HomeMy WebLinkAboutApplication,
--�
G3���QM�D
� ��-U �7 �4�P�� S���2 �MAi� �`� 2p17
°� ` TOWN OF YARMO " °EPT f
� � xealth
= 1146 ROUTE 28,SOUTH YARMOUTH,MASSACHt7SETTS 0266424451 -
�� Telephone(508)398-2231,eatt. 1241 Healrh
nivicion
Fax(508)760-3472
APPLICATION FOR OPERATION-2017
POULTRY
PLEASE COMPLETE ALL QUESTIONS
E-MAILm�1J�, �YFQ(��p��1���
NAME `r�' L�� �J �� HOME TEL.NO.��.7��v � �
LOCATION ADDRESS i� � �V �V R����� ��YI�` ��7�
MAILING ADDRESS(IF DIFFERENT) '-�+�•' ��� � L R� - � � ��
NUMBER OF FOWL�� NUMBER OF PENS/COOFS ! NUMBER OF ROOSTERS J
PLEASE NOTE: PLEASE DO NOT INCREASE THE NUMBER UF FOWL
WITHOUT PRIOR PERMISSION OF THE HEALTH DEPARTMENT.
TYPE OF SHELTER�VQ / �6fvGQ�,` �s—�—�IZE OF YARD/PEN AREA l a��C 17f
� (WOOD,CONCRETE,ETC.)
NUMBER OF WATER OUTLETS I WATER TROUGHS ,
TYPE OF STORAGE FACILITY USED FOR FEEDlGRAIN�!UV'!/ 'F����tj �� C1Sm�
TYPE OF FACILITY USED FOR MANURE STORAGE ��Q��{
v
METHOD OF DISPOSAL OF MANURE ��'���Q� �� HOW OFTEN jSr'���iZ�'
PEN AREA ENCLOSED BY WHAT TYPE OF FENCING? I/���� � �,���
� 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 Yarmouth taxes and liens must be paid prior to renswal o;i�a �e of your pecmits.
Please check appropriately if paid: Yes Na �(/ �,l
SIGNATURE DATE
THE FULL POULTRY CUUNT I T TO EXCEED THE AMOUNT OF PRIOR YEAR'S TOTAL.
FEES: POULTRY: i-9 chickens g30.00
l0 or more Chickens $40.00
ROOSTER (NOTE:SPECIAL APPROVAL REQUIRED FOR ROOSTERS)
NO ROOSTER I
TOTAL DUE:S
12/12/16