Loading...
HomeMy WebLinkAboutApplication 4 ) j .Q (3//OUP Ko-g35l -6s ..,..r TOWN OF YARMOUTH Board of 41 I 11 11444 Health I 1146 ROUTE 28, SOUTH YARMOUTH, MASSACHUSETTS 02664-24451 �E Telephone(508)398-2231, ext. 1241 Health Fax(508) 760-3472 Division APPLICATION FOR OPERATION -2019 POULTRY ` ; gei © J�. PLEASE COMPLETE ALL QUESTIONS ^(' ._ `'" E-MAIL1 U'(,�llf LhL Gd �ciL4 NAME rut Margot Churchill HOME TEL.N -,3�y- 5 l3 243 Pleasant St. LOCATION ADD South Yarmouth,MA 02664 MAILING ADD ,�.� ... .., NUMBER OF FOWL Id NUMBER OF PENS/COOPS J NUMBER OF ROOSTERS PLEASE NOTE: PLEASE DO NOT INCREASE THE NUMBER OF FOWL WITHOUT PRIOR PERMISSION OF THE HEALTH DEPARTMENT. TYPE OF SHELTER VU©001/1).)� re SIZE OF YARD/PEN AREA /0 X?_O OOD,CONCRETE,ETC.) NUMBER OF WATER OUTLETS l WATER TROUGHS TYPE OF STORAGE FACILITY USED FOR FEED/GRAIN9/Jag(2-- TYPE ZTYPE OF FACILITY USED FOR MANURE STORAGE '�' ) — U.f if e.._ METHOD OF DISPOSAL OF MANURE ((c i Q�s ��"'( HOW OFTEN PEN AREA ENCLOSED BY WHAT TYPE OF FENCING? U[ 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-Yartnoutn taxes and iieusmust tie-paid prior to-I euewal or issuaia.e ofyour-permits. Please check appropriately if paid: Yes No SIGNATURE 4 ) // DATE THE FULL POULTRY COUNT IS NOT TO EXCEED THE AMOUNT OF PRIOR YEAR'S TOTAL. FEES: POULTRY: 1-9 chickens e.:: 10 or more Chickens $40.00 ROOSTER (NOTE: SPECIAL APPROVAL REQUIRED FOR ROOSTERS) NO ROOSTER TOTAL DUE: $ 1110 HES rEMsD 11/07/18 JAN S V 2Q19 HEALTH DEPT.