HomeMy WebLinkAbout2022 App & License The Commonwealth of Massachusetts Fee
/Is Town of Yarmouth $40.00
Poultry License
Number: BOHP-17-3855-04 Issue Date: 1/1/2022
Mailing Address: Location Address:
MICHELLE JUMPER 7 PAINE RD
7 PAINE ROAD SOUTH YARMOUTH, MA 02664
SOUTH YARMOUTH, MA 02664
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 a total of 15 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 Weston1111
Bruce G. Murphy, NIP ,R.S., CHO
Health Director
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°F..,..r -_ TOWN OF YARMOUTH
9 Board of
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t =+t1 1146 ROUTE 28, SOUTH YARMOUTH,MASSACHUSETTS 02664-24451 Health
MATTACHEESE
Telephone(508)398-2231,ext. 1241
Fax(508)760-3472 Division
APPLICATION FOR OPERATION -2021
POULTRY
PLEASE COMPLETE ALL QUESTIONS
E-MAIL r l �p l`e ®o O[-CUM
NAME
111 1,�\ ( I f1Q 1 1CC1tL Or'npt ( HOME TEL.NO. (�SOS 3(o3-t{ ({ /
LOCATION ADDRESS 7 'a I Yl e Rd S . %/a r KA v v+ MA 02_(,Co V
MAILING ADDRESS(IF DIFFERENT)
NUMBER OF FOWL Iy NUMBER OF PENS/COOPS / NUMBER OF ROOSTERS
PLEASE NOTE: PLEASE DO NOT INCREASE THE NUMBER OF FOWL
WITHOUT PRIOR PERMISSION OF THE HEALTH DEPARTMENT.cCoo p- /5K
TYPE OF SHELTER o OOCOD, 'CRETE,ETC.) SIZE OF YARD/PEN AREA 0 6 3 . t UYl
NUMBER OF WATER OUTLETS I WATER TROUGHS
TYPE OF STORAGE FACILITY USED FOR FEED/GRAIN PVC d fJ I u rn i r. v rv\ b t o
TYPE OF FACILITY USED FOR MANURE STORAGE�f -re i-� I I -e / / l.�j heel ba rt-e (
METHOD OF DISPOSAL OF MANURE C.ornp D,S+ .. HOW OFTEN 'R °Lt.\OLo
PEN AREA ENCLOSED BY WHAT TYPE OF FENCING? Ch 1 L(K.ex1 Wire / 44 C_pluict r-e
V 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 No
SIGNATURE DATE I a12.1 52.
THE FULL POULTRY COUNT IS NO 0 EXCEED THE AMOUNT OF PRIOR YEAR'S TOTAL. ._- Y
cir
FEES: LPPOULTRY: 1-9 chickens ickens $40.00$30.00 ��
10 or more Ch `
ROOSTER (NOTE:SPECIAL APPROVAL REQUIRED FOR ROOSTERS) 0 T2
NO ROOSTER
TOTAL DUE: $
12/30/19
DEC 2 1 2021
HEALTH DEPT.