HomeMy WebLinkAboutApplication �- f- �'!a -��0
� °' ` TOWN OF YARMOUTH Boardof
� Health
1146 ROUTE 28, SOUTH YARMOUTH,MASSACHLTSETTS 02664-24451 Health
''�+'' Telephone(508)398-2231,ext. 1241
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Fa1c(508)760-3472
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APPLICATION FOR OPERATION-2012
POULTRY FEg � 12D1Z
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PLEASE COMPLETE ALL QUESTIONS � � `
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NAME l v�- J l�-L HOME TEL.NO. � Z �T
LOCATION ADDRESS �--I U) I� a- _
MAILING ADDRESS(IF DIFFERENT)
NUMBER OF FOWL � NUMBER OF PENS/COOPS J NUMBER OF ROOSTERS
PLEASE NOTE: PLEASE DO NOT INCREASE THE NUMBER OF FOWL
WITHOUT PRIOR PERMISSION OF THE HEALTH DEPARTMENT.
TYPE OF SHELTER G,�o J�_ SIZE OF YARD/PEN AREA � � �
(WOOD,CONCRETE,ETC.)
NUMBER OF WATER OUTLETS ,� WATER TROUGHS �
TYPE OF STORAGE FACILITY USED FOR FEED/GRAIN _�'y...2.p,p e A9�.� l h � �.-Q �/�-
/ � i 5
TYPE OF FACILITY USED FOR MANURE STORAGE�f'���
METHOD OF DISPOSAL OF MANURE (�.� �'Jo,S� l� !.Q d Ir �U i�Ir� HOW OFTEN � lti.��. ��C
.� .S N�/1� 4�f'--�-.. - �`-.. C�. L„ c'� c � � (�t l L.
PEN AREA ENCLOSED BY WHAT TYPE OF FENCING? �W c� �y,
�RENEWAL
NEW APPLICATION- IF NEW APPLICATION, PLEASE ATTACH A COPY OF PLOT PLAN SHOWING I.OT
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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. �_ __
�"- -'Tawn of Yarmouth taxes and liens must be paid prior to renewal ar issuance of your permits.
Please check appropriately if paid: Yes_�� No �
SIGNATU DATE
THE FULL POULTRY COUNT IS NOT TO EXCEED THE AMOUNT OF PRIOR YEAR'S TOTAL.
FEES: �POULTRY: 1-9 chickens $30.00
10 or more Chickens 540.00
ROOSTER (NOTE: SPECIAL APPROVAL REQUIRED FOR ROOSTERS)
NO ROOSTER
TOTAL DUE:� �•�O ���� I
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