HomeMy WebLinkAboutApplications � � ,�l�--b�� �o��-�� c� - 1o}(� l �(��.
� � r - TOWN OF YARMOUTH l�Bo�dof ��"'�
'� � Health
w �E = 1146 ROUTE 28, SOUTH YARMOUTH, MASSACHUSETTS 02664-24451 -
'°°�°' Telephone(508)398-2231, ext. 1241 Health
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FaY(508) 760-3472 , , Q�;[��`ui�D
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� APPLICATION FOR OPERATION-2016 ����'''` � � ���b
POULTRY HEqLTH Q�PT.
PLEASE COMPLETE ALL QUESTIONS
E-MAIL �'2p�b�C7� IO2�� G�/�f�l,t"d�
NAME £`�j�� G'�,n r►D�`S HOME TEL.NO. � c.y,� �' 77[�- 713�
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LOCATION ADDRESS ��a Cc�r>li ��' ,�y�_�,�� •4 /'���i
MAILING ADDRESS(IF DIFFERENT)T���� � p �
NUMBER OF FOWL o NUMBER OF PENS/COOPS l NUMBER OF ROOSTER�.-�--�
PLEASE NOTE: PLEASE DO NOT INCREASE THE NUMBER OF FOWL
WITHOUT PRIOR PERMISSION OF THE HEALTH DEPARTMENT.
TYPE OF SHELTER��� QC SIZE OF YARD/PEN AREA�� G� .��
(WOOD,CONCRETE,ETC.)
G ����
NUMBER OF WATER OUTLETS � � C �,/- � ��►p/r�WATER TROUGHS
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TYPE OF STORAGE FACILITY USED FOR FEED/GRAIN_ �.���i-�
TYPE OF FACILITY USED FOR MANURE STORAGE�,�� ��_
Y
METHOD OF DISPOSAL OF MANURE ��yc�P�' � HOW OFTEN (I m� G��
PEN AREA ENCLOSED BY WHAT TYPE OF FENCING?_�,����,, --���%��
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.
Town of Yannouth 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: �i POULTRY: 1-9 chickens $30.00—
10 or mare Chickens $40.00
� ROOSTER (NOTE: SPECIAL APPROVAL REQUIRED FOR ROOSTERS)
sr NO ROOSTER N`'
TOTAL DUE: $ ��' � //� � /
10/14/15 �� _ �v ��� ����L���D
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c�� �,r � ��.s
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°� ` TOWN OF YARMOU I-�� ��p� �
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IA�TfACNEESE 1146 ROUTE 28, SOUTH YARMOUTH,MASSACHLJSETTS 0266 244s�AN� U 4�C�
�,, Health
Telephone(508)398-2231,ea�t. 1241 �;�����������.�n �
Faac(508) 760-3472
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._ , �,� �;..
APPLICATION FOR OPERATION - 2017
POULTRY
PLEASE COMPLETE ALL QUESTIONS �}-o��� 16a� �., ' ,C�
E-MAIL q
NAME � HOME TEL.NO. ��� ��]7 g �7 I�!3
LOCATION ADDRESS �p� C I� �A�' �� U l�U� , j�� ��`Z��.�
MAILING ADDRESS(IF DIFFERENT) �� �,� ��� �j �Lf Q:,('�(�(�'h
NUMBER OF FOWL - NUMBER OF PENS/COOPS I NUMBER OF ROOSTERS �
PLEASE NOTE: PLEASE DO NOT INCREASE THE NUMBER OF FOWL
WITHOUT PRIOR PERMISSION OF THE HEALTH DEPARTMENT.
TYPE OF SHELTER_ �.XjO� SIZE OF YARD/PEN AREA �� �( '�
(WOOD,CONCRETE,ETC.)
NUMBER OF WATER OUTLETS � WATER TROUGHS I
TYPE OF STORAGE FACILITY USED FOR FEED/GRAIN �`�("�� ��� �U�' r
TYPE OF FACILITY USED FOR MANURE STORAGE c�rdet�
METHOD OF DISPOSAL OF MANURE��(�r��� HOW OFTEN Cla� � � �
i--
PEN AREA ENCLOSED BY WHAT TYPE OF FENCING? �_A�� re, ��(�) 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.
Town of Yannouth taa�es and liens must be paid p ' to renewal or issuance of your permits.
Please check appropriately if paid: Yes�No
� �
SIGNATURE DATE ( � l �
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 $40.00
ROOSTER (NOTE: SPECIAL APPROVAL REQUIRED FOR ROOSTERS)
�/ NO ROOSTER
TOTAL DUE: $ �� � �
12/12/16