HomeMy WebLinkAboutApplication lq—oog/ ooP-is-IZo3-act
.r - TOWN OF YARMOUTH
Board of
' . + Health
l _' 1146 ROUTE 28, SOUTH YARMOUTH, MASSACHUSETTS 02664-24451
Health
Telephone(508)398-2231,ext. 1241 RIE@E�V�®
"" Fax(508) 760-3472
JAN 182019
APPLICATION FOR OPERATION - 2019
POULTRY HEALTH DEPT.
PLEASE COMPLETE ALL QUESTIONS
E-MAIL HEYSANDY@CAMPWK.COM
NAME SANDY RUBENSTEIN HOME TEL.NO.
LOCATION ADDRESS CAMP WINGATE*KIRKLAND
MAILING ADDRESS(IF DIFFERENT) 79 WHITE ROCK ROAD YARMOUTH PORT, MA 02675
NUMBER OF FOWL 16 NUMBER OF PENS/COOPS 1 NUMBER OF ROOSTERS
PLEASE NOTE: PLEASE DO NOT INCREASE THE NUMBER OF FOWL
WITHOUT PRIOR PERMISSION OF THE HEALTH DEPARTMENT.
TYPE OF SHELTER WOOD SHED SIZE OF YARD/PEN AREA 20'X 20'
(WOOD,CONCRETE,ETC.)
NUMBER OF WATER OUTLETS 0 WATER TROUGHS 1
TYPE OF STORAGE FACILITY USED FOR FEED/GRAIN METAL AND PLASTIC CONTAINER IN GARAGE
TYPE OF FACILITY USED FOR MANURE STORAGE RUBBER COMPOSTER
METHOD OF DISPOSAL OF MANURE COMPOST OR RUBBISH HOW OFTEN WEEKLY
PEN AREA ENCLOSED BY WHAT TYPE OF FENCING? 1/2 X 48 INCH HARDWARE CLOTH
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 taxes and liens must be paid prior to renewal or issuance of your permits.
Please check appropriately if paid: Yes No
SIGNATURE \ �� DATE 1/18/2019
THE FULL POULlik&VCOUNT IS NOT TO EXCEED THE AMOUNT OF PRIOR YEAR'S TOTAL.
FEES: POULTRY: 1-9 chickens '. 1 1 1
10 or more Chickens '.40.0
1 ROOSTER (NOTE: SPECIAL APPROVAL REQUIRED FOR ROOSTERS)
NO ROOSTER
TOTAL DUE: S V0, 00
11/07/18