HomeMy WebLinkAboutApplication , �
_ . � �� _6l y. �
�' � TOWN OF YARMOUTH Bo�-dof
� Health
1146 ROUTE 28, SOUTH YARMOUTH,MASSACHiJSETTS 02664-24451 Health
'�»• Telephone(508)398-2231,ext. 1241 •
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F�(508)760-3472
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APPLICATION FOR OPEI�'��0 � ''='4
POULTRY � ' ;� � t � < z � _
, ��� : �{�:-��3 � i��N t.
PLEASE COMPLETE ALL QUESTIONS ���` ����� -
E-MAIL (�,V Ct�h �/Y1CC V ��
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NAME Y/ �Pi�l OME TEL.NO. �� 3C�o� t`
LOCATION ADDRESS �Y) �_
MAILING ADDRESS(IF DIFFERENT) _ �
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�__, hT�3�R
� 3�T�$.�.�,,�.l�l�,�� �_�_����R OF ROOSTF,RS
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PLEASE NOTE: PLEASE DO N(?T INCRE�SE �'HE NUMBER OF FOWL �
WITHOUT PRIOR PERMISSION OF THE HEALTH DEPARTMENT.
TYPE OF SHELTER__ 1/l��� � SIZE OF YARD/PEN AREA � �
( OOD,CONCRETE,ETC.) '
NUMB�OF WATER OUTLETS � WATER TROUGHS �
'TYPE OF STORAGE FACILITY USED FOR FEED!GRAIN � �"'-�JC._._ <-(�/(�� ��� D y�r°
TYPE OF FACILITY USED FOR MANURE STORAGE ���Q,J2..�, � C
METHOD OF DISPOSAL OF MANURE p�l,(�.�(/ HOW OFTEN W �
�, I,� �
PEN AREA ENCLOSED BY WHAT TYPE OF FENCING? Cj. �� C�V�--�il/1 �tJ (,�'`��
�RENEWAL `
NEW APPLICATION- IF NEW APPLICATION,PLEASE ATTACH A COPY OF PLOT PL�N SHOWING LOT
LINES AND LOCATION OF STABLE, PEN, ETC.,AND ALL ENCLOSURES. ALSO, A
WRITTEN LETTER OR STATEMENT,SIGNED BY ALL ABUTTERS TO PROPERTY.
�, � Town�of Yarmouth t� � ' ' �nusti��.id��aQr�t�o renevYal or issuanc�.of your nermi s• _
Please check appropnate y i pai : Y�es `1Vo
SIGNATU DATE � � � ! � / �
THE FULL POULTRY COUNT IS NOT T EXCEED THE AMOUNT OF PRIOR YEAR'S TOTAL.
FEES: J POULTRY: 1-9 chickens
10 or more Chickens " 40.00 _
ROOSTER (NOTE: SPECIAL APPROVAL REQUIRED FOR ROOSTERS)
�NO ROOSTER
TOTAL DUE:$ ����� -�
�
10/08/13 �