HomeMy WebLinkAboutApplication �6�-0 I 3/eo�P!s- ��1�� � �
� � r TOWN OF YARMOUTH Boardof
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�--- E 1146 ROUTE 28, SOUTH YARMOUTH, MASSACHUSET'TS 02664 2445r
*"� Health
'�'' Telephone(508)398-2231, ext. 1241 ��� 2 ����n
Fax(508)760-3472
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APPLICATION FOR OPERATION-2016 �
POULTRY .'��'��� _
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PLEASE COMPLETE ALL OUESTIONS `r
E-MAIL ,if�C � � � �• - ,hu// ��
NAME � t - HOME TEL.NO. J U���� � Z/Z �✓
LOCATION ADDRESS G� ,- U�U C � �� (�' 1� Z '�
MAILING ADDRESS(IF DIFFERENT)
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PLEASE NOTE: PLEASE DO NOT INCREASE THE NUMBER OF FOWL
WITHOUT PRIOR PE ISSION OF THE HEALTII DEPARTMENT.
TYPE OF SHELTER (� � SIZE OF YARD/PEN AREA ��1( ��
(WOOD,CONCRETE,ETC.)
NUMBER OF WATER OUTLETS WATER TROUGHS
TYPE OF STORAGE FACILITY USED FOR FEED/GRAIN���, � ��
TYPE OF FACILITY USED FOR MANURE STORAGE� i� US���
METHOD OF DISPOSAL OF MANURE � /�i'+�/f�i),(�,t_!/� HOW OFTEN K /
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PEN AREA ENCLOSED BY WHAT TYPE OF FENCING? J,/t�GK GD��`�+���!j h Ib�/�� � �
�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 be pai prior to renewal or issuance of your permits.
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SIGNATURE DATE
THE FULL POjd�,TRY COUNT IS NOT TO EXCEED THE AMOUNT OF PRIOR YEAR'S TOTAL.
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FEES: � POULTRY: 1-9 chickens $30.00
10 or more Chickens $40.00
ROOSTER (NOTE: SPECIAL APPROVAL REQUIRED FOR ROOSTERS)
✓ NO ROOSTER
, TOTAL DUE: $ 30•O�
10/14/15