HomeMy WebLinkAboutApplication �l�-04�����+ �'-�s-(2� �-0 �( ����
� °� r TOWN OF YARMOUTI-� �.�, � �d�f ���
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= 1146 ROUTE 28, SOUTH YARMOUTH, MASSACHLJSETTS 02664-24��1 "I�b
��'E Telephone(508)398-2231,ext. 1241 � o
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� Fax(508)760-3472
� DEC �� 4 2015 �
APPLICATION FOR OPERATION-2016 HEALTH DEPT.
POULTRY
PLEASE COMPLETE ALL OUESTIONS ���� ���� �
� � E-MAIL ,
NAME eJ � ' HOME TEL.NO. �7s� '3������°�
LOCATION ADDRESS �+ (li�� � e < G�h ' �Z�O Z 3
MAILING ADDRES (IF DIFFE `"" ,5�����-C' —
NUMBER OF FO � MBER OF PENS/COOPS l N[JM�R9ER�O�TERS__---t�f� --- --'
PLEASE N E: PLEASE O NOT INCREASE THE NUMBER OF FOWL
WITHOUT P ISSION OF THE HEALTH DEPARTMENT.
TYPE OF SHELTER /,t;G� .��ri,</ �c� C� P.�C SIZE OF YARD/PEN AREA
�� (WOOD,CONCRETE,ETC.) '
NUMBER OF WATER OUTLETS � ,p �-tr'� WATER TROUGHS 3
TYPE OF STORAGE FACILITY USED FOR FEED/GRAIN C 5�'� �'`�2
TYPE OF FACILITY USED FOR MANURE STORAGE ��rv+-i�'Ci�� '
METHOD OF DISPOSAL OF MANURE ��S�G�� Gu� �� HOW OFTEN � `��-- '
PEN AREA ENCLOSED BY WHAT TYPE OF FENCING? ��1
V 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 Yarmouth taxes and liens must b�aid rior to renewal or issuance ofyou�ermits____ _
--
Please check appropriatel if paid: Yes No
---__ --- _ – _ _
Y� /
SIGNATURE DATE �01 � �� ��
THE FULL OULTRY UNT IS NOT TO EXCEED THE AMOUNT OF PRIOR YEAR'S TOTAL.
FEES: ✓ POULTRY: 1-9 chickens
10 or more Chickens $40.00
ROOSTER (NOTE: SPECIAL APPROVAL REQUIRED FOR ROOSTERS)
NO ROOSTER
TOTAL DUE: $ � G� �
10/14/I S
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