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°' TOWN OF YARMOUTH���:'� � �f� �. �`�
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1146 ROUT'E 28,SOUTH YARMOIJ"TH,MASSACHtTSETTS 02664-2445T"" �'�`�'°�' �`a
* Telephone(508)398-2231,ext. 1241 Health
Fax(508)760-3472 1�iv;s;nn /
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APPLICATION FOR OPERATION--�9i�d Z v ' � '"''l�
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POULTRY ��
PLEASE COMPLETE ALL QUESTION� E� �.en�e I��y d�� (��/e � !�j
N� xoME�L.No. (0 I�7- 33S-6Z7 y
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LOCATTON ADDRESS �'{I �� t✓1
MAILING ADDRESS(IF DIFFERENT)
NUMBER OF FOWL ,�� NUMBER OF PENSlCOOPS NUMBER OF ROOSTER� �,
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 I,17�t-x��� ;.
(WOOD,CONCRETE,ETC.)
NUMBER OF�VATER OUTLETS C�� WATER TROUGHS �
TYPE OF STORAGE FACILITY USED FOR FEED/GRAIN '�A I J(ai�'1 I Z e�S�P��
TYPE OF FACILITY USED FOR bZANURE STORAGE
METHOD OF DISPOSAL OF MANURE���n(h HOW OFTEN (�.LfYI ,)YX16�
PEN AREA ENCLQSED BY WHAT TYPE OF FENCING? (a �I�..�@,I�L.-C�C�'►'l
�1•rEwEu.
_�NEW APPLICATION- IF NEW APPLICATTON,PLEASE ATTACFI 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 taxes and liens must be paid prior to renewal or isszzance of your permits.
Please check appmpriately if paid: Yes No
SIGNATURE DATE ��J���
THE FULL POUL RY COUNT IS NOT TO EXCEED THE AMOUNT OF PRIOR YEAR'S TOTAL.
FEES: �D POULTRY:�$rhir�
�lU or more Chickens
��y ROOSTER (NOTE:SPECIAL APPROVAL REQUIRED FOR ROOSTERS)
NO ROOSTER
TOTAL DUE:S
10/08/13