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HomeMy WebLinkAboutApplication Zz -O ►S a ap . r---1 TOWN OF YARMOUTH Board of Health 1146 ROUTE 28, SOUTH YARMOUTH,MASSACHUSETTS 02664-24451 Telephone(508)398-2231,ext. 1241 Health i7rvi� Fax(508)760-3472 1 e APPLICATION FOR OPERATION-2020 POULTRY PLEASE COMPLETE ALL 1� J QUESTIONS �y� E-MAIL NAME fOctCr( r) C 5 k4 HOME TEL.NOS66 3 4,1-- lqe LOCATION ADDRESS .2 q C 7✓1ST l d ( n Q 0 2 477 MAILING ADDRESS(IF DIFFERENT) NUMBER OF FOWL W NUMBER OF PENS/COOPS NUMBp.OF ROOSTERS C PLEASE NOTE: PLEASE DO NOT INCREASE THE NUMBER OF FOWL WITHOUT PRIOR PERMIS ION OF THE HEALTH DEPARTMENT. TYPE OF SHELTER Via © SIZE OF YARD/PEN AREA S t (WOOD,CONCRETE,ETC.) NUMBER OF WATER OUTLETS WATER TROUGHS TYPE OF STORAGE FACILITY USED FOR FEED/GRAIN ir � TYPE OF FACILITY USED FOR MANURE STORAGE s (14 METHOD OF DISPOSAL OF MANURE +5L./ ) EL, t / .HOW OFTEN VS- �1 PEN AREA ENCLOSED BY WHAT TYPE OF FENCING? 5+4A-1 `— c� 1< - r \ 1,Vof— 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 SIGNATURE -OV DATE 2 , 2-6 - C THE FULL POUL RY COUNT IS N T TO EXCEED THE AMOUNT OF PRIOR YEAR'S TOTAL. FEES: I. -POULTRY -' chi , - .30.0 1 11 or more ickens '.'' ROOSTER (NOTE: SPECIAL APPROVAL REQUIRED FOR ROOSTERS) NO ROOSTER RECEIVED TOTAL DUE:$ 30-00 RRE t ' /1020 12/30/19 MO HEALTH DEPT HEALTH DEPT.