HomeMy WebLinkAboutMiscellaneous - 65 BEAR HILL ROAD 4/30/2018 (2) 65 BEAR HILL ROAD ad
2101064.0-0080-0000.0
1
i
Address 4X 1'3,6h Q 4-1 L Title of File
Page 9 of
Date File Open: Date fide 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 - Planniing Board - Conservation Commission - Building Departrne4
WATERSHED RESIDENTS QUESTIONNAIRE
1. Name
2. Street Address 62 l�E��1/` P"r/ / A)
3. How many members are in your household?
4. What type of sewage disposal system do you have?
❑ cesspool
❑ septic tank and leaching area
connection to municipal sewer
❑ other (describe)
❑ do not know
5. Are the plans (drawings) for your sewage disposal system on file with the Board of Health?
yes ❑ no ❑ do not know
6. How old is your sewage disposal system? El� 0-5 years ❑ 6-10 years ❑ 11-20 years
❑ over 20 years ❑ do not know
7. Has your sewage disposal system been rebuilt or repaired?
❑ yes 2' no ❑ do not know
If ves, approximately how long ago? years. What was done?
8. How frequently is your sewage disposal system pumped out? ❑ annually /W
❑ every 7-1-4 years ❑ every 5-10 nears ❑ over 10 years ❑ never /
9. Have you had any problems with your sewage disposal system? ❑ yes ❑ no
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 Z dishwasher garbage disposal
dehumidifier drain sump pump toilet
roof/pavement drains shower/bathtub '?'
11. Please state the brand and type (liquid or powder) of detergent you use for:
dishwasher i- _�Yl e'er C:v
clotheswasher 4100, /1 , c'_
U
12. Does your property have a lawn? [/ yes ❑ no
If yes, approximately what size? /1/2
Elless than 'A acre El1/4 acre acre ❑ 3/4 acre ❑ 1 acre
❑ more than 1 acre (Specify) acres
13. How often do you fertilize your lawn?
No. of applications per year J A /
Season(s) of the year %3k4 lnP,r, 5,01cl a q .'ll
J
14. Please tate the brand and type (liquid or granular) of lawn fertilizer you use:
ER/ Check here if your lawn is maintained by a professional landscape contractor.