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HomeMy WebLinkAboutApp-Permit The Commonwealth of Massachusetts Fee Town of Yarmouth $30.00 Poultry License Number: BOHP-17-0089-04 Issue Date: 1/1/2022 Mailing Address: Location Address: CHRISTOPHER P. BERNIER 158 SETUCKET RD 158 SETUCKET ROAD YARMOUTH. MA 02675 YARMOUTHPORT, MA 02675 IS HEREBY GRANTED A 2022 LICENSE This license is granted in conformity with the statutes and ordinances relating thereto, and expires December 31, 2022 unless sooner suspended or revoked and is not transferable. Conditions Allowed to have a total of up to four(4) fowl at above address. Allowed to have one (1) rooster. Board Hillard Boskey, M.D., Chairman Mary Craig, Vice Chairman of Charles T. Holway, Clerk Debra Bruinooge Health Eric Weston . Bruce G. Murphy, MP R.S., HO/James G.Gardiner Health Director/Assistant Health Director 6011111t4 TOWN OF YARMOUTH Board of • Health r. -=...i► _1 1146 ROUTE 28, SOUTH YARMOUTH,MASSACHUSETTS 02664-24451 - YATfACHEESE Telephone(508)398-2231,ext. 1241 Health Fax(508)760-3472 APPLICATION FOR OPERATION- 202212 1 APR 4 2022 POULTRY // HEALTH DEPT. PLEASE COMPLETE ALL QUESTIONS E-MAIL N'011 NAME CL� `S4 °(�1`�r 3��` � HOME TEL.NO. To IC a9 a. 5-630 LOCATION ADDRESS t 5-42( 5 k4 Re), 4wt-rivcrotL ac± w�•4. 02_4'Pi MAILING iMAILING ADDRESS(IF DIFFERENT) NUMBER OF FOWL 5 NUMBER OF PENS/COOPS 1 NUMBER OF ROOSTERS d PLEASE NOTE: PLEASE DO NOT INCREASE THE NUMBER OF FOWL WITHOUT PRIOR PERMISSION OF THE HEALTH DEPARTMENT. TYPE OF SHELTER t'`i°°C _ SIZE OF YARD/PEN AREA 12.I J� I C (WOOD,CONCRETE,ETC.) NUMBER OF WATER OUTLETS WATER TROUGHS TYPE OF STORAGE FACILITY USED FOR FEED/GRAIN S 4 it I CA n S TYPE OF FACILITY USED FOR MANURE STORAGE Ca''"'P•3 4' P'1'4 METHOD OF DISPOSAL OF MANURE C b.h P a s} t' Q d e�� HOW OFTEN 3 4.1'"'' P° '' r r PEN AREA ENCLOSED BY WHAT TYPE OF FENCING? Ch 4.n Is FS CC IN%6(e n w t two W''<'� 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 © 6 -4------- DATE apt' 1 1 b pgoa g,. THE FULL POULTRY COUNT IS NOT TO EXCEED THE AMOUNT OF PRIOR YEAR'S TOTAL. FEES: n Z. POULTRY: 1-9 chickens $30.00 10 or more Chickens $40.00 ROOSTER (NOTE: SPECIAL APPROVAL REQUIRED FOR ROOSTERS) NO ROOSTER TOTAL DUE: $ t LQD 12/30/19