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°� ` TOWN OF YARMOUT '���� ���14 ��
� � HEALTH DEPT.
wr�EEa� 1146 ROUTE 28, SOUTH YARMOUTH,MASSACHLJSETTS 02664- e��
"�� Telephone(508)398-2231, ext. 1241 a-d��
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Fax(508) 760,3472 ��. ,� �(Q �q
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APPLICATION FOR OPERATION-2014
POULTRY P�ST ��G , '
PLEASE COMPLETE ALL QUESTIONS '
E-��ar�pec�.o-��V e���Y:N�
NAME \ �1'J'�/�' �,lc'_-C`�D`-tJ HOME TEL.NO.7��{``�9'Y'�
LOCATION ADDRESS I� P�N N/�� �,N` � �A�7t�C�iJz'T , � `�r a'�6�-�
MAILING ADDRESS(IF DIFFERENT) S�ME
NUMBER OF FOWL �' NUMBER OF PENS/COOPS � NUMBER OF ROOSTERS ��PP� t
- - - - - - -- _ __---— _ _ _. ______ _ __ _-- - -- ----- ____ _ _ _ �
PLEASE NOTE: PLEASE DO NOT INCREASE THE NUMBER OF FOWL
WITHOUT PRIOR PERMISSION OF THE HEALTH DEPARTMENT.
TYPE OF SHELTER �O'G1D SIZE OF YARD/PEN AREA �� �g'• � �
(WOOD,CONCRETE,ETC.)
NUMBER OF WATER OUTLETS �� WATER TROUGHS / ��
TYPE OF STORAGE FACILITY USED FOR FEED/GRAIN Cy�o�a1� F�L N wI C'��'�'L- CO'N'Z4l i-+a-p-�S'
TYPE OF FACILITY USED FOR MANURE STORAGE 1,✓o,o��p �JLl•,1
METHOD OF DISPOSAL OF MANURE �o�Pa sT HOW OFTEN �•-+�G([�L`�`
PEN AREA EN SED BY WHAT TYPE OF FENCING? l.✓ L�-
RENEWAL
NEW APPLICATION- IF NEW APPLICATION, PLEASE ATTACH A COPY OF PLOT PLAN SHOWING LOT
LINES AND LO ATION OF STABLE, PEN, ETC.,AND ALL ENCLOSURES. ALSO,A
WRITTEN LE TER OR STATEMENT,SIGNED BY ALL ABUTTERS TO PROPERTY.
Town of Yannouth taaces and liens must be paid rior to renewal or issuance of your permits.
__ Piease eheel�a�spro ' ' aiu:-----�'es- _ AIc�-. _ __ _ _ - _ __ ____ ------ - — -_ _ -- _
SIGNATURE Dp� � 1 � 1 7� ��'
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THE FULL POULTRY COUNT IS NOT TO EXCEED THE AMOUNT OF PRIOR YEAR'S TOTAL.
FEES: POULTRY: 1-9 chickens
10 or more Chickens 40.0
R OSTER (NOTE: SPECIAL APPROVAL REQUIRED FOR ROOSTERS)
O ROOSTER '_' P'Ro'�"�rS� ( NC%��' �o�'N
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TOTAL DUE: $ �G���U
i 10/08/13