pay o to the City of Salem) This permit is not tmnsferoble and must be reissued upon change of ownership. In accordance with the State Sanitary Code,before any renovations,improvements,or Equipment changes are made,all plans for -1�1ch must be submitted to and approved by the Salem Board of Health. Pu want to MGL Chu 63C,Soetion 490,I certify under 'he pains and panaltiea of Perjury that I,to my beet knowledge and boliof,have I§1 Il stat t, retur d p id all stet laxes royuircd u at t law. igi c Date SS#or Padua[Identification Number vlocd 923!11 poolappll-doe C c N nn :� I "'f r'��' d `�/ ';I">'c f�o=�Xy.•� - J �"xr q'�yl�t$ }e rgj4`,p/�,.Wt�}y � �: :.. x '...•y :� is" +'^Y r �.�'F��i \, Irl f.-. ,F Y1+y`t .. Y'� V1"9 1°t° 'Y IY'O�t:Y1'' eS , f! ♦ ♦ 1• ie 1 '1, • e S • ��i qx�1° s j • ��l4�• f i eye•a Y o f Y x n x .ty'I �+' x 4 rV 9 R' ,y 1 1lI+ ,. `9! f1 1 >gx�IN I f.•1 .�,f }`�x x � xx1Y1P.., '1 / F• � x �,�, Y t M' x:t t 1d 1'fa 4 Y 1+ °I �1 lY. °t° f " ° I1 `"�� 1 Y `• +' x �Y q� �•r 1 K - r `� - - rr�� r - - II'^• o -al .'Illi !� r�:+ �,...�II I. . 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C 1��1,'7:Ili :rI'IIIIII�I�I IIIIINIII IIIII�!'I�I) 111 III h q III,II IIII •Il:i+ II��MII ;perator ofldid'I' b�, �'ities �I,�:� .lullll ',IIIII�I�I � Il� � 1 ,�; IIIIII IIIIIIII -olhlh (IIII �I,ll I VIII � I II� ,III,�gV�fi�� N�III:IIV� h,IvPll� �,UI�I�I�� Issu®dby the r r e t rt NATIONAL'SWIMM'jNGIUN� son { .Cerfifig," on Date,, rill30 20x13`' J*'j yr.I �r} :!'n I .[+¢'/ sr•d�^f✓ CPYr?'Nd >u� �k `�'x: a l,e 4� Certification'Nwfilber':'CPO- X23083 ,,�IL Expires:= Apri13U iot —' � II�IIIII�I IID•` II,:III III III IIIiIIIuiI �;' I ' IIII s4 dINI,.I'I IIII �`�' I 7 NI II i II r'�;I OIAI ~+ ��` I I �y I X11 + q II , IIII , ..I�IIGI LlIlI MllIIIII 4 Illll loll f IIlu�j1 4:l:]IIIIIIII�I I1I11 I 9�JII,I,1I,�I7�11IIj1III�L,..,�' �n- 1 NaI,lI l�l,IuN l'IlIIll IIIFII>Ifl IIVqr �'II,IpViIlI�l--.:,i11dI1l,IldII I 1n1IIV1 Il II I lI IIIYlI 1I I � b$SIIII"f,1wlli�'�l II I6'1IIll11lIlIl'I11 1 1 II'III Ili,'� j ho IIVIr1LaChog1c � I NSPF®Instructor r ^ , r I � ti w Healthy Fools l�eadthyBodes t ° Chief E Ove'(1ffl6E;7-, rte, , r ' • s4v .�. w 100941 b09645 'r:4 , , e 4 >a :,,` a. ,{ yy .i(. 4, cm Mal v Mill+ i' x°�is ti ° .J °+ rIV �r JI':.,: r _ ./`�sv^ �"•. y::i,. '• �cr 3 �' `" • / s 1 s a CITY OF SALE-M, MASSACHUSETTS lu BOARD OF HEALTH 120 WASHINGTON STREET,4.° FLOOR Public Health Prevent.Promote,Protect. TFL. (978) 741-1800 F_aZ (978) 745-0343 KIMBERLEY DRISCOLL ]ramdin&salem.com LAIiR]'RAiAM1DIN,RS/RGI-IS,ChIO,CP-FS MAYOR HI,AJ;n i AG i-:N7 SWIMMING POOL INSPECTION REPORT (� I� L. 3 NAME: 1 t t. "l'�a 1 R IL� e�*1�' DATE: S Z 4 � TIME IN. °I, � 7s1 ADDRESS: PHONE: O-:2&- TIME OUT: 1V?-0 CERTIFIED POOL OPERATOR: 17o 0 �A Regulations 105 CMR 435.000 :Minimum Standards for Swimming Pools, State Sanitary Code, Chapter V Regulation Compliance Number Yes I No 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/ftz • Cartridge filters—0.375 gpm/ft' Automatic hypochlorinators required feed-rate capacity: • 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/car 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 1 ` ` SWIMMING POOL INSPECTION REPORT Regulations 105 CMR 435.000 Minimum Standards for Swimming Pools, State Sanitary Code, Chapter V NAME: �, C.k f— n-o DATE: 6/-1"`f 16 Regulation Compfiance Number Yes No 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 orjackets 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 readilyavailable a backboard with straps 435.25 / First Aid Equipment and Emergency Communication—Provide a standard Red Cross first aid V kit—Working, convenient, immediate, toll-free communication system with emergency medical services, local/state police, fire department available to staff and public at all times with instructions 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 • Alkalin 50—150 PPM 435.30Water 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 forspecial 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 V and sanitary manner. Remarks,Results and Action Taken: Swimming Pool Wading/Kiddie Pool Spa Type: Type: Free Free Free Free Free Chlorine Chlorine Chlorine Chlorine Chlorine Combined Combined Combined Combined Combined Chlorine Chlorine Chlorine Chlorine Chlorine Bromine — Bromine Bromine Bromine Bromine H $ PH H H pH AlkalinityI Alkalinity Alkalinity Alkalin Alkalinity Calcium X90 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:_fILr_KA-O f :LK- C6-44 4 n. DATE: 5 Remarks,Results and Actions: T e: T e: Ty e: Free Free Free Chlorine Chlorine Chlorine Combined Combined Combined Chlorine Chlorine Chlorine Bromine Bromine Bromine H PH PH Alkalini Alkalinity Alkalinity Calcium Calcium Calcium Type Type' Hardness Hardness Hardness Type' Pool Pool Pool Volume g Volume g Volume Sand Sand DE Filter Type DE Filter Type DE Filter Type Cartridge Cartridge Cartridge Filter Size ft' Filter Size ft' Filter Size ft' Minimum Minimum Minimum Flow Rate gpm a Flow Rate gpm Flow Rate gpm Maximum O Maximum Maximum Flow Rate gpm Flow Rate gpm Flow Rate gpm Actual Actual Actual Flow Rate gpm Flow Rate gpm Flow Rate gpm 0.Q A-' Q.bMh�C Passed Inspection: Yes E]No ❑ Re-Inspection Date: Inspector's Signature: Person In Charge: City of Salem, Massachusetts lu B0oard of Health PublicHealth 120 Washington Street, 4th Floor, Salem, n prevent. Promote. Protect. MA 01970 Kimberley Driscoll Tel. (978) 741-1800 Fax. (978) 745-0343 Larry Ramdin, MPH, RENS,CHO Mayor Iramdin@salem.com Health agent Swimming Pool Inspection Report Pool: Date: Date: ^Zd" tJ Address Phone: Operator: Max Bathing Load: In accordance with 105 CMR 433 00 Minimum Standards for Swimming Pools,State Sanitary Code Chapter V. d Annual Permit Posted ealth 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 j >� one instructions t Emergency numbers ✓Phone in unlocked area Safety Equip: for each 2000,sq. feet 1,._-Rescue tube or ring buoy(with rope) i'Backboard with collar and straps First Aid: Equipment area v!/ 3S)I"band-aids 1/_ _Jrl'0)3x3 gauze 5x9 surgipads12)antiseptic wipes 8x 10 Surgi L2)2"soft roller bandages Scissors _ {2/ )3"Soft roller bandages T ezers d/�3)'/2 roll hypoallergenic tape �ueblanket (/' packs �^ Pocket mask _sterile isotonic eyewash V 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/1) o ✓Recoils Kept: i 16 `� v Water tests P-- ChemtcalsUsed �ckwashing I—Attendance 1/Tours of operation Depth Markings Sidewalk and inside pool t 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 dr�liking water facilit�ie�$\ Notes: 5 S�l_ey t TMF�NlJ^} ! Received by: Inspected by:� City of Salem, Massachusetts lu Board of Health 120 Washington Street, 4th Floor, Salem, MA 01970 1P1 tth Pmen[.Promote.Protect. Tel. (978) 741-1800 Fax. (978) 745-0343 Kimberley Driscoll Iramdin@salem.com Larry Ramdin, MPH, REHS, CHO Mayor Health Agent PUBLIC POOL HEALTH PERMIT Permit# PO-15-4 License For : Pool (seasonal) Date of Print 4/28/2015 Granted To: Pickman Park Condominiums Permit Issued 5/24/2015 Address: 6 Dewey Drive Salem MA 01970 Permit Expires 9/15/2015 Location of Establishment: DEWEY DRIVE Permit Fee $140.00 Restrictions: Late Fee $0.00 Notes: This permit or license is granted in conformity with the statues and ordinances relating thereto, and expires on 9/15/2015 , unless sooner revoked or suspended. RFR-1aV-l 015 08:41 FROM: 70: 17815692657 P.2/2 CITY OF SALEM, MASSACHUSETTS BOARD OP l.ILAVI'I r 12Q WASHINC'I'UN 5'I1t1uF r•41"FLOUR KIMBERLEY DRISCOLL FAX(978)741-1840 FAX(978978)741-1800 745-0343 MAYOR LPANIDIN&ALENt.:OM LARRY RAMDIN,RS/ItEl IS,(-.KO,CP-ES H.Ia.A.I.I'H AGENT 2015 APPLICATION FO/R, PERMIT TO OPERATE fAI'ScWIMM(INNG POOL I�C,1(p LOCATION OF POO o4TC4IL �`�� ` �+/✓ _ NAME OF APPLICANT 0 ILK irn ►lll� MAILING ADDRESS IL CERTIFIED PpOL OPE ATQR Name; N Cert#: IZLTEL# L q11) ?I DATES OF OAERATION(if not annuap:�l DAYS &HOURS OF OPERATION: < �'� • `� TYPE,OF POOL Public Semi-Public Special Purpose FEE: $210,00 for year round pools 140.00 for easonal$40.00 Non-Profit (Please pay total with one check p able a City of Salem) This permit is not transferable and mus IC reissued upon change of ownership. In accordance with the State Sanitary Code,before any renovations,improvements,or Equipment changes are made,all plana for such must be submitted to and approved by the Salem Hoard of Health. Pu uant to MGL ha er Section 49a, I certily under the pains and penalties of perjury that[,to my best knowledge and belief,have 010 al I state x r m aid all st a taxes reouired under the law. Sign ure. I Date SSP or Federal Identifica Ion Number vis vzan peeiappl Laoc cnea u ; XXL CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREET,4O.FLOOR KIMBERLEY DRISCOLL TEL. (978)741-1800 MAYOR Fax(978) 745-0343 kamdin@asalem.com LARRY RANIDIN,RS/RFI IS,CI 10,CP-FS HEALTHAGENT Swimming Pool Inspection Report - Pool: ?/ G /r)A1d PnIL)Z. Date: 5"-2:2-14) Address Phone: Operator: Max Bathing Load: In accordance with 105 CMR 435.00 Minimum Standards for Swimmine Pools:State Sanitary Code Chapter V. Annual Permit Posted 7 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 Y Emer.Communication:phone at pool _✓Phone instructions _Emergency numbers t7Phone in unlocked area safety Equip: for each 2000,sq.feet ✓ Rescue tube or ring buoy(with rope) Backboard with collar and straps Firs�.Kld: Equipment area V (35) 1"band-aids ✓10)30 gauze ✓(2)5x9 surgipads2)antiseptic wipes �(1)8x10 Surgi 2)2"soft roller bandages //ctssors 2)3"Soft roller bandages weezers �1)V2 roll hypoallergenic tape 777777 Rescue blanket _v e packs ✓Pocket mask _sterile isotonic eyewash ✓Disinfection -Chlorine _pH 7.2–7.8 Residual free 1-3,Combined 0-0.2 10•d Gl♦� Bromine _pH 7.2–7.8 Residual z-6-6 (ppm)(mg/1) Rec�Kept: Ater tests �/�emicals Used �kwashing Attendance _/Hours of operation Depth Markings Sidewalk and inside pool P 4 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 Y 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: Received by` Inspected by rm,:o>ZRM ' f aIy �wx a s e'" tr ''y,` .,'x •s x 5s a = z ._.,j7.,, 0� M, i ? §n a' r ".5' 4 d" 's ,sF, A �" v"#�' st $'l `f` �ht� Lt Pe v n 5 a ,4.F x*ra' + `pn g dm ,• ��h °C 1. a S. ') -.•x� a 7 n M �^ t+"£A vtsSx h 'v`E'I r 1 y. „ M y: a a •'i. a[ 1 r 7„' P f ", r'r.` x .1 a +.. " ee2'r. `",1,+ ih iY' "' P ;y w .rti.x' �q:t aa&}` •"�, x V ,. , Pr a `t'kw ;m n '° Clty MISalern aMassachusetts M P Fr. x t r. ,3"i ,�{� ,.'kAw ,+) a '�Z �'stk r4 4. g�` " r } •a r F Ire,., 'S LsLk 'af Nt M1 x aw xf - ';rF �$r a Y ' � Y a d v '"' Board of Health^ t a " tl ,4 - 120 Washington SUeet 4th Floor'Salem'':MA 01970 t PubflcHealth' n >sz r,a r rt � � � • . = , i Tel 97$ 7411800 az 978 � ` i a m x n £ 45 0343 f d F N" -.k nay ' {#�+.��a wrtrd h!�fi �•ICIfntJerley Driscoll ,` h..it.xruekrt�'�:%� r. r. ror� .ar. leen com rrrrr a �T' 5 Wnynit ,a rpt n'Ramdm RS(REHSCFIO CP FS..t. ,,T` 'SSpnr a o Health Agent',,, ^r k$"r � ;s :� V s :,�* (�.xy Viz! <A'a 9 x.!t 3 ,c y.,:._wa �� fr'#„..'sSy v aX '1'i � y�¢.,',,v'r ),�,i k ,a- " s1` s M P7•.e f `r 5 t F' �r M1tr "'3 vv,� 1,;:{`$, yA1y VA'„::. :"I .`` �, lS�,' ;, SNL7w':. ✓xy t�.. 'a. a 1,'a , &.e s3h"u..,$�,�,,�� d� �'� �§� + r� �,” /�{ '7 P�I�LI�IY w�,t a POOL EALTH x ., a a ,PerRllt#q,rA'. r b�'p';t' ,a.r .rw. •f `;` ixy{+, . r `rss +r,:5a. ^ [ a tx h' a e kt1V p r 'c ah a a s 4X •6 •s, Axa n;''C,r i , ' `Tye, �"k _'+, v" ., aY"rh 'dvf�E '.rt 3'£•ni;,,.A `A s;�a}:. � y h h$ F3,, ,s„@+i*. '�'f 5„µwYal � �",�`,�T i, �ifS r„n•;'rd �x r x,.��e:j� 3 "' C� `.tz t pdi"Ur � '�;"' a,,'ir A rs ++,wa:Fk�`f^ (:'s"^ gNlF •¢!+a' rf^'xa#,ra x ,.,.RMI 'TwPQ. •"Ar $L.Ah,f v.rl !"�. �.".'.4. 1 r,Fv'`, -P Y €',Y' ...: '., 1.4,, r r .Y. 4 , I' ? M ( LA?i.: Y T Y nFb r'k r #, a 3 4 1 rryr wC 3 W Y'�1 3 , Llcense,For F]"tt [ r Yt f? r 4 '+la §if 'N" l'F a ,.y�¢ ,•.,:�! t 1 . JY.ngq ,ay �r, as r�vwt�a; �t .'i''x :� ,Y W 1 h.:,� t' mr#.y ., dF�. '�.tt^#r« �tY: Pool�(Seasonal) +� x � � b �� °p �^ d1r m ., L ti, w has a�., t,� �+1 �rr a �,�.!x +v ,y, •k yr a, 7ant y ,a w} P^e ,h k?'.„1 '�}8mt' p. z l` M s iw'S z ,+ u. x t" v. a ,e` .i as+F4 r ,,,,5� r{,¢I>I` .g y,.'a. pa�q",kt!''' ^` .cta e'ltt,., ar 'x:.yrt } Date-ofaPrint � dYRF x ,t y��*✓n .kR•: t5 �5) C'x;4tm�;(� 4 rh 3D k p a�q'". °r�+lif ( w „ r�.�X dYV,,, F ,rY, P�r 1aR�� py »r r s q+• �' vsv ':* �e k� ,n z�. ,, &'"x« ,fi.,. ", :$� stt r F>u;S1 4 d 7'rv, i''b :u's r 'S e`i t iii uk L` `,a -' +,m a • �. � k,F;;M �� X ;Granted TO' n YTx �P,iekm m'Park'COndominiums fired<t e t .,cx +";w r5 s a°, aF i " 5/2212014 w 5 a x.x� vrr.S,. &Aiw '+h✓ .Kt wu �'ys+l > a nS din_ ,n Fya sena t:NyirvM n2";' a, Vd ix x z p4,t4°,'.t ,+n CF q "a w 3' r .q`r` ,}p' Y:.en +a.r p:r �. i' ! 1!� '� ,i•5 ,K'. �"^' r_. r :� 1a '33',, } 3 '' � � •x,;!'#' �x s. g c Q, �y ,�a.4">t":'� '� ,r q,3�,r a .c Fy�P'�s'a c �;+;r "'sx y+=�c)L a"` & `` '/ r � ,:Y'.rt i w � # Y, ?xn y,,. 1 �".r'- at4M� �` Y r'x pw{X e.•. °"w r a. w< N� .`i' tA � iFs "SY Y �tK�,��al� `n� x�Y 4 ° ` tea d4a� M{' it Permit Issia6 ( A:�v ka an "}e 'eR` k r sm i .4 ,"i .i`mtt fi°4 ¢ z` .>s t SwF.. a r .0 i 0 ✓'. •. $� 't5- 'J r .tk, e# al m l w, +. ^2 � w 3 :f �z t mw- r x r l + e!n«c'�"i:: .. 'S' tt R� .:.!t.'lty IyFhx«^Cf' h*"`9i ,. 'k W, Z, P `�::� 1gk t''^�' c4 'SkW`tl r}'AtJdress Pickman.Park �'.'e ;a " M ak wS `; r sr tk i Xu o- x f in 9 ¢ c WOBURN Mf m ` .... .' � rx N>".�e� MA : +` 01807.1 7N,, pFj;y 4aS y 5,„..'.} x� a a•” w :.i 5/22/2014 r� , S. k*k, "� x^d t ,;- ;Condos./Jiti Fatna,: M1i a t , ,,N`i.' » n., w 2 t s '.• }' 7, e„ . d ti 2xI'+ +'e,> f ^ dxgy: t .•y.. f ��"r�' i, ". "ri E� " ,500 W CummingssS�y}.' xar'a,_r.`k .t Mt v ry 1+y~ ,`d*,r,a! '`<'.y& yR •"; dg °r ,. r"" as'>. aM'yy' st ryrgv 5, . 1 ,:"2 Y fi •`,�yN � C , £ Penmt EXplr@S Fa s K a aq l r �, xfl +i fce r'<"a °• S r f-a s '9 " iy tqk 4r` r` > 'F >qge r^n yr r ice'^ y :. t - 1x `4/30/2015 (( W a 1g <R`�'fif S ^ rx +r M c M ^P a 6 '4 x a V A i4 srh wG Fv 4x e P >P+ rnd,, L.rIj :. a° •ti, } Location of-Establkshment <' r L)EWEY DRIVEr Permit 5 i ! N b s a .:k r }'r s . < a 'ix e x a , 3:< a • .n x + T E M1 4 [ CYyka!• .. rf '£ i'S t ] M.' `# k nr.5 -0 k f`. ,£I :p. Yv / t a 0.00 yr ? r K n ar s.w. x u,. "„ „Wn S. e y„✓C ^u taA iwa" t ya v z�fr' ,m 'C t Y d ew � L•", x 4„� h �,t :� t x a 1+` a � �e ;a hap i„ � r A s Y t m:r� � st% „�• "% " T"" m Ct z vr. 1 ad` 4 YM1 'd"- M Q'1, N - 1 rr Gd, y� ij h'� i.wk '� a` Late Fee "�%; ' r`:!;�� +,max,. Restnchons 1 rr r13 r * "" F`t,:' "` x r.��f 's9r. d{s 4itry v tri �.r` ,: .'„ j <,s • ,' r i s '�txa,w % " -"2 t, `� ` ri z�s '�' £iykf $000'�t R Y" 4f 4y, �'" c dS,pt:a s4 a a#i+`i " p P t flip; a '{+. n i.^4` 'k +t JSMi• # 'vr'.'^" E ty "' r"'" ' a °r :e;r yva h'' rr" rx tfiey§T' „jays y.a pT fi;.=X r s "ar y}fb» r `7�✓p'ti� }'S x,� : x cu6t ' B'N YF d A.H'�0.! } ktyj tfvke,!'• w 'ki §" I :ir2' V 3'.gke l i YI kk 'A d Y { ik^ i. 4 1 Y /.{� L 5... o- a yxyrgzan'k :tom "a i +R' fy , a i w e s:. $'x g ^ 4 r r fI.� ".u'. at xs }5t ' ; t` 5n a a M K: Y e u,.� t. rc f 3 •sAa 'fi s r r.- umvDIl Y4.k,;p�+9 ;#` xj s eY .�'r 4ct`4^'v s x•`c 3",•, 'FT rzf,^� ,,„, S.A tiN AWAM& ,..'Mr�fN i t'k �t .�J/csas,r;. k fix " i ,^,y�"`,v r :'r '1y;� t,l� •} r• •-N �£h. 'S°:.-r t h.rk.e,.r.. 3t .-a. rr ts. i Y .r ' t r xIc RR,. ya'k5'r.z e rk xfi vY fl r yy��. �i n a rrRs aY a ` gY 'C' i ,.�, w. 15, 3 a•sy, h•.: 4R 1A, 1,5 '� iy+ �' r .xx .. m �,: 4 �z ra Ur 2 z•sF ,, t ~MY ',uF x $ � �. . t '"a:" ,K r, X 'y T* rm ;; r S"" P*"t rar w 4 'a•t#s hi Wi t'.'" ti Gx dAx iai' Y 5s v :&1€ > f+° yy 1 +)� A'k`^y 4W.a F y p� pj, a S y # ', �5 �? d ( 1N ✓d t - L l - a% 4 .Mf e; a , a ✓ xi rsn. "" x 4p:} S sK 5ds h j.`: A v v t $„a Yy &r v'. lip, m txh>e { `nt aV;k;4TM '} d"y l:4tx �C "ut`r� Xa zy, M M'. • y, � tas# a#5. .x My ��} im fes+; T xrs'`� 'o : w �': f z d k# � r �F r a to ' - 4 , rx# 5s r ,x• za Y + r yX' i' rvx'w n� :! bhlx: SI':,'yM 14A6 "R�t "'V:t' •"fT A S �" w: •ml:. Y 0. ) :t Vk •. `�'' Y{. ri°Y 4. k 4a a idinkt a -"tr b This permit or license is granted m conformity';unth the,statues and o inancesrelating thereto;and;expires on 4/30/2015,unlass;sooner: av ,,, ;;r@VOk@d'Or SUailend@d"'rV a:{',<, '�" r.da *it ay, +$ ey, a1` v r :;i ! .I x 'YI ux"rr u r '.N u v b t r>";• + " a r 3 n 8 'a3yrrt ti YVFw �" , Y d rJ xt �� k � &� ♦ s h.a b d' r „s4a vx° t^ ° >Pe 4 s ',� r r >r x � 1 SM m $ eIt" I ✓ T 1 x ej r "F s r ^ .3 �.w...m.,,«.,,� a -....w,.w«.:.. ._.....*.«mi..�+-,.w..-ammm4am..-. ...r..,=.m,.«�•,,.•.w-ffiM1.�cam„a,.,.wmv..«..c,.s.�.,.xm. ., ... r „x n.~ww.o.=... - ,. o....�.„s:.. ,n.n._. .m.a ,...z.&...� MAY-9-2014 15:31 FROM: TO:17815692657 P.2,2 i � I CITY OF SALEM, .MASSACHUSEY S BOARD OF HIMCt11 120 WASHINGTON STm3GP,4"'n.onR KSIvfBP_RLLY D1USCOII 1'131..(9?R)741-1,800 MAYUIt FAX(978)745-0343 I AMJINIII� LARRY RAMQIN,RS/RPITS,CITC),CPtpS H r,w'rrt AC BNr 20 PPLICATI N FOR PERMIT TO OPERATE A SWIMMING POOL LOCATION OF POOL PIrC,46rj NAMEOFAPPLICANT Cr,k( n Q2k,. TE ( )� "' -C7w ) MAILING ADDRESS i Name, VV iE.D POOL OPERATOR 40 J^ k I�„O62,G Name, .�-{n'// Cert#: TCL# ((� / �J DATES OF OPERATION (if not annual): 1.�. T _�Ar ll7 - --- - - - ---_ 4 �-�,-i - DAYS &HOURS OF OPERATION: if TYPE OF POOL Public Semi-Public Special Purposc FEE: $210.00 for year round poo $140. or seasonal$40.00 Non-Profit (Please pay total with one check pays e W the City orSulem) This permit is not transferable and must be reissued upon change of ownership. In accordance with the State Sanitary Cal e,before any renovations,Improvements,or Equipment ehunues are made,all plans for such must be submitted to and approved by the Salem Board of Health. 49m; certity under the pains and penalties of perjury that I,to my best knowledge and belief,have s requ'ved Lind r t I law,) V - 9IUW, Date SS#or Federal Identification Number a,:vised 50111 PuolaPPI I.doc Cheek#Dua: ') _1 1 CITY OF SALEM, MASSACHUSETTS IV BOARD OE HE,\LTH 120 WASHINGTON STREET 4"'FLOOR PablicHealth > Prevent.Frnmote.Protect. TEL. (978) 741-1800 FAX(978) 745-0343 KIMBERLEY DRISCOLL Iramdin(a�salem.com L,\RR1'RAMDIN,RS/RJ§;IiS,0-10,(',P-RS MAYOR HP AI xt-1 AGENT Swimmine Pool Inspection Report Pool: yi Date: a 1-3 Address Phone 7a'– Operator: 0V) I Max Bathing Load: In accordance with 1 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 _Phone in unlocked area Safety Equip: for each 2000, sq.feet _Rescue tube or ring buoy(with rope) _Backboard with collar and straps V First Aid:Equipment area _%,�(35) 1"band-aids /(10)3x3 gauze ,L(2)5x9 surgipads Z(12)antiseptic wipes (1)8x10 Surgi VS2)2"soft roller bandages _Scissors (2)3"Soft roller bandages Tweezers (1) 'h roll hypoallergenic tape escue blanket L/'ice packs ✓Pocket mask sterile isotonic eyewash Disinfection Chlorie e�1.6:9 )pH 7.2–7.8 Residual free 1-3,Combined 0-0.2 _Bromin _pH 7.2–7.8 Residual 2-6 (ppm)(mg/1) Records Kept: _Water tests Chemicals Used _Backwashing Attendance t/Hours of operation I Depth Markings Sidewalk and inside pool ()K9-CL t { . 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 facili ies Notes: Q,6,1Clr' f \k Received by: Inspected by�7Fc.exq=FGh ,., 777777777=a cr �p,yy r y 177' 777'r it �. r �^5,�` v' tx $m� � '�A AN, �iaar 7a -bo `` 4 Wa{ a,^k AM � :, i -S x� ✓.., y �.��' rr � �: � !E t7.y L �'iri" 3� , .n w e �, x �4� Uk r S:. � `fix, s 4 i " + '�?R ✓fix,: � i��"Urv�+ A �Y .. �*� ^�r n At y R �,. a . ° i "u q d �': ,', qk a�. W re O 3 ' r�, �. y c `i. ! Pnb�; ', M '�+ c A:m .v3' 4W .:4 o ,p� �. �4,rvv�a+f P 110. " Mv.��y3 q ++a x 40 „ m 4R ^a "rb v m5 + aka n ' . i V "�' �h+ '�� } 69 Vi Y1N '' kY ` A e r^: �s a k'v, � , V 'CJ y ,a d + 4 Q v try 'ir O ` � ' pl'i n m ,. f S a ` ''" W`r, p e ��. r ^' n „° � ac X17;. # 9 �' < . 311 '.. 1,0 + , may,.�. .�" *, v re r.",.�sr , ;' w wVr` r,,,lbhh ''b�:'tn5 k ` d Or ,Fs r : 4r �i'K '� l+' aw¢ r O in ♦a a : w9 A _:V� [, � a4s, � y N dk m •a ,y.r I� a'�a, Ui'r a'rti !c. .ra„ . na `': '� V � . �'r.,'+:� u. "ON, M t 8 Vi � � � " �C/s.;�o p� " y ��, �„�;p.'. �W�Sx� •�' „r ' �y,� � .r� ,� s �; }�a� , p; 0.+ , J W �"� ! � .. a al rrY 'Y • r w-:� « F � t A. m ire` ss � �'. .' �` '. ' � y . . ' P +UPr Ot x ry tl P 1t Pr S - ob, w 4 an + VI ia�4� � i RPR-17-2013 01:06 FROM: TO:17815692657 P.2'2 RPR-23-2013 21:43 FROM:PICKMRN 978 741 7666 70:17815692657 P.1�1 I. CITY OF SALEM,MASSACHUSE7195 ItUAILL7 UN�InpL711 izOWesltwcrrort5ntrer,aa�inega I ,,,,, 7111,(v7tt)9b1-18W FAX(978)745.0343 i K11vI13ERl.FSYvUscOr.L Way unMtylN,xs/xl?til?,rtTo,cr-t*� MAYOR 1IrnL17tAG1T17 I i AE RLI CATIpElba PERMIT TO OPERATE A SWIMMING POOL LOCATION OF POOL k_ � gtj r(jr�_ l I (W NAME OF APPLIC. ' V� C d T$L iG -) MAILING ADDRESS l can t"SRTTFT}ro. OT.OPERATOR Name �POOT. 1FI 11 �� 979~ o�Zg DATES OF OPERATION orrapne,wl): DAYS 8t Hp11R,3 OF OPERATION: TYPE -E,M- 2,L- semi-Public L rublla� semi-Public Svociel Purpose FEE; S210.00 for year round peekC4OM1br seesdap 00 Non Profit (Please pay total with ono check paylem This permit is not uenatiirablc and must be re(eaued upon charge SP4vmvolp� To accordance*th the State Satdtaq Code,before any renovatlolu4,Improvements,er Egtdpmegf Chap are made,all plain for inch must be submitted to and approved by the Salem Bnard of Health. Aowd C.Section 49a.Eaer*under the pains and penalties of prrjury dint I,to my boas knowledge and belief have paid ON to Lomas required under the Jew, oy ` o (ed t� wrFcaionSS#of Federel Comdfloodon Number ChooY d 11a1 . .. 4Y 0 2 2013 01T*OF SALEM CITY COLLECTOR a� CTTY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREET,4"'FLOOR - 'I'FiL. (978)741-1800 FAX(978) 745-0343 _ KIMBF]ILEY DRISCOLI, lramdinto saletn.com . IritUM tauY � UIN,�zs/R: Hs,Cl u),(T-1,,S MAYOR Hrw:rn AG kNr Swimming Pool Inspection Report 1 Pool: f lei Lr 4a Date: SLd_�111 a Address Phone: Operator: Max Bathing Load: In 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. N 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 _Phone in unlocked area V 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)8x10 Surgi (2)2"soft roller bandages Scissors (2)3"Soft roller bandages Tweezers (1)Yz roll hypoallergenic tape ,/',.Rescue blanket ice packs ti/Pocket mask —sterile isotonic eyewash j'I t J Disinfection —Chlorine Q Zr d _pH 7.2—7.8 Residual free 1-3,Combined 0-0.2 _Bromine `j,0& ,pH 7,2-7.8 Residual 2.6 (ppm)(mgrl) Records Kept: _Water tests Chemicals Used Backwashing _Attendance _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 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 water fac li es Notes: TDrAWWJA COVfi .S Received by: Inspected by: Commonwealth of Massachusetts e City of Salem Board of Health Kimberley Driscoll 120 Washington Street,4th Floor Mayor SALEM,MA 01970 Swimming Pool Seasonal Permit DATE PRINTED: 05/16/2012 ESTABLISHMENT NAME: Pickman Park Condominiums Pool FileNumber:BHF-2004-000238 Pickman Park Condos/Jill Fama 500 W. Cummings Park#6050 WOBURN MA 01801 LOCATED AT: SALEM, MA 01970 Permit Type Permit No. Permit Issued Permit Expires Fee Restrictions/Notes SWIMMING POOL- BHP-2012-0441 May 18,2012 Sep 23,2012 $140.00 SEASONAL Total Fees: $140.00 PERMIT EXPIRES ISeptember23, 2012 Board of Health Page 1 MRY-9-2012 04:46 FROM: 70:17615692606 P.2/2 MRS:-3-2011 22:06 FROM:PIGKMAN 976 741 7666 TO:17615692613 P.1/1 CT.t'X'OF SAMM,MASSACKSETTs BnAURoaHr+ayw I 1,96 WA"Wm".orst tr.4m m rshp 7%3.(07A)74s4= ICK I6Xcttrrltr)LL FAYMO)MM43 MAYOR I PAVIAGRIMBAUM,b AG'11CIuRdIs u 1v:Aum, 9, , PLIQArION-FORe.IRMM.,M RPN I A W m►Na 2r026 IAQATIODtOFPt 1 /'rck �4Sdt...LBr d/t'�a .L'1p �t�w NAMBOFAPPLtr rt �atcct .• �l�f.C/��trsrer�, �a8� • a� NAUM0 Oo r CHRTIBtfffl POOL OP��,AATOR Nemlx M r it H'adA r-1°17 Con .,,. —18t.�7�1 W06 DATES OF OPIMATION (Unm+nnaagt...� Z'�,17�Di 1 i /1001 I DAYS&HOURS OF OPERATION lam ! 1MeBo � I 9p�eabirPmpole I I OM UIUQforyWmwd SAW 46i"ON11&P7O(Beftwhai 7hbY�+itboatt�q+pld oto +>Denokengeota�BesehtaK fa nuard?m i t(h0 Stue BWtW Coda before any to wdlonA Immo u %arApipmwk chalomm M2044411uu for aucb mart b. d to wd rrpiaed.by the S�sel(fd�of tfeldt4' . .� . .. ._.__ i ro pG 5eodoq d,9i,t oartJ�v�er dlepelnermd pfnR►tios otp�Jagt Oust 4 ro pylmt�oMladpe ald'bd{e4 hew+ 8 B8 mA.�eep tBxeue�drads:dcl6'ekir. BiIwA � l�l��s a �r�tlaa ' 10036 I �' I i I; iI I 0 1 1 .� .` � i �� ,,. - � . . .. -- . .- .. . � . i . , . � . � �� i .�,�� - I -"- .- ... r IMPORTANT MESSAGE FOR C A.M. DATE / TIME P. M ( ' L J-L _ OF PHONE �REO AA COO NUMBER NBION O FAX ❑ MOBILE AREA CODE NUMBER TME TO U- TELEPHONED PLEASE CALL CAME TO SEE YOU WILL CALL AGAIN WANTS M SEE YOU RUSH RETURNED YOUR CALL WILL FAX M YOU MESSAGE SIGNED M 4009 E IN U.S.A. I ( IMPORTANT MESSAGE FOR— DATE OR DATE /E 2,-,2L2-,Z TIME Z M l �ct'' 4— OF PHONE X' .-V 0 � n-;- / C/ ❑ FAX E AREA CODE NUMBER ENSSI'OY U MUk3ILE AREA COO NUMBER TIME TO CALL TELEPHONED PLEASE CALL CAME TO SEE YOU WILL CALL AGAIN I WANTS TO SEE YOU RUSH I RETURNED YOUR GALL WILL FAX M YOU MESSAGE I{ SIGNED FO 4009 MV IN U.S.A. Commonwealth of Massachusetts e City of Salem Board of Health Kimberley Driscoll 120 Washington Street,4th Floor Mayor SALEM,MA 01970 Swimming Pool Seasonal Permit DATE PRINTED: 05/24/2011 ESTABLISHMENT NAME: Pickman Park Condominiums Pool File Number:BHF-2004-000238 Pickman Park Condos/Jill Fama 500 W. Cummings Park#6050 WOBURN MA 01801 LOCATED AT: SALEM, MA 01970 Permit Type Permit No. Permit Issued Permit Expires Fee Restrictions/Notes SWIMMING POOL- BHP-2011-0445 May 30,2011 Sep 12,2011 $140.00 SEASONAL Total Fees: $140.00 PERMIT EXPIRES September 12, 2011 Board of Health Page 1 MAY-10-2011 TUE 09:49 AM APT FINANCIAL SERVICES FAX N0, 7819354289 P. 01/02 MAY-,3-2011 22:96 FROM;PICKMFIN 978 741 7666 TO:17B156%613 P.1/1 io ` CUY OF SALEM, MAMC�IUSE' 5 1'IehagovFl&&i,i Y20w mmm .mm.47hPl1f1iR TI16 FM 7414800 la eatt WUM147"4$ MAYOR iw.,arMjnAi7hgaWZaCOM pnvin CpR1T.�leaUDG,ItS Aey7Na3ixnd 1r!akraw9' ' Aar APPWealION CPA A siMnMMINGRoo� I I.00A'IIONOFPOOb f; ./��., j NAW0FAPPMiCANTji3ftir+rh (lI Rei�re le rt �,#� •�. a o�-7 MAtWNGAD�ItE3 dd ^�{/l(/ CRULFLED POOL OPERATOR Name; 1*4Yy ,(wild earn„ I DATES OF OPERATION (tfnptamlotn_�/�{�� _-� .gfJx ae i r i DAYS&Noun Of 0Fmwl70Nsh%A 2E i Sam�Padlic Spada]Paz" I FW. SE1Q1giFmyarrrmuadpaole 94pORi<ur.oaxwu[Sr0O8N�.$iotit f (P4dam pay'totat wim anm a'heaic pgyade to dut l�gsaf Seda�mil ' ?hisparp+it isaal�eAada►B+dllaraidamdaims dlFt�gaofawaanillp: i Inoaaaedanaaad9sthoState SammyCode.term w9mwwdom hopumnub,(Wa qWpmmt etull eaedaauak.eLLpfimstar sad!stmt be aaLlmttwtA�aod al�r9�eot.�yrda3 SaAtray�aerlBwfll'ae�l. � Pursuant m MG1.t�leptvlpC,Sealms�9a,t�lhcpaiaaalaipeoudliaafpegmy Baa I,ta mylxszl�,owlod8e andt ,have edsa to andpaidallrp tasar4 �uderlhe�it. arl,aa daa�a qo MAY 112011 CITY OF SALEM BOARD OF HEAL HEALTHJ U I Certinfied Xe -� t � L -♦ r 4 Operatoras a IME Agmag-c Facilities ik.-P(P Registration No. Is here6y Certified. and Registered -b the tv on 1 8109, ! ( l INSTRUCTOR CIALt ` G 1� 111 I 1 ..... J� [.111 II l[ ; Il].Il Ikl j If�l. Iljn Il] } 'Jt. I II yI[]l IIt C 'll {`1111 - S1f 11 I 'AJJ X111 ❑ .S I,. 1 Ai ❑ I' ] L.. S CITY Or SALEM, MASSACHUSETTS _ BOARD OF HHAi-n-i - 120 WASHINGTON STREET,4"'FLOOR TEL. (978) 741-1800 IQMI3ERLEY llRISCOLL FAX(978) 745-0343 MAYOR lramdin@salem.com salem.com LARRY RAMDIN,RS�R731-IS,CI-10,C11-1'S HHAL II A(;1.x1' Swimming Pool Inspe'�ctiioin Report Pool: PIG� P t/I V, Date: S+C7J1 �I Address Phone: Operator: Max Bathing Load: In accordance with 105 CMR 435.00 Minimum Standards for Swimming Pools•State Sanitary Code Cho Annual Permit Posted Health and Showers signs Posted Health: no sick employees, no sick bathers, bathers take showers, spitting prohibited,no glass. 4E Lifeguards: Present _Certification _Red/orange suit _"Guard"printed on jersey _Sun block avail. _Voice Amplifier _Elevated seat Einer.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) _Backboard with collar and straps _First/Aid: Equipment area _V(35) 1"band-aids V 0)3x3 gauze VA)5x9 surgipads ✓ 12)antiseptic wipes 1)8x10 SurgiJ,2)2"soft roller bandages cissors _0)3" Soft roller bandages Tweezers VJI) Y2 roll hypoallergenic tape _ escue blanket Vice packs Pocket mask ✓sterile isotonic eyewash Disinfection Chlorine _pH 7.2—7.8 Residual free 1-3,Combined 0-0.2 U " _Bromine _pH 7.2—7.8 Residual 2-6 (ppm)(mg/1) Records Kept: Water tests _Chemicals Used Backwashing / _Attendance _Hours of operation V Depth Markings Sidewalk and inside pool t`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 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: Received by: Inspected by:E Inspection of Cry -t� ..f c 1 �:�`.7 1 Date ll�T�/ Time Name Address Owner Tel. No. Type of Inspection Inspector 1 Remarks and Violations are listed below: ,ems/ r n (J S � I F A10 C('VP POM - `7 � ,e {55ued .5�r,�15/11 —a (I A1C ( f, m +n 4ni-> ,-4 ran ( G(hEM'GrUm-il /rFf/CP/' Report Received by: Inspection p 1 Date �/:= Time Ins Name Address Owner Tel. No. Type of Inspection Inspector ( ' Remarks and Violations are listed below: <t7Y7 � 10 �� C1lylPlc ( t,(°r°P VIJ�C_J Gi P t /c tit ! a S� fil IAZ/ 0A �;1� i w i° h(.✓01 IC'ct S 0/0 kr:, I `z rl r '( 106 C� J 2 b1 N'lr • � � I u r,nn f-}- � f I � ,P � `51,t'<� .Sf r� I( —� f � ,�� :1 � �� 7y' ;• —�-' �C' it ✓/• Iv; V Report Received by: ��=?�•e C �/ /3t�!''r/1,�_�._. CITY OF SALEM BOARD OF HEALTH — 120 WASHINGTON STREET 4TH FLOOR, SALEM, MA 01970 V SWIl4IMING POOL INSP MON REPORT Pool: �"Un Date: Address: Phone: Operator: ftyAg-irS651 Max. bathing load: 1n accordance with 105 CMR 435.000 Minimum Standards for Swimming Pools,- State Sanitary Code: Chapter V - ANNUAL PERMIT POSTED HEALTH and SHOWER SIGNS POSTED d'3� -HEALTH: no sick employees, no sick bathers, bathers take showers, spitting prohibited, no glass. N -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) backboard with collar and strapA'�+c�5 0 - FIRS i AiD. : equipment area Vt�td o- C,0l10A, V/ -(35) 1" bandaids — -(10) 3x3 gauze V-(2) 5"x 9" surgipads (1) 8x10 surgi __V/-(2) 2" soft roller bandages scissors ✓-(2) 3" soft roller bandages - tweezers -A/— -(1) 1/2" roll of hyperallergenic tape - rescue blanket -U/— - ice packs ✓ -(12) antiseptic wipes V - pocket mask ✓ -(1) sterile isotonic eye wash DISINFECTION 064 _- chlorine pH 7.2 - 7.8 Residual: free 1-3, combined 0-0.2 - bromine pH 72 - 7.8 Residual: 2-6 (PPM) (Mg/1) RECORDS: kept 6-9 V - water tests _✓- chemicals used add- backwashing jCtdk{t L { ✓ - attendance - hours of operation t c i li n DEPTH MARKINGS: sidewalk and inside pool G1LQiMO(T ��@��I 5 - DIVING BOARDS: rigidly constructed, properly anchored, braced for heaviesi load, no splinters or cracks, non-slip surface, not over 10' above water level and atleast 13' unobstructed headroom. BATHHOUSE: sepemte dressing and sanitary faeilitics for each sex - adjacent to pool, wcll hgMed.dramed. ventilated, imp—ious constmcuon,one shower and one toilet pa 40 bathers, hot and cold walo. soap provided. no S (' OYN common cups, towels, combs pool adequately enclosed approved dunking water facilities received by:_ __ Inspected by: a: 30 I American Properties Team, Inc. June 25, 2010 0,�,e�j City of Salem �t�(Tjy Board of Health 120 Washington St. Salem, MA 01970 + To Whom It May Concern: It has been brought to our attention that we erroneously double paid for pool permits on behalf of Pickman Park Condominiums located in Salem. Unfortunately, both of these payments have already been cashed by the city. I have attached copies both front and back for you to review. Please send payment for $140.00 to: Pickman Park Condominiums' c/o American Properties Team 500 West Cummings Park, Suite 6050 Woburn, MA 01801 If you have any questions regarding this matter, please feel free to contact me. Sincerely,. 1 4j Eunice De Pena Accounting American Properties Team 500 West Cummings Park Woburn, MA 01801 781-569-2642 500 WEST CUMMINGS PARK • SUITE 6050 • WOBURN + MA + 01801 • 781-932-9224 • FAX 781-435-4289 Date Account Number Serial Number Amount 0610242010 60036174r, Q0000100076 ei an nn Ri4kmiu. park Cond=11miums c(a Xs4scaaPrvysttioa 3osod 500 TAO t Gt ngs .7k, sts 5030 NSGa-rn oata Check Wu Fay. This Smotut 05/1T/3(110 1000�b. S•ak�+rrsK64:Oa c� rAx: Once fIurtdred Forty sad nontip D�LI:�RS �sww.��aa+M+asit,�i�rMf�ttw+K+lass k .Cr MLamm vM azo .u1sNxa sxsr otosa yrs rat, 01970 1+� OF a' i:�0076:�• x'30 � i3©i'�9$f. 60D�;6'�745n•' - .. i -i. • - PTi T'II^R bOT Ti\/ 3!1'h Till RL' .1:'.IT,EY T:: 46 ENDORSE MERE FOR DLP05rr ONLY 'T4 THE LRECIT- of CITY I'Y OF SALEM, MASS. I DO MOT W!,RM r-f,L Alp OA SrGN kF1 Ow t419 LINE ;L 14I - I t I I A A 0 C a A z C 3 se CD c;y rn �q �e ed _; ra g In LF n i o Y3 ` Y n e Eli =1 U t J> �,I T}e srl;,r: f+ afur.a gct.0 A.'nw.as theFe .I ,ryri ye,ereraf�nduury gi,..." rs. t ��-. Y m c �eeu'YF►�1�: ac --t-eta_.-.r.,aMO. _Tear- 1 n v: .fy.vaoxrwt -.r• � 1 " •. ��u�w..� ne__.Irc idneV ar �o�snna rn ner: 4� I • r � , Date Account Number Serial Number Amount 06102120 1 n &M A61745 000001 GOOK? �l all nn ©/u Awrican Faapertiikj lana 500 Ifdt, GTanmings_F!it:� Btb 6050 WQbuxm Mid 03801 Dato Cb**x tics Pay.Sdita Amount 05I14/2Q1Q 100092... �++•�a.r+1¢Q.t10 pAs= Out Hundred Fw'ty and uoXl�O DQi:I�hRS ar•s+rirsawMsR�M'�7+ssf M4#*+hrsrsrras4.Atlt` Cs 9 "Am : PO WX 4125 RECEIVED. OMAR M9, M t 104, 19 as23 MAY 2 d 2Cip � h CITY OFSAL M runax®s�uTxe �wpuv�•x�wls ClWCOLf3:CCi[}R r"4110CM21ir IM&-; 31341RBr. 600 36 r..�Om�j-.e—w� CAT TMI rTgW-•fYi cA-tE+Sl'- • ENDC RSE HERE apt ONLY TO TH° CRFDYT OF c.'rLY 0 r,9ALEM, MASS 170 NOT WRITE, SliMP 441 B.iGN MLOW THI9-.LIRE K 3rnr.R4ED ran HNAN, kL. NYIAU N.N USL * fe A co A 0 C R z C S A r • A z C S A R ro va ra c NC J => � rG Ln R J Y � V " i7ee ncw�ry fewf_ .a IfJRlLrti. r.as G4N®.(�.:.><e IKQ � �. r _ VJ :;ralr:a•.pet. , .. W Q A 'T .FUW . r 'Ts.N5l rrk "' 1 IGLGNA. 0..�td Yc 8...rnY 4� uvM tN � e l�.a ht4. LG � American Properties Team, Inc. PQS�t� 500 West Cummings Park �jL �ZM�Mw Suite 6050 nrrvcr Bowes Woburn, Massachusetts 01801 02 1M $ UU.610 Ali 0004287736 JUN25 2010 MAILED FROM ZIPCODE 01 801 /0? 0 ,�.�--.-:-� 711,,,,,,11I.l..h.rlllr„„Il,,i,i„6,LLLL1„Ll„LJ.► American I Properties Team, Inc.P i10 l June 25, 2010 City of Salem Board of Health 120 Washington St, Salem, MA 01970 To Whom It May Concern: It has been brought to our attention that we erroneously double paid for pool permits on behalf of Pickman Park Condominiums located in Salem. Unfortunately, both of these payments have already been cashed by the city. I have attached copies both front and back for you to review. Please send payment for $140.00 to: Pickman Park Condominiums c/o American Properties Team 500 West Cummings Park, Suite 6050 Woburn, MA 01801 If you have any questions regarding this matter, please feel free to contact me. Sincerely, odfiejesl Eunice De Pena cheo f• Accounting 1�jpds>r ,�c�tfs r lig rr American Properties Team West Cummings Park Wo *014 Woburn., MA 01801. 781-569-2642 500 WEST CUMMINGS PARK • SUITE 6050 • WOBURN • MA • 01801 0 781-932-9229 + FAX 781-935-4289 Date Account Number Serial Number Amount 06L0242016 tillfY2f 17a5 W10001 00026 -S-1-40 00 Picksaw .park Condcminiu s '� 70t E37 c�a 14MY=ICHw Eri.}iMtt1OM 2a 5110 iiaot Ct�n3ngt Pk, stir 6030 7Rsitiira Mik OY80Y tsaty 40hack Xb Pay Shia Aam4t 05t=/—^010 5000' 4 $***"xw-fit 40.ioo :. 1+k�MY�.i�f�YQf►#r#11kii#iY�FKs+iMw�## .#. s '� rAx: One fIvttdrerl Forte tNod no,{lt►D DOLLARS tO "4" WdP ar ems' TM U6 W.MD=TW gnMZTI M=t sit. i p 01970 �►} - �.vnglc�sw�*urdE..=•Gn''vulu�sru�+n::Arx _. EH• RBE HERE FOR DEPOSrr ONLY TO THE [RELIT' OF' CYIY OF SALEM, MASS. I \ m j DO MOT WNeS7pMp qq $tGrr kFl QW YN1S 4.rNE f .1L11'J!L Lhc iiJl i \ 1 I PJ A O G G R z G W i4 �L.�7 rn m � z LZ C m 1 0 ca 0 G r G CG M M I� v P'!r few,o?fy fpAur.m Nar-.CA AW.as. U 0.e A I 4tpt� Ird,excrod,ntiv"!ja.. r . = G :nl i m . I � hYY6h..L 41L�_r\fL YYA.11M LR �Y.LM11.J1•P M1fMF� y 44 C` j Date Account Number Serial Number Amount (161020010 6036J245 4(HH}tlifk O82 R14O t O t+ickxx�tt Fax7e.: oadc t asoma w"" 100002 n�'n Amrrictn Frapaztida hart 3t16 est Gmminget F�Iit,r Bte 6iT50 Woburn rn 1A 03805 DsGt aw-k Na pay-Thi.a Amount fl5t'191'Zs71L# TQ8092. +fat+tvii30,fl0 FAY: One Hu17dudFarcyandua11,iNM.Ili}LLPJZS*0**jRECE ��s�rKer�a� �►uaa*s+ir�»ssMoa ty E. OPDISR 717ZM, !dA 01H8w1-4135 MAY 2 4 MO � l�"1 CrTYGCti.EE.CTOR ri�QE18�1i� ipk1i02.q$r: 6�03Ei��S+� e VATWn.. PTR'V'�n7 CAT= t ENDCRSE HERE J L LL-kj3t I (XgLY T4 THR CR.F6IT OF C f-L-Y {7 SALE'.V, MASS U0 NOT WRITE, SYF:MP OR SIGN BELOW 7H18 LINE •d. if 5[iRYLG r.Jn YINh1. 5� NY1.IU.ILN LYC it A ft A A C ' o T z •1 r II>v ft R m uY � N C 1 �•'•JJ !T1 [ ) J L,� C7 R S. C N ZY1 --i i/le SK WJI)'fhuL -a ft'sRlbek. K.JS gym C�.:Ja •s'?�."YFlue 14 ".or .-r». x- ' W Q .1 R r+. ' : :;c�ra.� per �. ,7 lova 'u Hal T'Yf4 i ItLtMA� h_�ttl Mc b..wnY 6t u.rY to ieFa ht4. iC� Inspection of I Y--11r4Date 7 T C,1110 Time Name Address Owner Tel. No. Type of Inspection Inspector ( � 1 Remarks and Violations are listed below: r)��I�I�t�� ►lc�e �'�"fC��S �h� Ct7�� Ctr �"� � �,.,t`t� �,1C��a7rrr�� . A�o x Y c- clot p , Dfl d ('1` r\,P.S ,-t r e/ cls e�1Ke�' �c �ic l— c�i�l Klin � �t��lic`IrE1P 4(,f ail f�-'t 7"-) U// t F rt( il�c� i'fems Gird' nyr(d(`t tip ''0-e-Htcf Irl Coe D+ r)-)-)I. vr� biyd,-ti h,--x - ct.11 items n nil . ci - a,Lj II .. �ci Ipoi 1iYd2 II 1711 C�f'c ( 1 7Ni rlc� ' 1ram- 14 pi am-14yt pigoV C77ln CIi1d +t.irn wQ*f 17 Lt'11 )<;��r--�I �n �fc �� r�Icr Yip ftl cog ��I� cr'f�0 •U �. y 0 chi rom (err;C-60 CA Report Received by: r ✓f �, r� y )� 2,.4 .i ,y + - l.,F tv _f t �. '+�"� <*:+ 9 �k y 7 Y �. t§"' � ORM � :i tlSl IY r5l rXry �Y3 T �, :. � ,111 9 AA 7 � ,',t} }t� z rtl I .'+1r f a:.'-01 I�' " :I,ii.dVr � ,_ I111,n L_Iii l..fl ❑ n ti } �Y `{r,.,j( � { c - _ ❑ Y(Y. IL. f_. IIV'v llj I tlllli I Y',(.I ,EIf :,(6111'.-_ iL.S(.__ d.a '__ If:TI ._ u!.IhU If. i..�.117:11 . IlLLII � IiFu •.. uJl _� IrLtI �. 1L.II-.. 11 {II L.1.IIa IF._,IP.i 1� r . Ylr J/Sit `/{ ,�' + • III �3�I. Y il lim 104 . y Sr i ii lit l t- il Pool Spa Of a V .51 a y i "a rk 7 4 In deve &m <h' as an Operator of Aquatic CP01D Registration No. 02 -252783 is hereby Certified and Registered1 by the nom. •k. r ',: I t 'I NATIONAL I I . . o "zl1� th4 X DATE C to/\ Z � I _ wt. .'� i ► � I � M INSTRUCTOR ov ,�,�r I ❑ II 1 'Il ❑ II I 1 II II I 11 H' It 'I' !1 I II II II 'I; it I i I tl II ❑ ❑ II II I 'Il 1 1 ❑ JI S i l l rSrr 5: � r k � t a1�`n ✓ 14 � � xau.,: Y a ly,l v r n� r:. t -t.. +� 1 � r r ''G S 3Yr �. n I'.:} X F � Af s �� L, y)r�t g �s`�1 10 ff ._ 1n d e �S�h t i 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: 05/18/2010 ESTABLISHMENT NAME: Pickman Park Condominiums Pool File Number:BHF-2004000238 Pickman Park Condos/Jill Fama 500 W.Cummings Park#6050 WOBURN MA 01801 LOCATED AT: SALEM, MA 01970 Permit Type Permit No. Permit Issued Permit Expires Fee Restrictions/Notes SWIMMING POOL- BHP-2010-0425 May 28,2010 Sep 6,2010 $140.00 SEASONAL Total Fees: $140.00 PERMIT EXPIRES ISeptember6, 2010 Board of Health Page 1 ti r MY-ft-2010 01:30 FROM:PICKMPN 979 7414 '665 70:17812312374 F.112 CITY OF SALEM, MASSACHUSETTS 1)pE!AL7H RECEIVE® 1�!WA.4t1tN090WGCnN S 5'ntaaT,4111Ftnoe Trd.,(97�741.1000 1QMBF luxY DAISCOLL FAX(970)74S4)343 MAYOR WAkTA1gMNIG--SALWl'CObt hilk 24 2010 DAVIQ '(%%KKRAUA CITY OF SALEM *;mo CITY COLLECTOR 2040 ARPU.MLII.ON)R Eg AMIT TO OPEIRME A SWIMMING 921, LOCAmON OF POOLr Vl v �lI NAME OF A"LICANT ryry ,//J0�?TEL# J pn MAILING ADDRESS.�'U?2 V'CEKj NawC: FID]�00 ��dKw-% _ cat ih QBZ r 9.77,# 2 fl, 97,41- J'OE �I/ DATES OF FFIOPERATION Qtna omw� �7 � —J70, DAYS&HOURS OF OPERATION-—ziLO T'XPI?_OF POOL Public ,� em Si-hWic _ FF,p;: 5210,00'faryoarrotmdpooU rorm,m�m�0.001Vee-Front (Plain psy mea wlth one.chook paymbbo to I�BSry $slam) Thio paemit is not tranafeable and wont beroiseoed mlan change of ownership, IN aeemrdaaoe atm the State$talgry Code,befeet amy renovation,Improvomonlq or Equipment ehmeges are matte,ail plain for each moo be sabmleted to and approved by the Salem Eowd of Roa114. int to C7tepler ti3C,Section 494,t omlfy tinder die point md:pccalkiee of perjury&a 1,to ray bra knowledge cad belief,hive Op'l.m. me madpaid ll state Wo t garinad thaw the law. � ' dote 330 or Federal ideidliesdan Numtw I CITY OF SALEM, MASSACHUSETTS �� BOAiu)OF HFALTH 120 WASHINGTON STREF,T,4"'FLOOR TFi,.(978)741-1800 KIMBERLEY DRISCOLL FAX(978) 745-0343 MAYOR tiANCINi nl,ru.coM TANF.I'MANCINI ACTING xI ALn-i AGF,N'r Swimming Pool inspection Report Pool: ?ICKtnrani Qq•Rltw Date: 5 • 2.0—,=- Address Phone: Operator: rAg•24 r4a7GR.Son/ Max Bathing Load: -2-a In accordance with 105 CMR 435.00 Minimum Standards for Swimmine Pools:State Sanitary Code Ch_pter K __.,__ ,,A/ nnual Permit Posted e/ ealth 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 sL Emer. ommunication:phone at pool one instructions Emergency numbers Phone in unlocked area t/ Safety,Lquip: for each 2000,sq.feet Rescue tube or ring buoy(with rope) :0ackboard with collar and straps -N SMO PS _First id:Equipment area / (35) 1"band-aids f J,YO)3x3 gauze t.-'Q60 surgipads antiseptic wipes _✓(1)8x 10 Surgi !2"soft roller bandages scissors r� '' Soft roller bandages weezers '1z roll hypoallergenic tape +r Rescue blanket 'i packs Pocket mask sterile isotonic eyewash s.�D nfection ti-�orine� p, CbVpH 7.2-7.8 Residual free 1-3,Combined 0-0.2 _Bromine _pH 7.2-7.8 Residual 2-6 (ppm)(mg,I) Records Kept: �"Water tests Chemicals Used Backwashing ✓Xttendance :lours of operation 1/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 _ te/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: i TVM1 5 X11 t' ?Qa i v tiE �oy u a M'� K n R'.-a 6v F /j\aaeywT� Received by:_lL � � Inspected by: �T4ti Fay Y?t�t z Commonwealth of Massachusetts s ¢ City of Salem Board of Health Kimberley Driscoll 120 Washington Street,4th Floor Mayor SALEM,MA 01970 Swimming Pool Seasonal Permit DATE PRINTED: 04/23/2009 ESTABLISHMENT NAME: Pickman Park Condominiums Pool File Number:BHF-2004-000238 Pickman Park Condos/Jill Fama 500 W.Cummings Park#6050 WOBURN MA 01801 LOCATED AT: SALEM, MA 01970 Permit Type Permit No. Permit Issued Permit Expires Fee Restrictions/Notes. SWIMMING POOL- BHP-2009-0446 Apr 23,2009 Sep 30,2009 $140.00 SEASONAL Total Fees: $140.00 PERMIT EXPIRES rSeptember 30,2009 Board of Health " Page' p Oc409/2009 09:58 7812312374 SHEFFIELD HEIGHTS PAGE . 02 MAR-16-2008 ISN 11:32 AM APT FINAVAL fiERV!CES FAX N0, 7e1R3S42H I CITY OF SALEM:, AUSACHUSETTS B4nAW OF Hi,'ALTl I 120 WAc::iNMnN 9nlr!h7'.4'�+1 RZ)OA i4i,(978174 t-1900 XIMBERLEY DRIsCOU FAX(9713)74s-0343 WPM NANCIMM 1111 Coll ].ANRT bLk'NON1, ACTtNU HRAIAti AULN-1 ;2POCATIONORT G p L LOCATION qF PO /Gr � }""' 12 'NAME OF APPLIC *�5[1P1,� MAILING ADDRESSQ_ CBRTIF POO OPTOR �I ""g' OI b d l Name: B' ✓ C( _.cn �!►/ TEL+ 3�0 6 , DA ES OF OPERATION (If nvc annual): ! D 3 / ` � DAYS&HOURS OF OPBRATION': / 'nZ OF POOL Punic Semi-Public Spa"Purpose _ FEB., SE10.00 for year meadIm" 9140. r eoasrual$411.00 NotrProdt (Pleas pay taW 1010k ON chet9c pa the City of Salam) This patmit is not net finble and must be reissued upon nhan5e of ownarehip, is shmordanee with the sate Soi dtary Code,before any renovations,ns,improvements,or Equipment changes are oaede,all plans for such must no oebmktad to and approved by taw Salem Board of thaft Vs�wmkCb'*RtCrfjC' on 49a.T certify under the pains and penalties ofpod4ry that I,to my best knowledge and ballet lace tease dl ipolaw,°�!�DO S6N a T+cdarnl IdcpHAGaUon Numbm R JU4 -1L ( D im Y1 C�y1�Grl l OJT S�aa � Inspection of r� � Date Time Name Address Owner Tel. No. Type of Inspection tA-70' Inspector 4::-. l kdNjPc.. ( � 1 Remarks and Violations are listed below: VW-aoimirc Ujc�S co(duC.td avid ff t J J -C-cc c��rl kit recut �6 Xis'' ,u r rA emC� 1 c A ree�Zefs Qt S cue bl C.n ket _ Ph C,� -� (:,Vp, ausk acv. Dads most Shower_ k Gop \►rl�r;m pool " s;c-.ns :)n Aw -'o pm� o-1� . ' i -�c�,Y dWA YYlcxr kInc-S on �duc 3-P OSI . Y i yyV � c �YDU1l�Q �\��1� .S�xD IY1 �'61V1 YpS1"fo�Y�ts. U ��tt_ Ch�citlh� IevC',( ( f� Filen cr� �Y1� ptc"�i�n � c )Cr n f dBUST CVcrl��ct�S � P-,n Uri C-O(WCJ � P,t- LS ("iP r � ` .. J(�r l i7 afa aI1 Report Received by: )',6(,j!t/ ` /' Inspect n of C 1 '� t �1 q-� Date ��.��-'^ �.,Cl Time Name - Address Owner Tel. No. II j Type of Inspection .�� Inspectors I Remarks and Violations are listed below: COa1,� .Et�( � V J � c,ktt C1 P, 1) ( fsk k rob Av `' f1 �'v_5 W J-St Sk3we�r 66w \i�a- ,- oz-joI A'Zt -no*J AMh Of"t k nr� :;In Jg-ckop� P�� , W v � 4 t _ Report Received by: Commonwealth of Massachusetts City of Salem Board of Health Kimberley Driscoll 120 Washington Street,4th Floor Mayor SALEM,MA 01970 Food/Retail Establishment Permit DATE PRINTED: 05/22/2008 ESTABLISHMENT NAME: Pickman Park Condominiums Pool File Number:BHF-2004-000238 Pickman Park Condominiums SALEM MA 01970 LOCATED AT: SALEM, MA 01970 Permit Type Permit No. Permit Issued Permit Expires Fee Restrictions/Notes SWIMMING POOL- BHP-2008-0465 May 22,2008 Dec 30,2008 $140.00 SEASONAL Total Fees: $140.00 PERMIT EXPIRES IDecember3O, 2008 Board of Health f This Permit is not transferable and must be reissued upon change of ownership or location.The permit must be posted in a prominent location in the Establishment. In accordance with the State Sanitary Code,beofre any revonations,improvements,or equipment changes are made,all plans for such must be submitted to and approved by the Salem Board of Health. page 1 NAY-22-2008 THU 03:17 PN APT financial Services FAX NO. 7819354289 P, 02 CITY OF SALEM, MASSACHUSETTS BOARD OF Hr•.ALTH 120 WASW(NGTON STAFEr,4^'FL(X)s TEL(078)741.1800 KIMBERLEY DRISCOLL FAX(978)745-0343 u'!tTT(oL<:�Lrat. MAYOR COM JOANNESLarr, HEALTH AGENT 2008 APPLICATION FOR PERMIT /T�/O OPERATE AA SWIMMING POO(L LOCATION OF POOL l lc9-1LlLI�'/ hid-L 0—Od-66mt) ) _ NAME OF APPLICANT iii no,/7 eJX TEL WIJ7 n_3�-9a a 9 u 6 F} & U r7f �j y� /"g�� MAILING ADDRESS R / Yw �i CERT1FEp POOL OP KC T R Nems:/ 'h/I YI v Cert q: n TE �j,� DATES OF OPERATION (if not annual): o� old oLl 4/ e A- -�"� DAYS&HOURS OF OPERATION: l 1. X J 1 I a 7/ On TYPE OF POOL Public Semi-Public -- — Special Purpose FEE: $210.00 for year round pookb 40.00 or seasonal 540.00 Non-Profit (Please pay total with one check t a City of Salem) This permit is not transferable and must he 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. —INrsuant to MGL Chapter 63C,Section 49a,I certify under the pains and penalties of perjury that 1,to my best knowledge and belief,have ed all state t ret rrts 4� aid all state taxes required under the law. „� � A;,( -1 - 04 -.3) 03060 • Si a Vn P Date SSp or Federal identification Number I 4 R' /160 CITY OF SALEM BOARD OF HEALTH — 120 WASHINGTON STREET 4TH FLOOR, SALEM, MA 01970 1�1 OWN-- SWEM"NG P-ffl-LzMSP-ECT ON rR EWU Pool PlekMun__�Ar� �ov,c�dS Date: _ Address: Phone: 7£-I -93a -'70-14 Operator: 6WUC�L La ofr-o Max. bathing load:_ 1n accordance with 105 C R 4.35.000 Minimum Standards for Swimming Pools, Slate Sanitary Code. Chapter V �Z"'"UAL PERMIT POSTED HEALTH and SHOWER SIGNS POS FED _ HEALTH: no sick employees, no sick bathers, bathers take showers, spitting prohibited, no glass. LIFEGUARDS: Present - certification _ - red/orange suit - "guard" printed on jcrscy - sunblock avail. - voice amplifier _ - elevated seat C'I - LMER CONMCATION: phone at pool ne instructions C/emergency numbers phone in unlocked area ETY EQ�: for each 2000 sq. feet rescue tube or nng buoy (with rope) backbo-, d with collar and straps _- Fli4ir A11� � eywpmem �uca _ -(35) I" bandaids10) 3x3 gawkL—,,-(-2<) X- 9" surgipads (1) 8x10 surgi / ) 2" soft roller bandages �cissors _ 2) 3" soft roller bandages veezers 1/2" roll of hyperall ,enic ape escue bla ket - ice packs -(12) antiseptic wipes pocket mask �I) sterile isotonic cyc wash _ - DISINPEC I-30N chloiiuc 72 7.8 Residual. lice 1-3, combined0-02 - bromine pN 7.2 - 7.8 Rcsidual2-6 (Ppm) (w3/1) hP.C:OI:DS ke;;t (/ water tests - - chemicals used - backwashinn 9w attcndancc �nr hours of opciation 1)1?Pll1 MARKINGS. sidewalk and inside pool DIVING BOARDS: iih,idly r:onsuucictl, properly anchored, hl;w(cd fru llCilvlCil load, no splinters of cracks, non J11l ;ul fai.t., not ova 10' :Ibovr weld Icv(I r.nd :Itic'I"i I unobstilictcd headroom I;A I 1-11-101)Sh.: sqw ale dicr,ini,and vuutaty huhlle9lut each>o. xdp cn( to pool, -,11 1')hiN_dia.)"i ""I'latuf, imtxrnous conwnuumn one sho"u and one bile( Ixt 40 baiha s, hot and cold -zt1,. inal,p.o,,dcd no rznnnam rupY, towcli. comM txxil aztrquavly niclo:al Tppovrd dnnYmp, w-alcr IacihUc. me cd bymslx cu;d by F'v5 -7- 9-o q oo ;?� I if if ALLIED - : ii CONFROL ORP i 1- i ALLIED BIOLOGIGIL CONFROL CORPORATION ' 194 Worcester Street Wellesley H 11 Is,Massachusetts 02181 617-235-6620 1 1 i i REPORT OF BIOLOGICAL SURVEY i PICKMAN PARK SWIMMING AREA i SALEM, MASSACHUSETTS 1 iSUBMITTED TO : ' BOARD OF HEALTH SALEM, MASSACHUSETTS 1 iSUBMITTED BY : ALLIED BIOLOGICAL CONTROL CORPORATION i194 WORCESTER STREET WELLESLEY HILLS, MASSACHUSETTS 1 iSEPTEMBER 10, 1974 i 7 ALLIED BIOLOGIGL CONTROL CORPORATION ' 194 Worcester Street Wellesley Hi l Is,Massachusetts 02181 617-235-6620 ' September 10 , 1974 ' Mr. Colin E. Cameron, R.S. Senior Sanitarian Board of Health ' 5 Broad Street Salem, Massachusetts 01970 1 Dear Mr. Cameron: ' On August 26 , 1974, our aquatic biologist, Gerald N. Smith, completed a. biological survey of the Pickman Park Swimming Area located in Salem, Massachusetts. At the time of the survey, there was very little water in the swimming area. The flood gate had been opened, draining the pond, and only a small stream of water was flowing through the swimming area. Nevertheless, suf- ficient information was gathered during the survey to make the necessary recommendations to the Board of. Health. The following pages will include a report of our biological survey along with a 1 discussion of our findings and recommendations for methods to improve water quality at Pickman Park Swimming Area. ' MORPHOLOGICAL DATA AND BACKGROU14D INFORMATION Pickman Park Swimming Area encompasses a surface area of approximately ' one acre with an average depth of approximately two to three feet when full. The water leve]. of the swimming area is regulated by a tide gate located on the Forest River at Lafayette Street. When the tide comes in, the tide gate can be opened, thereby filling the swimming area. The gate can then be closed to retain the water. 1 ALLIED BIOLOC CAL CONTROL CORPORATION ' Salem Board -2- September 10, 1974 of Health 1 ' Every few days, it is the practice of the Town to drain and refill the swimming area. Bacteria levels in the swimming area have been approaching the U.S.P.H.S. maximum standards permitted in bathing areas. By periodically flushing the swimming area and exchanging the water when the bacteria level is on the rise, the Health Department has been able to keep the bacteria count down. The stream referred to in this report is the tidal stream flowing through the swimming area. ' AQUATIC FLORA POPULATION The following species of marine vegetation were found in the swimming area: FuCMS vesiculloaus rock weed UZva Zactuca sea lettuce Spartina aZternifZora marsh grass 1 At the time of our survey, there were no species of attached vegetation or algae actually growing in the swimming area. However, Fu--us vesicultosus, rock weed, UZva Zaetuca, sea lettuce, and Spartina aZter- nifZora, .marsh grass were observed in substantial quantities in the stream flowing through the swimming area. ' It appears that the Fucus and the UZva grow in the estuary and are brought in with the incoming tide, while the Spartina grows in the marsh above the swimming area and is carried down to the swim pond by the outgoing tide. ' These species are not rooted in the swimming area and are washed in and out with the tides. ' Because the water was almost completely emptied out of the swimming area, Mr. Smith determined that a microscopic algae analysis would not ' give a representative reading of the algae population that may cloud the area. Therefore, an algae count was not conducted. If the Board of Health would like to have the results of an algae count, samples should be taken when the swimming area is full and returned to our ' Water Quality Laboratory. ALLIED BIOLOGGLC0 ROLCORPORPON ' Salem Board -3- September 10, 1974 of Health BENTHIC ORGANISMS Benthic invertebrates found colonizing the substrate were the following : Mya arenaria soft shelled clam Modiolus demissus ribbed mussel Neris virens clam worm ' These are common marine invertebrates. WATER QUALITY ANALYSIS Several water quality parameters were analyzed at two stations. Sample Station 1 was at the swimming area and Sample Station 2 was at the ' flood gate at Lafayette Street. For exact values, see the attached Water Quality Laboratory Sheets. ' The dissolved oxygen content was higher in the pond than at the gate. Carbon dioxide levels were greater at the gate than in the pond. The most logical and probable explanation for this difference in dissolved oxygen and carbon dioxide concentrations is that a higher rate of ' aerobic decomposition of organic matter (decaying plant and animal material) was occurring toward the mouth of the estuary than was occurring in the swimming area. Dissolved oxygen concentrations at both stations were adequate to support those organisms that require high concentrations of oxygen. ' Although the Board of Health has observed high turbidity in the swimming area, we were unable to document this condition because there was so little water in the pond. Laboratory analysis of ' water samples collected at the time of our survey revealed that color and turbidity were low. ' Mr. Smith reported that the bottom substrate is a black silty/ organic sediment. It is common for swimmers to cause silt to become suspended in the water. Furthermore, if there is an algae problem ' in the pond, the high concentration of phytoplankton would contribute greatly to the turbidity of the water. ALLIED BIOLOG49L CONMOL CORPOWTION Salem Board of -4- September 10, 1974 ' Health Analysis of sodium chloride revealed that salinity concentrations are somewhat less in the bathing area than at the flood gate. This ' is to be expected as the swimming area is receiving not only tidal waters but also an influx of freshwater from surface runoff and street drainage as well. The concentration of sodium chloride in most sea water is in the range of 32,000 mg/l. Mr. Smith noted that the bottom substrate had a very slight hydrogen sulfide odor. However, he reported that the hydrogen sulfide odor was not so great that it would warrant complaints. Hydrogen sulfide gas is liberated during anaerobic decomposition of organic matter in the bottom sediment. RECOMMENDATIONS At the Pickman Park Swimming Area, we are confronted with natural conditions which one might expect to find in tidal pools of this nature. Straits Pond in Hull and Musquashut Pond in Scituate are tidal pools with similar problems. All three ponds have these con- ditions in common: little natural interchange of water, high bacteria, algae, odors, and free floating aquatic vegetation. ' In view of the nature of the tides, currents and exchanging volumes that occur .in the swimming area, chemical treatment for either algae or aquatic vegetation is not feasible. ' The schedule for draining and filling the swimming area should be revised so as to maintain the lowest possible algae and bacteria counts. ' Tbis may call for daily flushing of the swimming area, or perhaps flushingthree to six times a week. Microscopic algae counts and analysis of selected chemical and physical parameters could be conducted ' each Jay over a period of one or two weeks to determine the most effective schedule. Regarding the nuisance aquatic vegetation brought in by the tides ' from the Forest River and from the marsh, it is possible that this nuisance could be greatly reduced if not completely eliminated. Wire mesh screens could be placed above and below the swimming area, These screens would retain the sea weed, marsh grass, and sea lettuce and any other, aquatic vegetation that might flow in and out of the swimming area. A plan could be devised so that the vegetation would not accl=- ' "late on the screens, thereby obstructing the flow of water. ALLIED BIOLOG GIL CONTROL CORPO@9TION Salem Board -5- September lo, 1974 of Health The turbidity might be reduced by removing the silt and sediment from the bottom of the swimming area. Further studies would be rea_uired before recommending that this be done to determine what kind of base is under the silt and sediment and also to determine how much and how fast these sediments are introduced into the swimming area by the tides. Water quality might also be improved by making a study of the surface runoff and street drainage which enters the pond. If these waters are highly contaminated, a means of diverting these waters to another location might be devised. ' If there were a way to bring water in and increase the circulation through the swimming area, the bacteria problem might be improved. This might be accomplished by damming up the pond at Lincoln Road and converting it to a fresh water pool. A continuous flow of fresh water could be pumped into the pond while the outlet waters could be controlled by the dam, thereby providing the necessary circulation through the pond. CONCLUSION The alternatives that exist for dealing with the problems of the swimming area range greatly from the "Do Nothing" approach to exten-- ' sive studies and the concrete plans for change that could be derived from such studies. If the Town of Salem feels that the Pickman Park Swimming Area is a valuable resource and would like to take the necessary steps in an attempt to make a significant improvement in the quality of the swimming ' area, a comprehensive study would be required to carefully analyze any or all of the relevant biological, physical and chemical characteristics of the swimming pond and its surrounding area. These could include the following studies: I. A careful evaluation of the flushing schedule in order to maintain the highest possible water quality. ' II. Analysis of the currents and flows of the Forest River with special attention to the movement of the sediments in and around the swimming area. III. Analysis of the stratigraphy of the swimming area. This would involve analysis of the unconsolidated materials which lie at the bottom of the swimming area to determine the feasibility of removing undesired materials and of replacing these materials, if necessary, with a suitable substrate. ALLIED BIOLOGIOIL CONTROL CORPORATION Salem Board of Health -6- September 10, 1974 ' IV. . Evaluation of the nature and volume of the aquatic vegetation and algae which washes in and out of the swimming area to determine what method of screening the area would be most ' successful. V. Analysis of the incoming waters from the urban area surrounding the swimming pond to determine the possibility of diverting ' some or all of these waters to another location. VI. A feasibility study for damming up the swimming area and con- verting it to a fresh water pond with adequate ciruclation. The options open to the Board of Health and the Town of Salem are many and varied. If the Town of Salem would be interested in embarking upon more comprehensive analysis of the Pickman Park Swimming Area, we would be glad to outline a proposal for further study. We would like to thank you for giving us the opportunity to conduct a biological survey of the swimming area and to submit this report to the Salem Board of Health. We look forward to being of further assistance to the Town of Salem in any of its environmental endeavors. ' Sincerely, ALLIED BIOLOGICAL CONTROL CORPORATION ti.. ' FREDRICK M. BERK Administrative Assistant ' FMB/lfs Water Qualitjr _IrEaborat®ry"" 194 WORCESTER STREET-ROUTE 9-WELLESLEY HILLS, MASS. 02181 (617)235-0777 REPORT OF LABORATORY ANALYSIS ' FROM Pickman Park Salem, MA SAMPLE MARKED ANALYSIS NO. 677-74 DATE OF COLLECTION ' SSl — Bathing Area DATE OF ANALYSIS 8/26/74 Temperature — °C 310 Phosphate* Color-Apparent 18 —Ortho as PO4 Turbidity — JTU 10 --Total as PO4 Alkalinity* Oil-Grease* —Phenolphthalein Phenol* —Total pH Chloride* Carbon Dioxide* 24 .0 Hardness* Oxygen, Dissolved* 10.5 —Total Oxygen Demand, Metal* Biochemical (BOD)* —Cadmium Oxygen Demand, —Chromium Chemical (COD)* —Copper Solids* --Iron-Total —Total --Lead —Suspended '- —Manganese —Dissolved —Mercury Sulfate* —Sodium Sodium Chloride* 25,000 ' —Zinc Conductivity Nitrogen* (MICRO MHOS/CM) —Ammonia as N. Bacteria** ' —Nitrite as N. --Total Coliform -- —Nitrate as NO3 —Fecal Coliform Total Kjeldahl as N. —Fecal Streptococci ' —Total Bacteria REMARKS *Milligram Per Liter (mg/1) **Count Per 100 ml of Sample (MF) WAT (DUALITY LABORATORY ND — None Detected ( } r ey3 . < — Less Than BY frr 1(G) ! r ti ,l Water Quality' "Laboratory 194 WORCESTER STREET-ROUTE 9-WELLESLEY HILLS, MASS. 02181 (617)235-0777 - ' REPORT OF LABORATORY ANALYSIS ' FROM Pickman Park Salem, MA ' SAMPLE MARKED ANALYSIS NO. 676-74 DATE OF COLLECTION SS2 — Gate DATE OF ANALYSIS 8/26/74 ' Temperature — °C 290 Phosphate* Color-Apparent 30 —Ortho as PO4 ' Turbidity — JTU 12 —Total as PO4 I ' Alkalinity* Oil-Grease* I —Phenolphthalein Phenol* —Total pH ' Chloride* Carbon Dioxide* 40. 0 Hardness* Oxygen, Dissolved* 7.5 —1 otal Oxygen Demand, Metal* Biochemical (BOD)* —Cadmium Oxygen Demand, —Chromium Chemical (COD)* ' —Copper Solids* . —Iron-Total —Total --Lead —Suspended ' —Manganese —Dissolved —Mercury Sulfate* —Sodium Sodium Chloride* 29 ,000 ' —Zinc Conductivity Nitrogen* (MICRO MHOS/CM) —Ammonia as N. Bacteria** ' —Nitrite as N. —Total Coliform —Nitrate as NO3 —Fecal Coliform —Total Kieldahl as N. —Fecal Streptococci ' —Total Bacteria REMARKS 1 ' *Milligram Per Liter (mg/1 ) **Count Per 100 ml of Sample (M F) WATER UALITY LABORATORY ' ND — None Detected �f < — Less Than BYti2. David E. Newton I z _O pc U J m JW_ J Q SALEM HEALTH DEPARTMENT SWIMMING REGULATIONS FOR PICKMAN PARK . SWIMMING. AT PICKMAN PARK IS ALLOWED ON WEDNESDAY THROUGH SATURDAY. . SWIMMING IS NOT ALLOWED ON SUNDAY, MONDAY OR TUESDAY. . SWIMMING IS NOT ALLOWED FOR 48 HOURS FOLLOWING A RAIN STORM. FOR MORE INFORMATION PLEASE CALL THE SALEM HEALTH DEPARTMENT AT 741 -1800. IMPORT NT MESSAGE FOR DATE TIME M G� OFA PHONE AREA CODE NUMBERn, EXT NSION ID FAX ❑BILE , \ / AREA CODE N BE TIME TO CALL TELEPHONED PLEASE CALL CAME TO SEE YOU WILL CALL AGAIN WANTS M SEE YOU RUSH. RETURNED YOUR CALL WILL fAX TO Y94 SSA i SIGNED *NNERSAL. 48005AUE IN U.S.A. NOTES _ J IMPORTANT FOR �...MESSAGE )... -/ A. DATE `�=\// l�_TIME M -�01A✓� OF AP55dae/k&. r`p PHONE 1$ '�/�A�� '7 AREA CODE NO ER EXTENSION Cl FAX ❑ MOBILE AREA CODE NUMBER TIME TO CAI-1- TELEPHONED ALLTELEPHONED PLEASE CALL CAME TO SEE YOU WILL CALL AGAIN WANTS TO SEE YOU RUSH RETURNED YOUR CALL WILL FAX TO YOU MESSAGE �il/Jl DS Q 4 _ �rSr�fn/� �75 ham( 1tbuI-e ( I �L1IM 12 SIGNED *NIVERSAL. 48005 A E IN U.S.A. NOTES -- MAY-8-2012 22:51 FROM: TO:19787417666 P.1/1 Mf '=3-2011 22:06 FROM:PICKMW 978 741 7666 T0:1'7H15692613 P,3'1 } c= op uLEK mmsAcHTisE4Ts 6axnt+ani�uras+t � �'1!WANN7#Q`�'��S'�xiu�ilBm fiet�FA6 ` • 'Sb..(D78j'F.il � FAX Mg)74MM3 > n�lrYeki/it148extd.�� i MA'yM ! uxrnncswst�tea;sa�.� i Ar.iwuKuA4''naAa c i NAM OF APMCAWJAWUq4j^Ldjl,& �## AAPtiG/��Qtd EAFf PL�RR�l1�'�1lbFEl2lA?€A,81RIF1�IId!l�IA1A+ L. i NATt M / CERTYE 3O POOLTp� 03=;L� DAM40POPERATM Ofot , /20.0&+ �,�am ! see � 7 ° aem : sm]b am 1w ' i 1 i n�eae+orona�nd+Rsn,oat c�nQco � I 'I i !