HomeMy WebLinkAboutApp-License The Commonwealth of Massachusetts Fee
Town of Yarmouth $40.00
Poultry License
Number: BOHP-17-0431-05 Issue Date: 1/1/2022
Mailing Address: Location Address:
ELENA CENSALE 30 GREYHAMPTON RD
30 GREYHAMPTON ROAD WEST YARMOUTH. MA 02673
WEST YARMOUTH, MA 02673
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 thirty(30) chickens at above address. No roosters allowed.
Board Hillard Boskey, M.D.,Chairman
Mary Craig, Vice Chairman
Of Charles T. Holway, Clerk
Debra Bruinooge
Health Eric Weston
Bruce G. Murphy, PH .S., CHO/James G. Gardiner
Health Director/Assistant Health Director
„., .... TOWN OF YARMOUTH
,, � ;== Board of
Health
-�`- _• 1146 ROUTE 28, SOUTH YARMOUTH, MASSACHUSETTS 02664-24451
a MHealth
AT ACHEEESE
'��1btlltf[1I Telephone(508)398-2231,ext. 1241
Fax(508)760-3472 Division
APPLICATION FOR OPERATION-2022 APR 14 2022
POULTRY
PLEASE COMPLETE ALL QUESTIONS HEALTH DEPT.
,�/ ` E-MAIL
NAME E L-6/�/ I 0EY5 9Z -`J 6I(11'alCrl HOME TEL.NO. c-6:0S 3?v..?7‘
LOCATION ADDRESS 3 0 4 f We-7y 7v/ti 40 VV T etR.,171 earl/
,= MATT ING ADDRESS(IF DIFFERENT} __ - _ - _- _----- -.7_-
NUMBER OF FOWL .3O NUMBER OF PENS/COOPS A NUMBER OF ROOSTERS V
PLEASE NOTE: PLEASE DO NOT INCREASE THE NUMBER OF FOWL
WITHOUT PRIOR PERMISSION OF THE HEALTH DEPARTMENT.
TYPE OF SHELTER W D 4 /J SIZE OF YARD/PEN AREA 5/9N( A-S L,61-67. VEVA
—
(WOOD,CONCRETE,ETC.) 3 a 2 Q p
NUMBER OF WATER OUTLETS c WATER TROUGHS 3 [��J f. y
TYPE OF STORAGE FACILITY USED FOR FEED/GRAIN 5 J E ,0 --> 'matt!.sibtifGS
TYPE OF FACILITY USED FOR MANURE STORAGE Coin P O S T�d 5',P(2i i2 0 4/ 69,4POf/S
METHOD OF DISPOSAL OF MANURE //' // // ['
HOW OFTEN al � � 7�f�
PEN AREA,ENCLOSED BY WHAT TYPE OF FENCING? ”/.� �A / /r a r -R - -
we Keeper c4-ERdV ,
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.
�. _ - s
Town of Yarmouth taxes and liens must be paid prior to renewal or issuance of your permits.
Please check appropriately if paid: Yes l/ No
N
SIGNATURE alatql (4ZL.`.�y,L DATE /g/o) c"- --
THE
�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)
1/1NO ROOSTER/
.,..1 )`7/
TOTAL DUE: $ D
12/30/19