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HomeMy WebLinkAboutApplication 41,9-00 yeate- is--tvg--oci TOWN OF YARMOUTH `;;1�► Board of Health %kg; 1146 ROUTE 28, SOUTH YARMOUTH, MASSACHUSETTS 02664-2445i02664-2445i ,__., ealt- ;_'` Telephone (508)398-2231, ext. 1241 i n Fax(508)760-3472 JAN 6 fr APPLICATION FOR OPERATION -2019 POULTRY m -'"C t l' PLEASE COMPLETE ALL QUESTIONS rE-MAIL` / SSS' C 144 E h,( NAME a-CtiV\--(CtKbaLu HOME TEL.NO. S O0 3 9 - O 75 / LOCATION ADDRESS 9J o-O �()Q 2/ MAILING ADDRESS(IF DIFFERENT) NUMBER OF FOWL3 NUMBER OF PENS/COOPS 1 NUMBER OF ROOSTERS C PLEASE NOTE: PLEASE DO NOT INCREASE THE NUMBER OF FOWL WITHOUT PRIOR PERMISSION OF THE HEALTH DEPARTMENT. TYPE OF SHELTER 1.),.\ 0 O SIZE OF YARD/PEN AREA q 6 0 s pC'e l--- (WOO ,CONCRETE,ETC.) NUMBER OF WATER OUTLETS C3 _ WATER TROUGHS TYPE OF STORAGE FACILITY USED FOR FEED/GRAIN cLL t 7c _ a-uNt3 TYPE OF FACILITY USED FOR MANURE STORAGE l METHOD OF DISPOSAL OF MANURE " o C HOW OFTEN et (o-"`'k PEN AREA ENCLOSED BY WHAT TYPE OF FENCING? _ji 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)(l No _. SIGNATURE DATE J— 0 7-- (.- _ol7 THE FULL POULT' COUNT IS NOT TO EXCEED T AMOUNT OF PRIOR YEAR'S TOTAL. FEES: './ POULI 'Y: 1-9 chickens 10 or more Chickens C 40.00 ROOSTER (NOTE: SPECIAL APPROVAL REQUIRED FOR ROOSTERS) NO ROOSTER TOTAL DUE: $ 60.00 11/07/18