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HomeMy WebLinkAboutApplication and WC ���-ol?�Ba►��-(�—�3 s� � ` TOWN OF YARMOUTH � � Board of � Health � � �� �� �EE = 1146 ROUTE 28, SOUTH YARMOUTH,MASSACHLTSETTS 02664-2445I ^ '^��H�a� � � ��' Telephone(508)398-2231, ext. 1241 �^- , _ Fax(508)760-3472 �,�,s��; '''�` G3L�C�G�MGD . APPLICATION FOR OPERATION-2016 � POULTRY MAR 14 ZO16 �„� �- PLEASE COMPLETE ALL QUESTIONS HEALTH DEPT. E-MAIL Y C U lr � , NAME Y � I HOME TEL.NO.,�b���� `(�J� LOCATION ADDRESS � ' D ! MAILING ADDRESS(IF DIFFERENT) : NUMBER OF FOWL NUMBER OF PENS/COOPS�_ NUMBER OF ROOSTERS � PLEASE NOTE: PLEASE DO NOT INCREASE THE NUMBER OF FOWL ; WITHOUT PRIOR PERMISSION OF THE HEALTH DEPARTMENT. TYPE OF SHELTER i lG(„Y�tC.. � SIZE OF YARD/PEN AREA� O � � (WOOD,CONCRETE TC.) . NUMBER OF WATER OUTLETS � WATER TROUGHS C TYPE OF STORAGE FACILITY USED FOR FEED/GRAIN_�'f"S(, � �{/1 IlU�'� Cd Uc�Y ' TYPE OF FACILITY USED FOR MANURE STORAGE ��/I,IO QS'I� V�l � METHOD OF DISPOSAL OF MANURE�Q,(�S HOW OFTEN�►'�p � PEN AREA ENCLOSED BY WHAT TYPE OF FENCING? ����Q,(A . �� 1�,(�. j��p,���� 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. j f i Town of Yarmouth taxes and liens must be paid prior to renewal or issuance of your permits. Please check appropriately if paid: Yes No i SIGNATURE DATE THE FULL POULTRY COUNT IS NOT TO EXCEED THE AMOUNT OF PRIOR YEAR'S TOTAL. FEES: L POULTRY: 1-9 chickens �30.00 � 10 or more Chickens 40.00 �j� �"�"`' ROOSTER (NOTE: SPECIAL APPROVAL REQUIRED FOR ROOSTERS) 1 NO ROOSTER ' TOTAL DUE: $ � i ion4ns I I I