HomeMy WebLinkAbout2022 App-License The Commonwealth of Massachusetts Fee
Town of Yarmouth $40.00
Poultry License
Number: BOHP-15-1214-07 Issue Date: 1/1/2022
Mailing Address: Location Address:
CAROLE EMERSON 15 HIGGINS CROWELL RD
15 HIGGINS CROWELL 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 up to 25 chickens, 4 roosters at above address.
*RESTRICTION: Set back from property lines. Variance approved by Board of Health Agent, 08/29/83.
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
' BruceGMurphMPJanesGGardiner
Health Director/Assistant Health Director
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, TOWN OF YARMOUTH Board of
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Health
-x,1.11 =' 1146 ROUTE 28, SOUTH YARMOUTH,MASSACHUSETTS 02664-24451 Health
MATACNEESE
Telephone(508)398-2231, ext. 1241
moi'' Fax(508)760-3472 nivisiOn
APPLICATION FOR OPERATION - 2022 APR 1 4 2022
POULTRY
HEALTH DEPT.
PLEASE COMPLETE ALL QUESTIONS
E-MAIL j ,Vat hKve'
NAME C14-1414.1 cm o -�..Ai HOME TEL.NO. ,..civ ,7f t c77
LOCATION ADDRESS/6.- >ii/y, C/et,tab'Il RD 1,,i y,¢, r r p11,51- a 73
- 2G
MAILING ADDRESS(IF DIFFERENT)_
NUMBER OF-FOWL A/ NUMBER OF PENSICOOPS 3 NUMBER OF ROOSTERS
PLEASE NOTE: PLEASE DO NOT INCREASE THE NUMBER OF FOWL
WITHOUT PRIOR PERMISSION OF THE HEALTH DEPARTMENT.
TYPE OF SHELTER iti00 ( SIZE OF YARD/PEN AREA %' x' 30
(WOOD,CONCRETE,ETC.)
NUMBER OF WATER OUTLETS / WATER TROUGHS 2
TYPE OF STORAGE FACILITY USED FOR FEED/GRAIN ,7 L— 7'21.1 f',d,451. b 4 fp,"�/s
TYPE OF FACILITY USED FOR MANURE STORAGE
METHOD OF DISPOSAL OF MANURE 9,y,e_2)c,v - (rte n,/,,GS6- HOW OFTEN I X'E��/)
PEN AREA ENCLOSED BY WHAT TYPE OF FENCING? L.✓ tic
1. 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 peraliis,
Please check appropriately if paid: Yes ✓ No
SIGNATURE , `j c:„.... ..,.....,,_ DATE 1y/?/ z 2-
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)
NO ROOSTER
TOTAL DUE: $1.// "
12/30/19