HomeMy WebLinkAboutApplication 1,444 TOWN OF YARMOUTH Board of
Health
%O. 1146 ROUTE 28, SOUTH YARMOUTH,MASSACHUSETTS 02664-24451
Telephone(508)398-2231,ext. 1241 Hi111
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Fax(508)760-3472
AAR 0 4 2020
APPLICATION FOR OPERATIO1S 2A,2' , •LTH DEPT
POULTRY .� 1 '�
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PLEASE COMPLETE ALL QUESTIONS
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NAME /! /Z: v Cj/ ( HOME TEL.NO. D 3 33-6, 01
LOCATION ADDRESS 6 5 pir re-1 14 5 tar, Yl') y4-- Q �. (o T
MAILING ADDRESS(IF DIFFERENT)
NUMBER OF FOWL 4( NUMBER OF PENS/COOPS I NUMBER OF ROOSTERS CD
PLEASE NOTE: PLEASE DO NOT INCREASE THE NUMBER OF FOWL
WITHOUT PRIOR PERMISSION OF THE HEALTH DEPARTMENT.
TYPE OF SHELTER 4`G d SIZE OF YARD/PEN AREA 3 d
(WOOD,CONCRETE,ETC.)
NUMBER OF WATER OUTLETS D WATER TROUGHS I
TYPE OF STORAGE FACILITY USED FOR FEED/GRAIN 04 `e.-4 (2Ce V\
TYPE OF FACILITY USED FOR MANURE STORAGE TVl' 4 i-? b
METHOD OF DISPOSAL OF MANURE 1,)( 11->ed1 t c vA p HOW OFTEN 1 x W -K
• G
PEN AREA ENCLOSED BY WHAT TYPE OF FENCING? C, k 4 G ee 1 Li) 1112-6_< <. S
/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
X/i/Y
SIGNATURE 4DATE 3 e 1 - aZ�
THE FULL POULTRY COUNT IS NOT TO EXCEED THE AMOUNT OF PRIOR YEAR'S TOTAL.
FEES: ✓POULTRYI9 chickens $30.0
or more Chickens 40.0
ROOSTER (NOTE: SPECIAL APPROVAL REQUIRED FOR ROOSTERS)
V NO ROOSTER
TOTAL DUE: $ .30.00
12/30/19