HomeMy WebLinkAboutApplication �17-020 BO(�P�-!�-�l�.0
°� r TOWN OF YA MOUTH Bo�dof
� � Health
= 1146 ROUTE 28, SOUTH YARMOUTH, MASSACHUSETTS 02664 -
�� Telephone(508)398-2231, ext. 1241 ����
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Fax(508)760-3472 A�� .� "� ����
APPLICATION FOR OPERATION-2016 ����:
POULTRY
PLEASE COMPLETE ALL QUESTIONS
E-MAIL ����.aSh t�y�_�m�U!.�
NAME ��4����(�/ Sfi'a h�i 1 HOME TEL.NO. 17� "9�`1 -86 2�}
LOCATIONADDRESS �,3 vvinficr S�-_ �Jarmv� p�Yjt, M� ��i� L�
MAILING ADDRESS(IF DIFFERENT) `
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NUMBER OF FOWL � NUMBER OF PENS/COOPS NUMBER OF ROOSTERS C�
PLEASE NOTE: PLEASE DO NOT INCREASE THE NUMBER OF FOWL "
WITHOUT PRIOR PERMISSION OF THE HEALTH DEPARTMENT.
TYPE OF SHELTER W�� SIZE OF YARD/PEN AREA 13 x C>i
(WOOD,CONCRETE,ETC.)
NUMBER OF WATER OUTLETS I WATER TROUGHS Z
TYPE OF STORAGE FACILITY USED FOR FEED/GRAIN qalva�.rzed �GtY1�aG1 e Ca r1
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TYPE OF FACILITY USED FOR MANURE STORAGE ���1e
METHOD OF DISPOSAL OF MANURE ?�1IC (� L✓�� �I�r� HOW OFTEN `7 x f��-
PEN AREA ENCLOSED BY WHAT TYPE OF FENCING? WvO�I '�y'UWtc� f(IV�,C�dI -Fe�VI G!(�'t 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.
--- Towr�-of Yasmouth taxes and liens must be paid prior to renewaLar issnance o£your permits. __ _
Please check appropriately if paid: Yes� No
SIGNATURE Vl7 ' Y ��� � DATE 'T� � 1� ��
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 , �� ,/`
. _. __ ..__._._._...�,__.�.._..�
C� ,d9�
TOTAL DUE: $ 4'D -�0
10/14/15