HomeMy WebLinkAboutApplication 076-610 66#P-lS— 12.63-65
° ..... TOWN O YARMOUTH Board of
r Health
.4'Y 1146 ROUTE 28, SOUTH YARMOUTH, MASSACHUSETTS _ ----
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Telephone(508)398-2231,ext. 1241
Fax(508)760-3472 = �'v` Hea th
JAN 2 3 2020
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APPLICATION FOR OPERATION-2020 H EA LTH DEPT.
POULTRY4 ' ' '-
4 .
PLEASE COMPLETE ALL QUESTIONS ;� `�` a
E-MAIL HEYSANDY@CAMPWK.COM
NAME CAMP WINGATE KIRKLAND HOME TEL.NO. 508-362-3798
LOCATION ADDRESS 20 LINNELL LANE YARMOUTH PORT, MA 02675
MAILING ADDRESS(IF DIFFERENT) 79 WHITE ROCK ROAD YARMOUTH PORT, MA 02675
NUMBER OF FOWL 14 NUMBER OF PENS/COOPS 1 NUMBER OF ROOSTERS 0
PLEASE NOTE: PLEASE DO NOT INCREASE THE NUMBER OF FOWL
WITHOUT PRIOR PERMISSION OF THE HEALTH DEPARTMENT.
TYPE OF SHELTER WOOD SHED/KIDS PLAYHOUSE SIZE OF YARD/PEN AREA 20'X 20'
(WOOD,CONCRETE,ETC.)
NUMBER OF WATER OUTLETS 1 WATER TROUGHS I
TYPE OF STORAGE FACILITY USED FOR FEED/GRAIN FEED STORED IN METAL TRASH CAN IN GARAGE
TYPE OF FACILITY USED FOR MANURE STORAGE
METHOD OF DISPOSAL OF MANURE COMPOST OR TRASH HOW OFTEN EVERY 2 WEEKS
PEN AREA ENCLOSED BY WHAT TYPE OF FENCING? WIRE SCREEN FENCING
X 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
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SIGNATURE \. '\ DATE JANUARY 9, 2020
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THE FULL PO Y COUNT IS NOT TO EXCEED THE AMOUNT OF PRIOR YEAR'S TOTAL.
FEES: POULTRY. hickens $ 10
0 or more Chickens iI,n.
ROOSTER (NOTE: SPECIAL APPROVAL REQUIRED FOR ROOSTERS)
NO ROOSTER
TOTAL DUE:$ ''D•UD
12/30/19
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