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HomeMy WebLinkAboutApplication �D (3/5a0--h-3 10-03 °� TOWN OF YARMOUTH Board of ari �'� Health � �'�� 1146 ROUTE 28, SOUTH YARMOUTH,MASSACHUSETTS 02664-24451 Telephone(508)398-2231,ext. 1241 __ Health Fax(508) 760-3472 ' ' n vision FE3 I8 ?0?n APPLICATION FOR OPERATION,-„2 I I POULTRY HEALTI DEPT PLEASE COMPLETE ALL QUESTIONS '`� .%r °' E-MAIL S jds0) 11AL(.1/.COOL" NAME e. /G( 1 r&' Se HOME TEL.NO.SU g'(O l 7,j Q g' LOCATION ADDRESS IS N. r'1a 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 60C©/L SIZE OF YARD/PEN AREA 1.X 1 C L, (WOOD,CONCRETE,ETC.) NUMBER OF WATER OUTLETS l WATER TROUGHS I TYPE OF STORAGE FACILITY USED FOR FEED/GRAIN shed TYPE OF FACILITY USED FOR MANURE STORAGE Gam. -ej e ft) METHOD OF DISPOSAL OF MANURE ✓ it) HOW OFTEN Da.1 I y PEN AREA ENCLOSED BY WHAT TYPE OF FENCING? me.?/ a) AO Cy 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 or to renewal or issuance of your permits. Please check appropriately if paid: Yes V No SIGNATURE (1A,OLL., /b1_41. DATE O2 ` / - 8 THE FULL POULTRY COUNT IS NOT TO EXCEED THE AMOUNT OF PRIOR YEAR'S TOTAL. FEES: POULTRY: 1-9 chickens $30.00 0 or more Chickens $40.00 ROOSTER (NOTE: SPECIAL APPROVAL REQUIRED FOR ROOSTERS) V NO ROOSTER TOTAL DUE:$ j 0 10 12/30/19