HomeMy WebLinkAboutApplication 4i -0o8/ oo-P-d5-(2 -o-
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TOWN OF YARMOUTH
Board of
Health
%OF: 1146 ROUTE 28, SOUTH YARMOUTH, MASSACHUSETTS 02664-24451 -
.' Telephone(508)398-2231, ext. 1241 Health __._. 1
Fax(508) 760-3472 tvimn J
APPLICATION FOR OPERATION -2019
POULTRY 1 H'r z'.`T
PLEASE COMPLETE ALL QUESTIONS
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NAME orAs--A. ,' oc�� NO„-W---,44... 7-107/49'
HOME TEL.N '"07/49
LOCATION AD RESS /g 1;4" g52Z-li? AJ /Y - ` o-i-t' 7 i (7)k 6t,4175.
MAILING ADDRESS(IF DIFFERENT) PI 1•/' t'-ov jpZ, /qe ei9r� /( I) d,
NUMBER OF FOWL iis NUMBER OF PENS/COOPS / NUMBER OF ROOSTERS
PLEASE NOTE: PLEASE DO NOT INCREASE THE NUMBER OF FOWL
WITHOUT PRIOR PERMISSION 9,' THE HEALTH DEPARTMENT. r
TYPE OF SHELTER 1i1 7) 6151/ 1 t te6EZ SIZE OF YARD/PEN AREA /g-/-74. /
(WOOD,CONCRETE,ETC.)
NUMBER OF WATER OUTLETS / WATER TROUGHS /
� t
TYPE OF STORAGE FACILITY USED FOR FEED/GRAIN T /111/5), - /-
TYPE OF FACILITY USED FOR MANURE STORAGE (-6(699 (
23 1 % C
METHOD OF DISPOSAL OF MANURE66? ` HOW OFTEN 1445X6-
PEN AREA ENCLOSED BY WHAT TYPE OF FENCING? h./6-36. 4'- 0,13
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 a
�,,,* T DATE (/go?
, a Or
THE FULL POULTRY COUNT IS TO EXCEE I TH 1. 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: $ Gt 4i Vb
11/07/18