HomeMy WebLinkAboutApplication � �� ���������������� � �� � .�.
� � ` TOWN OF YARMOUTH Bo�-dof %
� � Health '
= 1146 ROUTE 28, SOUTH YARMOUTH,MASSACHUSETTS 0
�°E Telephone(508)398-2231,ext. 1241 (°3[�C�C�t��ICC�eal
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Fax(508)760-3472
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APPLICATION FOR OPERATION-2016 HEALTH DEPT. .__ ,. ,,.,_
POULTRY '4- � " �
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PLEASE COMPLETE ALL QUESTIONS ' C�u ��0 - '
��.�.b� E-MAIL
NAME �E�0.C� L t�WeS HOME TEL.NO. Jr� �3 1 Sr��J"J��f
LOCATIONADDRESS I�a- O Ky- C1�( r/1 �
MAILING ADDRESS(IF DIFFERENT)
� . . NUMBER O�E9WL NLIMBFR OF PFN�/('nnP4 Ni TMRFR nF BS�04TF.R�
PLEASE NOTE: PLEASE DO NOT INCREASE THE NUMBER OF FOWL
WITHOUT PRIOR PERMISSION OF THE HEALTH DEPARTMENT.
TYPE OF SHELTER SIZE OF YARD/PEN AREA
(WOOD,CONCRETE,ETC.)
NUMBER OF WATER OUTLETS WATER TROUGHS
TYPE OF STORAGE FACILITY USED FOR FEED/GRAIN
TYPE OF FACILITY USED FOR MANURE STORAGE
METHOD OF DISPOSAL OF MANURE HOW OFTEN
PEN AREA ENCLOSED BY WHAT TYPE OF FENCING?
RENEWAL
NEW APPLICATION- IF NEW APPLICATION, PLEASE ATTACH A COPY OF PLOT PLAN SHOWING LOT
LINES AND LOCATION OF STABLE, PEN, ETC., AND ALL ENCLOSURES. ALSO,A
WRITTEN LETTER OR STATEMENT,SIGNED BY ALL ABUTTERS TO PROPERTY.
'� _ Town of YarmoutlL.t�s�nd lienc m�s h�nai�nrior to ren��19L1sSua��4�Y4ur nermits. ___ ________ __ _�_
Please check appropriately if paid: Yes� No
�
SIGNATURE DATE��_:, �
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THE FULL POULTRY COUNT IS NOT TO EXCEED THE AMOUNT OF PRIOR YEAR'S TOTAL.
FEES: � POULTRY: 1-9 chickens �30.00
10 or more Chickens 40.00
ROOSTER (NOTE: SPECIAL APPROVAL REQUIRED FOR ROOSTERS) '
NO ROOSTER
TOTAL DUE: $ �O.Od
10/14/15