HomeMy WebLinkAboutApplication �,., �V' 1`/' V V 1 � i J�� ��f` ��
� °� TOWN OF ARMOUTH Boardof
� H�alth
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= 1146 ROUTE 28, SOUTH YARMOUTH,MASSACHLJSETTS 02664-24451
Health !
�d Telephone(508)398-2231,ext. 1241 n;v;ci�n i
Fax(508)760-3472 �,` �� ' I
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APPLICATION FOR OPERATION—2015 � �� �
POULTRY ����a-,, �.—,—,_�. ;
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PLEASE COMPLETE ALL QUESTIONS �
E-MAIL '
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NAME � 1 �: I� N L�IJr.�� ��TEL.NO. �d `�S�`�-�I� �
LOCATION ADDRESS � ` � � �' ��
MAILING ADIIRESS(IF DIFFERENT) C � �'
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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. r� �� '
TYPE OF SHELTER 7 �'c,o SIZE OF YARD/PEN AREA �
(WOOD,CON TE,E�•) S �
NUMBER OF WATER OUTLETS WATER TROUGH
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TYPE OF STORAGE FACILITY USED FOR FEED/GRAIN w
TYPE OF FACILITY USED FOR MANURE STORAGE ��-�s1'� C%`s/�' �"'�
METHOD OF DISPOSAL OF MANURE HOW OFTEN G���irw�.P
PEN AREA ENCLOSED BY WHAT TYPE OF FENCING? '�`�` �G C.,�'CC�2_ �" -N^ ''��
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 taaces and liens must be paid prior to r al or issuance of your permits.
Please check appropriately if paid: Yes No
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SIGNA DATE
� THE FULL NT IS NOT TO EXCEED THE AMOUNT OF PRIOR YEAR'S TOTAL.
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FEES: ✓ POULTRY: 1-9 chickens 30:0
10 or more Chickens
; ROOSTER (NOTE:SPECIAL APPROVAL REQUIRED FOR ROOSTERS)
� �NO ROOSTER
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TOTAL DUE:$ 30•op
i l/03/14
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The Commonwealth of�.Vlassachusetts Fee ;
Town of Yarmouth s3o.00 ;
Poultry License
Number: BOHP-15-1208 Issue Date: 03/03/2015
Mailing Address: Location Address: ;
JOHN DIGI 69 SHELBURNE RD ,
PAR.ADISE STABLES WEST YARMOUTH.MA 02673
69 SHELBURNE ROAD
WEST YARMOUTH,MA 02673
IS HEREBY GRANTED A 2015 LICENSE
This license is granted in conformity with the statutes and ordinances relating thereto,
and ezpires December 31, 2015 unless sooner suspended or revoked and is not
transferable.
Conditions
Allowed to have a total up to 9 chickens at above address.
PLEASE POST LICENSE ON PREMISES.
BOarC� Tanya Daigneault,Chairman
Hillard Boskey,M.D.,Vice Chairman
Of Mary Craig,Clerk
Evelyn P.Hayes
Health Charles T.Holway
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Bruce G. Murp ,MPH, ., O/Amy L.von Hone,R.S.,CHO
Health Director/Assistant Health Director
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