HomeMy WebLinkAbout2021 App * License The Commonwealth of Massachusetts Fee
Town of Yarmouth $40.00
Poultry License
Number: BOHP-17-3855-04 Issue Date: 1/1/2021
Mailing Address: Location Address:
MICHELLE JUMPER 7 PAINE RD
7 PAINE ROAD 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 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 Weston (�
V
Bruce G. Murp y, MPH, R.S., CHO
Health Director
2 a 2
49= TOWN OF YARMOUTH Board of
Health
_ 1146 ROUTE 28, SOUTH YARMOUTH,MASSACHUSETTS 02664-24451 -
�., EESE Health
Telephone(508)398-2231,ext. 1241
Fax(508)760-3472 Division
APPLICATION FOR OPERATION-2022
POULTRY
PLEASE COMPLETE ALL QUESTIONS ( - f
E-MAIL 1C1 Y`(�I. 'J. G.O C-C�X�
NAME i - l t l✓Ine t lc_ J v M 1 e. ( HOME TEL.NO. 5D&')3c C•(c�q?
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LOCATION ADDRESS (PC(‘t `J • /C�r ru 0
r
MAILING ADDRESS(IF DIFFFERENT)
NUMBER OF FOWL / NUMBER OF PENS/COOPS I NUMBER OF ROOSTERS
PLEASE NOTE: PLEASE DO NOT INCREASE THE NUMBER OF FOWL
WITHOUT PRIOR PERMISSION OF THE HEALTH DEPARTMENT. �x g S� �
TYPE OF SHELTER (A)oval SIZE OF YARD/PEN AREA "tor
(WOOD,CONCRETE,ETC.) ZVh x /0 Ls? f
/
NUMBER OF WATER OUTLETS I WATER TROUGHS a
TYPE OF STORAGE FACILITY USED FOR FEED/GRAIN A I v rn t n u r 13 / Dv C -Y - ed-e(I
TYPE OF FACILITY USED FOR MANURE STORAGE `1{r 4. l (A) k- ( b a r r e I
METHOD OF DISPOSAL OF MANURE w h.e.I b a f r[ (( HOW OFTEN RCL r\A-0-
PEN AREA ENCLOSED BY WHAT TYPE OF FENCING? 1-1- r- d w r< CA 6 LL / G k ( c, n CA) r 4
`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 0
DATE a /aZ
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 HLL; 2 1 2021
TOTAL DUE: $ !+"30 HEALTH DEPT.
12/30/19