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1146 ROLJ1'E 28,SOUTH YARMOUTH,MASSACHUSETTS 02664-24451 H�
Telepha�e(508)398-2231,ext, 1241 ����
Fax(508)76(}-3472 ;--�,�,,,_ _.._
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APPLICATION FOR OPERATIUN-2011 �E� 1 ,� �'�i� ,�
PODLTRY -.t � � �` � ���,
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PLEASE COMPLETE ALL QUESTIONS ' a "
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NAME �J Gf/J'� �� � , . HOME TEL.NO.��O� ��Y� '
LOCATTON ADDRESS U�� -P/L.J��G�
MAILING ADDRESS(ff DIFFEREN'1�
NLJMBER OF FOWL � NUMBER OF PENS/COOPS � NUMBER OF ROOSTERS � C
TYPE OF SHELTER W�O D SIZE OF YARD/PEN AREp 7��C� t
(WOOD,CONCRETE,ETC.)
NUMBER OF WATER OUTLETS � WATER TROUGHS Z
TYPE O�S1'ORAGE FACILITY USED FOR FEED/GRAIN_._�i� m�2! 4
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TYPE OF FACILTTY USED FOR MANURE STORAGE �
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METHOD OF DISPOSAL OF MANURE �D Gt�X. �U �� HOW OFTEN
PEN AREA ENCLOSED HY WHAT TYPE OF FENCING? G , (�tJ l /z-�-
'� RENEWAL
NEW APPLICATION- IF NEW APPLICATI(yN, PLEASE ATTACH A COPY OF PLOT PLAN SHOWINCr LOT
LINES AND LOCATION pF STABLE, pEM,ETC.,AND AI,I,ENCLOSURES. ALSO,A
WRIITEN LETTER OR STATEMENT,SIGNED BY ALL ABUTTERS TO PROPERTY.
Town of Yermouth taxes and liens must be paid prior to renewai or issuance of your permits.
Please chxk appropriately if paid Yes,� No
SIGNATiJI�E��/ �'l�- -
� DATE � �S^�-D ��S
THE F[TLL POiTLTRY COUNT I3 NOT TO EXCEED 1'�AlyOUNT OF PRIOB YEAR'3 TOTAL '
FE&4: � POULTRY: 1-9 chic.lcws 530.00
10 ar ma�e Chicicais 540.00
ROOSTER (NOTE:$P�CIAL A�'pROVAL REQ(IiREp FOR ROOSTERS)
TOTAL DIIE:S �U �
IQ/Z6/IO
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