HomeMy WebLinkAboutApplication -����a�b6�-P-1�-�3s� � I
� °� r� TOWN OF YARMOUTH Boardof
� .� Health
M�ITTACMEEBE 1146 ROUTE 28, SOUTH YARMOUTH,MASSACHUSETTS 02664-24451 -
� �°"'�°'O Telephone(508)398-2231, ext. 1241 Heaith ��:�
Fax(508) 760-3472 (� �,�;`;""
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� DEC 2 0 2016 �
APPLICATION FOR OPERATION-2017 �
� � POULTRY � � �
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PLEASE COMPLETE ALL QUESTIONS R., 4� �
, " E-MAIL � � ��� �
NAME HOME TEL.N '� �� (
LOCATION ADDRE ���
MAILING ADDRESS(IF DIFFERENT)
NUMBER OF FOWL l� NUMBER OF PENS/COOPS_�__ NUMBER OF ROOSTERS�--
PLEASE NOTE: PLEASE DO NOT INCREASE THE NUMBER OF FOWL
WITHOUT PRIOR PERMISSION OF THE HEALTH DEPARTMENT.
TYPE OF SHELTER SIZE OF YARD/PEN AREA
(WOOD,CONCRETE,ETC.)
NUMBER OF WATER OUTLETS WATER TROUGHS
TYPE OF STORAGE FACILITY USED FOR FEED/GRAIN
TYPE OF FACILITY USED FOR MANURE STORAGE
METHOD OF DISPOSAL OF MANURE HOW OFTEN ' V
PEN AREA ENCLOSED BY WHAT TYPE OF FENCING?
RENE WAL
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.
Town of Yarmouth taxes and liens must be paid prior to renewal or issuance of your permits.
Please check appropriately if paid: Yes No
SIGNATURE DATE
THE FULL POULTRY COUNT IS NOT TO EXCEED THE AMOUNT OF PRIOR YEAR'S TOTAL.
FEES: J� POULTRY: 1- $30.00
0 or more Chic ce $40.00
ROOSTER (NOTE: SPECIAL APPROVAL REQUIRED FOR ROOSTERS)
�NO ROOSTER
TOTAL DUE: $ �O,bd
12/12/16