HomeMy WebLinkAboutApp-Permit- The Commonwealth of Massachusetts Fee
Town of Yarmouth $40.00
Poultry License
Number: BOHP-15-1204-06 Issue Date: 1/1/2021
Mailing Address: Location Address:
RENEE BRYDEN 341 NORTH MAIN ST
341 NORTH MAIN STREET SOUTH YARMOUTH, MA 02664
SOUTH YARMOUTH, MA 02664
IS HEREBY GRANTED A 2021 LICENSE
This license is granted in conformity with the statutes and ordinances relating thereto,
and expires December 31, 2021 unless sooner suspended or revoked and is not
transferable.
Conditions
Allowed to have a total of up to 10 chickens at above address. No roosters.
PLEASE POST LICENSE ON PREMISES.
Board Hillard Boskey, M.D.,Chairman
Mary Craig, Vice Chairman
of Charles T. Holway, Clerk
Debra Bruinooge
Health Eric Weston
4IP1
Bruce G. Murphy. MPH. R.S., C I / ory R. Langler, R.S.
Health Director/Assistant Health Director
TOWN OF YARMOUTH Board of
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6I' 6 . Health
1•• -111 = 1146 ROUTE 28, SOUTH YARMOUTH,MASSACHUSETTS 02664-24451 Health
YATTACXEESE
'9,....o Telephone(508)398-2231,ext. 1241
Fax(508) 760-3472 Division
APPLICATION FOR OPERATION -2040- 2-6z(
POULTRY
PLEASE COMPLETE ALL QUESTIONS E-MAIL W''171-1212 jCiYdg9"eji/e/4kzD
NAME --P.. >°>° Bryden-) HOME TEL.NO. 6/-2-335-0----7,
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LOCATION ADDRESS (1_'W /" t �"'( ()
j---
MAILING ADDRESS(IF DIFFERENT)
NUMBER OF FOWL ) NUMBER OF PENS/COOPS ) NUMBER OF ROOSTERS--
PLEASE
OOSTERSPLEASE NOTE: PLEASE DO NOT INCREASE THE NUMBER OF FOWL
WITHOUT PRIOR PERMISSION OF [T,HE HEALTH DEPARTMENT.
Vi
TYPE OF SHELTER a`9 C. Ge.N1C'/ k) SIZE OF YARD/PEN AREA 36C) (°6�-
(WOOD,CONCRETE,ETC.)ill--
NUMBER
f VNUMBER OF WATER OUTLETS 1 WATER TROUGHi 2
TYPE OF STORAGE FACILITY USED FOR FEED/GRAIN - (k Jnr) i 204. ,(
TYPE OF FACILITY-USED FOR VIANtJRE -- j'°
METHOD OF DISPOSAL OF MANURE 7 ► HOW .OFTEN ,en ) )
PEN AREA ENCLOSED BY WHAT TYPE OF FENCING? reC�\,1 /IC, Ct(4 T I
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 pa' : Yes No
SIGNATURE / ------------" DATE dj Ze)) 4
THE FULL POULTRY COUNT IS NOT TO EXCEED THE AMOUNT OF PRIOR YEAR'S TOTAL.
FEES: POULTRY: 1-9 chickens $30.00
10 or more Chickens $40.00
ROOSTER (NOTE: SPECIAL APPROVAL REQUIRED FOR ROOSTERS)
NO ROOSTER
TOTAL DUE:$
I MAR 0 4 2021
12/30/19
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