HomeMy WebLinkAboutMiscellaneous - 40 APPLEDORE LANE 4/30/2018 �� 1
40 APPLEDORE LANE
210/097. 0092-0000.0
Address - -I o Aol Title of Fie Page of
Date File Open: Date File closed:
Doc Document/Action Title Date of Refer to other Purpose of Document/Action and notes:
action Document/ document/
Num. Action Department
Board of Appeals - Board of Health - Planning Board - Conservation Commission - Building Departrnent
WATERSHED RESIDENTS QUESTIONNAIRE
1. Name 44 2k( ' Iq L-C) bL's k
2. Street Address 'f' p t9 0 �C
3. How many members are in your household.
4. What type of sewage disposal system do you have?
❑ cesspool
❑ ,peptic tank and leaching area
®/connection to municipal sewer
❑ other (describe)
❑ do not know
5. Are the plans (drawings) for our sewage disposal system on file with the Board of Health?
Elyes Elno do not know
6. How old is your sewage disposal system? ❑ 0-5 years [W 6-10 years ❑ 11-20 years
❑ over 20 years ❑ do not know
7. Has your sewage disposal system been rebuilt or repaired?
❑ yes P' no ❑ do not know
If yes, approximately how long ago? years. What was done?
8. How frequently is your sewage disposal system pumped out? ❑ annually
• ❑ every 2-4 years ❑ every 5-10 years ❑ over 10 years ❑never
9. Have you had any problems with your sewage disposal system? ❑ yes [-Ko
If yes, what problems?
❑ repeated pump-outs needed
❑ system clogs, backs up, or drains slowly
❑ odors
❑ sewage surfaces through ground
10. How many of each appliance are connected to your sewage disposal system?
washing machine ! dishwasher garbage disposal
dehumidifier drain sump pump toilet
roof/pavement drains shower/bathtub ::2-
11. Please state the brand andlype (liquid or powder) of detergent you use for:
dishwasher CWS CA\t_.
clotheswasher T �� (2 LORA
12. Does your property have a lawn? [ yes ❑ no
If yes, approximately what size?
U less than 1/4 acre ❑ 1/4 acre ❑ 1/2 acre ❑ 3/4 acre ❑ 1 acre
❑ more than 1 acre (Specify) acres
13. How often do you fertilize your lawn?
• No. of applications per yearTa-
Season(s) of the year
14. Please state th and and type (liquid or granular) of lawn fertilizer you use:
❑ Check here if your lawn is maintained by a professional landscape contractor.
I�,
'1VA_'L'_`i_1RSHED _4JESID, 7,--,,NTS QUESTIONNAIRE
1.
P-P,(I LC) �l
2. Street Address
3. How many members are in your household?
4. V,"hat type of sewage disposal system do you have?
Li cesspool
,peptic tank and leaching area
connection to municipal sewer
❑ other (describe)
❑ do not know
5. Are the plans (drawings) forr your sewage disposal system on file with the Board of Health?
❑ yes ❑ no V do not know
6. How old is your sewage disposal system? ❑ 0-5 years 6-10 years ❑ 11-20 years
over 20 years ❑ do not know
7. I�as your sewage disposal system been rebuilt or repaired?
❑ yes Q' no ❑ do not know
If yes, approximately how long ago? years. What was done?
8. lova frequently is your sewage disposal system pumped out? ❑ annually
❑ every 2-4 years ❑ every 5-10 years ❑ over 10 years B-never
q. lave you had any problems with your sewage disposal system? ❑ yes CcL-tfo
11; yes, what problems?
❑ repeated pump-outs needed
❑ system clogs, backs up, or drains slowly
❑ odors
❑ sewage surfaces through ground
10. How many of each appliance are connected to your sewage disposal system? J
NArashing machine dishwasher garbage disposal
bel-fumidifier drain sump pump toilet
._ �
x�,;-._.,,pavement drains shower/bathtub
11. ''lease state the brand and`yt pe (liquid or powder) of detergent you use for:
SC
t.'i:�t�s�rasher O e9 ft ht'
�lwheswasher TI t' LORA)(
12. Noes your property have a lawn? Lyes ❑ no
If yes, approximately what size?
Y less than '/4 acre ❑ 1/4 acre ❑ 1/2 acre ❑ % acre ❑ 1 acre
_I more than 1 acre (Specify) acres
13. How often do you fertilize your lawn?
Nio. of applications per year /— —L'
of the year
14. 'i-a-e sate tl and and type (liquid or granular) of lawn fertilizer you use:
- - G
F Cive6k here if your lawn is maintained by a professional landscape contractor.