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��; '''�`
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APPLICATION FOR OPERATION-2016 �
POULTRY MAR 14 ZO16 �„�
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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
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Town of Yarmouth taxes and liens must be paid prior to renewal or issuance of your permits.
Please check appropriately if paid: Yes No
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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: $ �
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