HomeMy WebLinkAboutApplication r 1 i1—0{0o4.4P--(5-( 20—0'1
TOWN OF YARMOUTH
, �` Board of
Health
B,U 1146 ROUTE 28, SOUTH YARMOUTH, MASSACHUSETTS 02664-24451 Health
.„ ;' Telephone(508) 398-2231, ext. 1241 ►
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Fax(508) 760-3472 �� 1";,
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APPLICATION FOR OPERATION -2Q19
POULTRY 1-4W-Th IRPi3TDijoieo _
PLEASE COMPLETE ALL QUESTIONS " "
E-MAIL '119A-1,43--6A �19.A1. 4-744-
NAME �/L�5 HOME TEL.NO. OL.2 FC2-,7
LOCATION ADDRESS 0240. l./�� �,,,k,.�� — a 5--
MAILING ADDRESS(IF DIFFERENT)
NUMBER OF FOWL' NUMBER OF PENS/COOPS ` NUMBER OF ROOSTERS
PLEASE NOTE: PLEASE DO NOT INCREASE THE NUMBER OF FOWL
WITHOUT PRIOR PERMISSION OF THE HEALTH DEPARTMENT.
TYPE OF SHELTER (.014,.3e71:::,(5-- SIZE OF YARD/PEN AREA 1.�
(WOOD,CONCRETE,ETC.)
NUMBER OF WATER OUTLETS WATER TROUGHS \
TYPE OF STORAGE FACILITY USED FOR FEED/GRAIN .A �
TYPE OF FACILITY USED FOR MANURE STORAGE CYyww$ y�
METHOD OF DISPOSAL OF MANURF (AA. HOW OFTEN
PEN AREA ENCLOSED BY WHAT TYPE OF FENCING? C V►.c.��.R.:� GSA -(Z�
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.
TownofYarmouth taxes and liens must be paid prior to renewal or issuance of your permits.
Please check appropriately if paid: Yes No
SIGNATU DATE D. // 40/ 't.
THE FULL POULRY COUNT IS NOT TO EXCEED THE AMOUNT OF PRIOR YEAR'S TOTAL.
FEES: POULTRY: 1-9 chickens 110
10 or more Chickens '.40.01
`.7 ROOSTER (NOTE: SPECIAL APPROVAL REQUIRED FOR ROOSTERS)
NO ROOSTER
TOTAL DUE: $ L 00
11/07/18