HomeMy WebLinkAboutApplication 11-01/60-01%-16-11-2-4 4
°� rte-., TOWN OF YARMOUTH
Board of
�, g': Health
F
MA=oh 1146 ROUTE 28, SOUTH YARMOUTH, MASSACHUSETTS 02664-;4
" Telephone(508)398-2231, ext. 1241 Gs'
Fax(508)760-3472 Fax
APR 01 2019
APPLICATION FOR OPERATION-2019
" ALD EST' c.
POULTRY alt -
PLEASE COMPLETE ALL QUESTIONS
E-MAIL '% /0-,()j 4(
NAME A/9R ig /4frirribt.1 HOME TEL.NO 362 VVO
LOCATION ADDRESS 21G vt� 2 v b ''e c,� L v` a cwt)d'tt f o✓i- /�c`
MAILING ADDRESS(IF DIFFERENT)
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.
TYPE OF SHELTER WOG OC SIZE OF YARD/PEN AREA / 0 x Z�
(WOOD,CONCRETE,ETC.)
NUMBER OF WATER OUTLETS 7, WATER TROUGHS k
TYPE OF STORAGE FACILITY USED FOR FEED/GRAIN 5 ( 'C L. &/l`l
TYPE OF FACILITY USED FOR MANURE STORAGE £ C .$( (L)
METHOD OF DISPOSAL OF MANURE I 0(2 h -k;)J/& P HOW OFTEN \11/4-)k
Ly
PEN AREA ENCLOSED BY WHAT TYPE OF FENCING? e.).—ai U C« S -e-e
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".‘, 6/ DATE 4.4..f,Q /
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
TOTAL DUE: $
11/07/18