HomeMy WebLinkAbout2021 License & App The Commonwealth of Massachusetts Fee
Town of Yarmouth s30.00
Poultry License
Number: BOHP-15-1221-06 Issue Date: 1/1/2021
Mailing Address: Location Address:
DOUGLAS & LAURA SHERMAN 18 PINNACLE LN
18 PINNACLE LANE YARMOUTH, MA 02675
YARMOUTHPORT, MA 02675
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 25 chickens at above address. 2021- 9 fowl reported
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. M rph,, MPH, R.S.. CHO
Health Director
,,,,,,,,,,
-_ TOWN OF YARMOUTH Board of
it.*
Health
1146 ROUTE 28, SOUTH YARMOUTH, MASSACHUSETTS 02664-24451 -
Telephone(508)398-2231,ext. 1241 Health
Fax(508)760-3472 Division
APPLICATION FOR OPERATION -2021
POULTRY
PLEASE COMPLETE ALL QUESTIONS r
E-MAIL /Q4CA- O .4 /ob tit
NAME Doi...) �� S .� 4k S)1.Sc', ( HOME TEL.NO. 77 —
LOCATION ADD'ESS I4 OL O N (a cR L114,.o c
MAILING ADDRESS(IF DIFFERENT)
(11
NUMBER OF FOWL 5 NUMBER OF PENS/COOPS 0 NUMBER OF ROOSTERS
PLEASE NOTE: PLEASE DO NOT INCREASE THE NUMBER OF FOWL
WITHOUT PRIOR PERMISSION OF THE HEALTH DEPARTMENT.
TYPE OF SHELTER LJood SIZE OF YARD/PEN AREA / X 2
(WOOD,CONCRETE,ETC.)
NUMBER OF WATER OUTLETS WATER TROUGHS a
TYPE OF STORAGE FACILITY USED FOR FEED/GRAIN '�'� lv CO 1.9 S 4 h S'1 Cie W 00 d PN I� N
TYPE OF FACILITY USED FOR MANURE STORAGE C D Nk the
METHOD OF DISPOSAL OF MANURE -'a t 14 C_/ v p HOW OFTEN 3 X AN)6/t.
PEN AREA ENCLOSED BY WHAT TYPE OF FENCING? 1,) & /(v i r C
DL---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 pa' prior to renewal or issuance of your permits.
Please check appropriately if paid: Yes No
SIGNATURE %d4 1M1 _ DATE O / vC Ova
THE FULL POv UI RY COUNT IS NOT TO EXCEED THE AMOUNT OF PRIOR YEAR'S TOTAL.
FEES: POULTRY: 1-9 chickens
10 or more Chickens 40.00
ROOSTER (NOTE: SPECIAL APPROVAL REQUIRED FOR ROOSTERS)
NO ROOSTER
TOTAL DUE:$ �•
12/30/19
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