HomeMy WebLinkAboutApplication � �"�-6►� Bo�4 P— � �-3�`�� :a�
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°� r TOWN OF YARMOUTH y
� Board of
Health
1146 ROUTE 28, SOUTH YARMOUTH,MASSACHUSETTS 02664-24 51 REC�I�ED
`+�� Telephone(508)398-2231,ext. 1241
Fax(508)760-3472 APR '�v���17
HEALTH D PT.
APPLICATION FOR OPERATION-2017
POULTRY /..� 'y,��
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PLEASE COMPLETE ALL QUESTIONS E-MAIL���N�'lv_�I_A-F4�1� • �WI
NAME SI� �OS�I' HOME TEL.NO. ,, ���(�S�'�I�I 1
LOCATION ADDRESS I�.
MAILING ADDRESS(IF DIFFERENT)
NUMBER OF FOWL �A 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 W O O� SIZE OF YARD/PEN AREA � ��`' �
(WOOD,CONCRETE,ETC.)
NUMBER OF WATER OUTLETS WATER TROUGHS (
TYPE OF STORAGE FACILITY USED FOR FEED/GRAIN �1'✓1 l�t�. r�
TYPE OF FACILITY USED FOR MANURE STORAGE Cj(�YYI �OST �Ilt�
METHOD OF DISPOSAL OF MANURE�►�YI OnST/NCs HOW OFTEN �q'1 L.a�
PEN AREA ENCLOSED BY WHAT TYPE OF FENCING?_�1�� A�/�A�Q („�(�I ,�
RENEWAL
�NEW APPLICATION- IF NEW APPLICATION,PLEASE ATTACH A COPY OF PLOT PLAN SHOWING LOT
LINES AND LOGATION 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 perrnits.
Please check appropriately if paid: Yes No
SIGNATURE DATE
THE FULL P UNT IS NOT TO EXCEED THE AMOUNT OF PRIOR YEAR'S TOTAL.
FEES: l� POLJLTRY: 1-9 chickens 30;00
10 or more Chickens
ROOSTER {NOTE: SPECIAL APPROVAL REQUIRED FOR ROOSTERS)
�NO ROOSTER
TOTAL DUE:$ 30„OC7
12l12/16