HomeMy WebLinkAboutApplication � � ��o ��2
�. � r TO WN OF YARMOUTH Bo�-dof
� � Health
= 1146 ROUTE 28, SOiTTH YARMOUTH,MASSACHIJSETTS 02664-24451 -
'�a Telephone(508)398-2231,ext. 1241 Health
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Fax(508)760-3472 M �,��, '
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APPLICATION FOR OPERATION 20 �� �'�
po�r�..�� .- � � � � ��� DEC 1��,� 201U
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P�,EASE COIVIPLET�ALL CJUESTIC�NS . � �. � ... � � �
NAME Y/ /// 1�( � � � HOME TEL.NO_ S_�� 3�� y�y�
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LOCATION ADDRESS -�9 G!�JrQ"^-���-. �--" Y �lj�sr`�t,�i-�'_.�'Z�jg-���-- �
MAILING ADDRESS(IF DIFFERENT)
NUMBER OF FO�'VL � NUMBER OF PENSICOOPS � NUMBER OF ROOSTERS O �
TYPE OF SHELTER _�/�/O U � SIZE OF YARDr'PEN AREA S� X (o '
(WOOD;CONCRETE,ETC.} +
l�'UMBER OF WATER OUTLETS O ��ATER TROUGHS �-- �
TYPE OF STORAGE FACILITY USED FOR FEED!GRAIN �/�'�V�Nl Z � D S !� � L, 1��- �LS I
TYPE OF FACILITY USED FOR MANt)RE STORAGE �� � ` � � !
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METHOD OF DISPOSAL OF MANURE TU(.✓�u � U/VL f HOW OFTEN D� � L- 7 k
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PEN AREA ENCLOSED BY WHAT TYPE OF FENCING? G t"{l C�(� C� I� � (,e. �- i
RENE�VAL
�/ NEW APPLICATION- IF NEW APPLICATION, PLEASE ATTACH A COPY OF PLOT PLAN SHOWING L4T
LINES AND LOCATION OF STABLE, PEN, ETC.,AND ALL ENCLOSURES. ALSO, A
�VRITTEN LETTER OR STATEMENT,SIGNED BY ALL ABUTTERS TO PROPERTY.
Town of Yarmouth taxes and liens must be paid priar to renewal or issuance of your peimits.
Please check appropriately if paid: Yes v� No
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srv�r��` D�;�'E ��- /6 L,olb
THE FULL POULTRY COUNT IS NOT TO EXCEED THE AMOUNT OF PRIOR YEAR'S TOTAL.
FEES: � POIJLTRY: 1-9 chickens $30.00
10 or more Chickens $40.00
ROOSTER (NO�'E: SFE�IAL�PFROVAL REQiIIIZED F'OR RQfT�'�RS)
TOTAL DUE:$ �G
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