HomeMy WebLinkAboutApplication -�aO 4 P-45-1 Z1$-D5
C TOWN OFYARMOUTHBoardof
� Health
}ice 1146 ROUTE 28, SOUTH YARMOUTH,MASSACHUSETTS 02664-24451 -
Telephone(508)398-2231,ext. 1241 Health
; :., Fax(508)760-3472 RECEIIiIVED
APPLICATION FOR OPERATION-2020 JAN 1 5 2020
POULTRY ti'HEALTH DEPT
PLEASE COMPLETE ALL QUESTIONS " `
/it ! "� $DLJ 3 E-MAIL cNAME -\ HOME TEL.NO. ''.*.o Ff 3`L'T 3 Sit'1
LOCATION ADDRESS l�Z 6t r'lCu.to _ Sp .`�A CJ L' 2-At- LZ L Z
MAILING ADDRESS(IF DIFFERENT)
NUMBER OF FOWL 1 D NUMBER OF PENS/COOPS l NUMBER OF ROOSTERS 0 -
PLEASE NOTE: PLEASE DO NOT INCREASE THE NUMBER OF FOWL
WITHOUT PRIOR PERMISSION OF THE HEALTH DEPARTMENT.
TYPE OF SHELTER 1� �G1)---A SIZE OF YARD/PEN AREA tl`t. A.tnd—
(WOOD,CONCRETE,ETC.)
NUMBER OF WATER OUTLETS ( WATER TROUGHS Z
TYPE OF STORAGE FACILITY USED FOR FEED/GRAIN ! -k b -S
TYPE OF FACILITY USED FOR MANURE STORAGE 0,0rIcr-, -r -- w„N A., DEQ
METHOD OF DISPOSAL OF MANURE HOW OFTEN
PEN AREA ENCLOSED BY WHAT TYPE OF FENCING? W S vim.
RENEWAL
NEW APPLICATION- IF NEW APPLICATION,PLEASE ATTACH A COPY OF PLOT PLAN SHOWING LOT
LINES AND LOCATION OF STABLE, PEN, ETC.,AND ALL ENCLOSURES. ALSO,A
WRITTEN LETTER OR STATEMENT,SIGNED BY ALL ABUTTERS TO PROPERTY.
Town of Yarmouth taxes and liens must be paid,prior to renewal or issuance of your permits.
Please check -appropriately if paid: Yes No
2
SIGNATURES , (
(`��.1�>(S� 7Rt�21.ZL>DATE � � Za 7�
THE FULL POULTRY COUNT IS NOT TO EXCEED THE AMOUNT OF PRIOR// YEAR'S TOTAL.
FEES: ' POULTRY 9 chickensOAO
( 10 or more Chickens
ROOSTER (NOTE: SPECIAL APPROVAL REQUIRED FOR ROOSTERS)
NO ROOSTER
TOTAL DUE:$ 11&OC�
12/30/19