HomeMy WebLinkAbout2022 - New Owner no chickens 4:pt-iii------.;,----.____„ TOWN OF YARMOUTH Board of
` Health
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iJ► 1146 ROUTE 28, SOUTH YARMOUTH,MASSACHUSETTS 02664-24451 Health
YATTACMEESE
`**n Telephone(508)398-2231,ext. 1241
- Fax(508) 760-3472 Division
APPLICATION FOR OPERATION - 2022
POULTRY
PLEASE COMPLETE ALL QUESTIONS
E-MAIL
NAME HOME TEL.NO.
LOCATION ADDRESS
MAILING ADDRESS(IF DIFFERENT)
NUMBER OF FOWL — 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 SIZE OF YARD/PEN AREA
(WOOD,CONCRETE,ETC.)
NUMBER OF WATER OUTLETS WATER TROUGHS
TYPE OF STORAGE FACILITY USED FOR FEED/GRAIN
TYPE OF FACILITY USED FOR MANURE STORAGE
METHOD OF DISPOSAL OF MANURE HOW OFTEN
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 permits.
Please check appropriately if paid: Yes No
1 SIGNATURE ////iLdic.,,,...5 ,t ►; DATE /0 1 / �a,
THE FULL POULTRY COUNT IS NOT TO EXCE THE AMOUNT 1 PRIOR YEAR'S TOTAL.
FEES: POULTRY: 30.00 i L�`j =!J
101-9 or mochickens 4 re Chickens 0.00
ROOSTER (NOTE: SPECIAL APPROVAL REQUIRED FOR ROOSTERS) OCT 2 4 2022
NO ROOSTER `
,9 HEALTH DEPT.
TOTAL DUE: $ O C.„.
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12/30/19 ��c
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