HomeMy WebLinkAboutApplication (00 e- --6 3 (
TOWN OF YARMOUTH
42 i_ Board of
E LT Health
="h 21 1146 ROUTE 28, SOUTH YARMOUTH, MASSACHUSETT, 02664-24451
IIA EEEE He i lth
Telephone(508)398-2231, ext. 1241 JAN J 2019
Fax(508) 760-3472 Divi inn
HEALTH DEPT.
APPLICATION
FORPOULORYRATION -2019 it
PLEASE COMPLETE ALL QUESTIONS
E-MAIL
NAME fJ LE/1447 C E7VS,5 L HOME TEL.NO. SO 6 3 - 6
LOCATION ADDRESS 8-75 11 45it/ t,0 t j %/11 Q 0114 i 4
7...3
MAILING ADDRESS(IF DIFFERENT) ,
NUMBER OF FOWL -3c9 NUMBER OF PENS/COOPS / NUMBER OF ROOSTERS 0
PLEASE NOTE: PLEASE DO NOT INCREASE THE NUMBER OF FOWL
WITHOUT PRIOR PERMISSION OF THE HEALTH DEPARTMENT.
1
TYPE OF SHELTER /4/4r9 r.® SIZE OF YARD/PEN AREA l 5( `5 r
(WOOD,CONCRETE,ETC.)
NUMBER OF WATER OUTLETS 1 WATER TROUGHS
TYPE OF STORAGE FACILITY USED FOR FEED/GRAIN C® VC7? O o''IL C4-/YS
TYPE OF FACILITY USED FOR MANURE STORAGE
METHOD OF DISPOSAL OF MANURE , ,47(,/ (f //U G#9-'/e 17 SIM OFTEN
PEN AREA ENCLOSED BY WHAT TYPE OF FENCING? ' I r c k J/9( e r (1/e-'T ( , ��r ftp cl
NE WAL
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 Dior to renewal or issuance of your permits.
Please check appropriately if paid: Yes V No
SIGNATURE //� f —go .. DATE /7/
THE FULL POULTRY COUNT IS NOT TO EXCEED THE AMOUNT OF PRIOR YEAR'S TOTAL.
FEES: ✓POULTRY: 1-9 chickens 3 .00
10 or more Chickens
ROOSTER (NOTE: SPECIAL APPROVAL REQUIRED FOR ROOSTERS)
V NO ROOSTER
TOTAL DUE: $ 110•0 O
QQ�1,ck4 f qo. 00 4e AiEl/E/2 e-GC VED a.oi 6 R.EUedA-L J
Ate, eize.
11/07/18 - .4))..v
9'8Q00 ct e.a
-a-r" Y00 NO LONGER- Po U X772 ' Pc. se" tor- us Yid cJ a -kc