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HomeMy WebLinkAboutApplication .,...r = TOWN OF YARMOUTH '-°`Btdoo3 TaPalth 1146 ROUTE 28, SOUTH YARMOUTH, MASSACHUSETTS 02664-24 '`.`�\` Health MATTACHEEBE Telephone(508)398-2231,ext. 1241 b Fax(508) 760-3472 JAN 3 ' 19'on HEALTH DEPT. APPLICATION FOR OPERATION - 2019 ~, POULTRY Com" at%„;\ tcom PLEASE COMPLETE ALL QUESTIONS E-MAIL NAME C- , ,�1� Tr0&-t S HOME TEL.NO. S0 -3q8-- ,3- 5 qI ES / LOCATION ADDRS /6 a Old a r v o1. Jjii/Lludtk p d�6 MAILING ADDRESS(IF DIFFERENT)I NUMBER OF FOWL. Z NUMBER OF PENS/COOPS _ / _ NUMBER OF ROOSTERS 6 PLEASE NOTE: PLEASE DO NOT INCREASE THE NUMBER OF FOWL WITHOUT PRIOR PERMISSION OF THE HEALTH DEPARTMENT. TYPE OF SHELTER &)dog '1” (0017 01,c7C SIZE OF YARD/PEN AREA (WOOD,CONCRETE,ETC.) NUMBER OF WATER OUTLETS WATER TROUGHS TYPE OF STORAGE FACILITY USED FOR FEED/GRAIN MAL b tivl.�5 TYPE OF FACILITY USED FOR MANURE STORAGE METHOD OF DISPOSAL OF MANURE L )TLf t // f I ..c__ ✓ HOW OFTEN t1-8 f -�-- PEN AREA ENCLOSED BY WHAT TYPE OF FENCING? I a k i tJ i V NI 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 � • Iwc�3 DATE I i81 cI THE FULL POULTRY COUNT IS NOT TO EXCEED THE AMOUNT OF PRIOR YEAR'S TOTAL. FEES: /POULTRY: 1-9 chickens $ .00 10 or more Chickens ROOSTER (NOTE: SPECIAL APPROVAL REQUIRED FOR ROOSTERS) NO ROOSTER TOTAL DUE:$ 410,O O 0 O Ste /4 Ye R ✓� .24(8 •26 -L 11/07/18 # 80•0O /F yd) ►00 SAWAVE Poll t-- ey Re066 cords YJJO LA)•