HomeMy WebLinkAbout2023 The Commonwealth of Massachusetts Fee
Town of Yarmouth $30.00
Poultry License
Number: BOHP-17-4130-06 Issue Date: 1/1/2023
Mailing Address: Location Address:
SALLY EVANS 24 WEST GREAT WESTERN RD
P.O. BOX 875 YARMOUTH. MA 02675
HARWICH, MA 02645
IS HEREBY GRANTED A 2023 LICENSE
This license is granted in conformity with the statutes and ordinances relating thereto,
and expires December 31, 2023 unless sooner suspended or revoked and is not
transferable.
Conditions
Allowed to have a total of up to 5 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
Bruce G. Murphy, PH, CHO/James G. Gardiner
Health Director/Assistant Health Director
°v..�:; TOWN OF YARMOUTH
it...„
,9 Board of
Health
-Alt 1 146 ROUTE 28, SOUTH YARMOUTH, MASSACHUSETTS 02664-24451 Health
MATT�CNEESE
�� ;•' Telephone(508)398-2231, ext. 1241
- Division
Fax(508)760-3472
APPLICATION FOR OPERATION- 2023
POULTRY
PLEASE COMPLETE ALL QUESTIONS
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NAME O,ll A\A.e 0.fN HOME TEL.NO. S CZ—'D3-7-1 07 a,
LOCATION ADDRES QLt 1 c-'c cre.04 f'-If a\
MAILINGADDRESS(IF DIFFERENT) ? () , >c X <isl C 4 1 '"`" WAE1: AMA o -
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 TROD HS
TYPE OF STORAGE FACILITY USED FOR FEED/GRAIN y L 2 2n,97
TYPE OF FACILITY USED FOR MANURE STORAGE '\() '
METHOD OF DISPOSAL OF MANURE HOW OFTEN
PEN AREA LOSED 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'I'd'mouth taxes and liens must he aid • to-renewal vi issuance of yvurpei uiita.
Please check appropriately if paid: Ye No
SIGNATURE 0)--/-i2,4 Z L4- DATE
THE FULL POU 'RY CO 6
T IS NOT TO EXCEED THE AMOUNT OF PRIOR YEAR'S TOTAL.
FEES: POULTRY: 10 1-9or chickensmore Chickens $340.000.00
ROOSTER (NOTE: SPECIAL APPROVAL REQUIRED FOR ROOSTERS)
(/ NO ROOSTER
TOTAL DUE:$ 3o oD
12/30/19