HomeMy WebLinkAboutApplication �I�' b�5 ���-P��5- I 22�t--�Z
� � TOWN OF YARMOUTH Boardof
� � - Health
= 1146 ROUTE 28, SOUTH YARMOUTH,MASSACHUSETTS 0266 - 451
�a Telephone(508)398-2231, ext. 1241 RECEI , „ I
Fax(508) 760-3472 �
MAR �0 2017 �
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APPLICATION FOR OPERATION - '�� ,H DEPT.
POULTRY �-�%` - �
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PLEASE COMPLETE ALL QUESTIONS n �,{
E-MAILj�'J�l /�N/��J v PC�'� �V��ir"\�
NAME ` �/�'t�J/`�� � HOME TEL.NO. �b U 3�i Z 7 �
LOCATION ADDRESS 2� ! `i��n � ��O �' � �
MAILING ADDRESS(IF DIFFERENT)
NUMBER OF FOWL 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 P/h-�L� �-�`�� ��d� SIZE OF YARD/PEN AREA T� ,X Z C�
(WOOD,CONCRE E,ETC.)
NUMBER OF WATER OUTLETS WATER TROUGHS � �
TYPE OF STORAGE FACILITY USED FOR FEED/GRAIN � �' �� � � �-' � '-`-�� �� E
TYPE OF FACILITY USED FOR MANURE STORAGE T�V�' �l f/�� �
METHOD OF DISPOSAL OF MANURE
< < � � HOW OFTEN i
PEN AREA ENCLOSED BY WHAT TYPE OF FENCING? S�'`�-��.- f
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� `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 ,
DATE � ` � � ' �
SIGNATU �
I
THE FULL POULTRY C NT IS NOT TO EXCEED THE AMOUNT OF PRIOR YEAR'S TOTAL.
FEES: � POULTRY: 10 orhmore Chickens $40.00
ROOSTER (NOTE: SPECIAL APPROVAL REQUIRED FOR ROOSTERS)
NO ROOSTER
TOTAL DUE:$ �
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{ 12/12/16
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