HomeMy WebLinkAboutApplication �(� — � l � �BolfP-I S-1 zZy— D t
°� r TO WN OF YARMOUTH Boardof
� � Health
� E = 1146 ROUTE 28, SOUTH YARMOUTH,MASSACHUSETTS 02 4- �
'°*�'' Telephone(508)398-2231, ext. 1241 '�'�'�'�I�i''� a
.�L���s ,vic;�
Fax(508)760-3472
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APPLICATION FOR OPERATION-2016 HEALTH DE�T ',
POULTRY '
PLEASE COMPLETE ALL QUESTIONS ����,� �k3 �,
E-MAIL " � �'�� P Z-DfV ,'
NAME �(��` ���" f `�-� HOME TEL.NOS� 3�oZ. �{��I� �l '
LOCATION ADDRESS�-'` � � ��
MAILING ADDRESS(IF D T) '
NUMBER OF FOWL � NUMBER OF PENS/COOPS NUMBER OF ROOSTERS �
PLEASE NOTE: P DO NOT INCREASE THE NUMBER OF FOWL
WITHOUT PRIOR PERMISSION OF THE HEALTH DEPARTMENT.
TYPE OF SHELTER C�'U U Q� SIZE OF YARD/PEN AREA ( � x ��
(WOOD,CONCRETE,ETC.)
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NUMBER OF WATER OUTLETS � WATER TROUGHS �
TYPE OF STORAGE FACILITY USED FOR FEED/GRAIN � �C.. G CL (/1 '�
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TYPE OF FACILITY USED FOR MANURE STORAGE �(,,CJ Yl U�L( �
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METHOD OF DISPOSAL OF MANURE � < < � HOW OFTEN (� --2S��C ;
PEN AREA ENCLOSED BY WHAT TYPE OF FENCING? � �(`��il �, 1 �, �
�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.
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Town of Yannouth taxes and liens must be paid prior to renewal or issuance of your permits.
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Please check appropriately if paid: Yes � No
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SIGNATURE ATE �� /J�
THE FULL POULTRY COUNT IS NOT TO EXCEE 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: $ � �
10/14/IS