HomeMy WebLinkAbout2022 - App-License The Commonwealth of Massachusetts Fee
Town of Yarmouth $30.00
Poultry License
Number: BOHP-15-2041-04 Issue Date: 1/1/2022
Mailing Address: Location Address:
JESSE HAGOPIAN 95 ROUTE 6A
95 ROUTE 6A YARMOUTH PORT. 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 up to 9 chickens at above address.
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
Bruce G. Murphy, MPH, ' S., ' 0/James G. Gardiner
Health Director/Assistant Health Director
,� ''°F '�'9 TOWN OF YARMOUTH Board of
.. " Health
_ 1146 ROUTE 28, SOUTH YARMOUTH,MASSACHUSETTS 02664-24451
MATT/CNEESE
--: °'^��`' Telephone(508)398-2231, ext. 1241 Health
Fax(508)760-3472
•
APPLICATION FOR OPERATION- 2022221
POULTRY 11
PLEASE COMPLETE ALL QUESTIONS
-�. E-MAIL tfrsl'c. layi cv 0%41,C...
NAME kjeSrC ����;c✓t HOME TEL.NO. 77y—1 1C-/-374/
LOCATION ADDRESS �c G� «� ��^ f�� �� fr,-.04- 6 e. 6 75
MAILING ADDRESS(IF DIFFERENT)
NUMBER OF FOWL q NUMBER OF PENS/COOPS NUMBER OF ROOSTERS
PLEASE NOTE: PLEASE DO NOT INCREASE THE NUMBER OF FOWL
WITHOUT PRIOR PERMISSION OF THE HEALTH DEPARTMENT.
TYPE OF SHELTER Y" SIZE OF YARD/PEN AREA 7f SAF
(WOOD,CONCRETE,ETC.)
NUMBER OF WATER OUTLETS WATER TROUGHS .�
TYPE OF STORAGE FACILITY USED FOR FEED/GRAIN M.e4.l J/V1
TYPE OF FACILITY USED FOR MANURE STORAGE 5 '
METHOD OF DISPOSAL OF MANURE t9)J-yer etA,_ /�^ 6/1lb" HOW OFTEN e /n�.1 1i
PEN AREA ENCLOSED BY WHAT TYPE OF FENCING?
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 3cciaillts.
Please check appropriately if paid: Yes X No
SIGNATURE _DATE 7 1 . i1�
THE FULL POUL RY I UN IS NOT TO EXCEED THE AMOUNT OF PRIOR YEAR'S OTAL.
FEES: X2- PO RY: 1-9 chickens $30.00
10 or more Chickens $40.00
ROOSTER (NOTE: SPECIAL APPROVAL REQUIRED FOR ROOSTERS)
NO ROOSTER
TOTAL DUE: $ O
APR 2 2 2022
12/30n9 HEALTH DEPT.