HomeMy WebLinkAboutApplication ���—�a�z/6 a�P—c�-3���I
� °� r TOWN OF YARMOUTH Bo�dof �
� � Health
= 1146 ROUTE 28, SOUTH YARMOUTH,MASSACH[JSETTS 02 t 4-24451 Health
""�° Telephone(508)398-2231,ext. 1241 �'�
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F�(508) 760-3472 � JAN 3 C 2��`��
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APPLICATION FOR OPERATION— 2017 , �� �'� � �`' ��
POULTRY ���-'� �` % '
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PLEASE COMPLETE ALL QUESTIONS
^ Z`�,�� E—MAIL
NAME f� � �1 (,�' (.� 2�C Vt� I i HOME TEL.NO. �jJ �"" c3 3`—'(9 r��
LOCATION ADDRESS D v Ir�`q� (�G� ���,'�' , �
MAILING ADDRESS(IF DIFFERENT) ,��p� �
NUMBER OF FOWL NUMBER OF PENS/COOPS I NUMBER OF ROOSTERS 0
PLEASE NOTE: PLEASE DO NOT INCREASE THE NUMBER OF FOWL
WITHOUT PRIOR PERMISSION OF THE HEALTH DEPARTMENT. '
TYPE OF SHELTER s � I�"f'Q ( � ��o� SIZE OF YARD/PEN AREA�a►`'�� �4� tt'��
(WOOD,CONCRETE,ETC.)
NUMBER OF WATER OUTLETS C� WATER TROUGHS l ,
TYPE OF STORAGE FACILITY USED FOR FEED/GRAIN ?`��,-"�'Gl,� C G, Y1 '
TYPE OF FACILITY USED FOR MANURE STORAGE W � �'�' M d d e 'f` C 1�2 a.y� ��22k(_�
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METHOD OF DISPOSAL OF MANURE � GL wI Q,c� rp � t�►M.('� HOW OFTEN l��2�{L��' i
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PEN AREA ENCLOSED BY WHAT TYPE OF FENCING?�1�'�a., t 1A' ( (Z,� i
G� RENEWAL �
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. '
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Town of Yarmouth taxes and liens must be paid prior to renewal or issuance of your permits.
Please check appropriately if paid: Yes No '.
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SIGNATURE DATE 1 a 3 ' I � �
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THE FULL POULTRY COUNT IS NOT TO EXCEED THE AMOUNT OF PRIOR YEAR'S TOTAL. ;
FEES: �POLTLTRY -9 chick �30.00
or more hickens 40.00
ROOSTER (NOTE: SPECIAL APPROVAL REQUIRED FOR ROOSTERS)
NO ROOSTER
TOTAL DUE:$ c3p,O�
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12/12/16
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