HomeMy WebLinkAboutApplication g-�o -oo, e o 44p'- 17- -O3?
°r ` TOWN OF ARMOUTH Board of
:Health
4! 1146 ROUTE 28, SOUTH YARMOUTH,MASSACHUSETTS 026 �
Telephone(508)398-2231,ext. 1241 ��.'" ' 'e
Fax(508)760-3472 cop-` 1I•r n' T16(Lj
APPLICATION FOR OPERATION-2020 JAN 1 3 2020
POULTRY
HEALTH DEPT
PLEASE COMPLETE ALL QUESTIONS
E-MAIL
NAME L Q :"``Nz-c--
HOME TEL.NO. 51Di 5c/q- 5`6 -3
LOCATION ADDRESS i 551 $el-.)Lk,e.}- (Z q rgr,,,,,® /1-1(N. c-Z 6-7 -1
MAILING ADDRESS000% FEREN )
BER OF PENS/COOPSNUMBER OF ROOSTERS
NUMBER OF FO. b � I
PLEASE Nil TE: PLEAS • ) 0 NOT INCREASE THE NUMBER OF FOWL
WITHOUT ' '_ • RMISSION OF THE HEALTH DEPARTMENT.
TYPE OF SHELTER G4100 J SIZE OF YARD/PEN AREA /é .' /6
(WOOD,CONCRETE,ETC.)
NUMBER OF WATER OUTLETS / WATER TROUGHS /
TYPE OF STORAGE FACILITY USED FOR FEED/GRAIN 5>Lee l Cr*el S
TYPE OF FACILITY USED FOR MANURE STORAGE 6—,r' 1
METHOD OF DISPOSAL OF MANURE Ce'r'P° ' 'I HOW OFTEN .e r k ti
PEN AREA ENCLOSED BY WHAT TYPE OF FENCING? Ch 4-1 4' " f e
V RENEWAL
NEW APPLICATION- IF NEW APPLICATION,PLEASE ATTACH A COPY OF PLOT PLAN SHOWING LOT
LINES AND LOCATION OF STABLE, PEN, ETC.,AND ALL ENCLOSURES. ALSO,A
WRITTEN LETTER OR STATEMENT,SIGNED BY ALL ABUTTERS TO PROPERTY.
Town of Yarmouth taxes and liens must be paid prior to renewal or issuance of your permits.
Please check appropriately if paid: Yes v No
SIGNATURE
C�tc DATE / 6-0
THE FULL POULTRY COUNT IS NOT TO EXCEED THE AMOUNT OF PRIOR YEAR'S TOTAL.
FEES: `POULTRY -9 chicken t H
i or more is ens .41.11
ROOSTER (NOTE: SPECIAL APPROVAL REQUIRED FOR ROOSTERS)
NO ROOSTER
TOTAL DUE:$ 30.00
12/30/19