HomeMy WebLinkAbout2023 The Commonwealth of Massachusetts Fee
Town of Yarmouth $40.00
Poultry License
Number: BOHP-15-1214-08 Issue Date: 1/1/2023
Mailing Address: Location Address:
CAROLE EMERSON 15 HIGGINS CROWELL RD
15 HIGGINS CROWELL ROAD WEST YARMOUTH. MA 02673
WEST YARMOUTH, MA 02673
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 up to 25 chickens, 4 roosters at above address.
*RESTRICTION: Set back from property lines. Variance approved by Board of Health Agent, 08/29/83.
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, R.S. CHO/James G. Gardiner
Health Dire for/Assistant Health Director
.,� °F TOWN OF YARMOUTH Board of
`� VI Health
_ 1 146 ROUTE 28, SOUTH YARMOUTH, MASSACHUSETTS 02664-24451 -
MATTACHEESE Telephone(508)398-2231, ext. 1241 Health
Division
'•' Fax(508)760-3472
APPLICATION FOR OPERATION - 2023
POULTRY
PLEASE COMPLETE ALL QUESTIONS E-MAIL
3)tf /t,r`i- 4-.44/1,' . '
NAME ..elf.d)L EA„ 12501I HOME TEL.NO.. 3VF' 7y 6S/7
— LOCATION ADDRESS AS' / F/'zfir t—'���t%1' / '— 7�1�IOGt rL eiQ, 6 73
MAILING ADDRESS(IF DIFFERENT)
NUMBER OF FOWL C J NUMBER OF PENS/COOPS 3 NUMBER OF ROOSTERS l
PLEASE NOTE: PLEASE DO NOT INCREASE THE NUMBER OF FOWL
WITHOUT PRIOR PERMISSION OF THE HEALTH DEPARTMENT.
TYPE OF SHELTER ji./p0,/ SIZE OF YARD/PEN AREA yoAZ 3r1
(WOOD,CONCRETE,ETC.)
NUMBER OF WATER OUTLETS / WATER TROUGHS Z_
TYPE OF STORAGE FACILITY USED FOR FEED/GRAIN /0.0�,�/ 7'Z'..ri, g,,,, is,.
TYPE OF FACILITY USED FOR MANURE STORAGE
METHOD OF DISPOSAL OF MANURE pr•tberad — C-01-VJOJ, HOW OFTEN W� fr
PEN AREA ENCLOSED BY WHAT TYPE OF FENCING? Le/t it C-
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 4..,. !19 ��-•-�v3--- DATE Ql— y--,20..3
THE FULL POULTRY COUNT IS NOT TO EXCEED THE AMOUNT OF PRIOR YEAR'S TOTAL.
FEES: ✓POULTRY: 1-9 chickens $3 .OQrO
10 or more Chickens ��
ROOSTER (NOTE: SPECIAL APPROVAL REQUIRED FOR ROOSTERS)
NO ROOSTER
X u0V71.
TOTAL DUE:$ 7/a °`1
FEB 10 2023
12i30/19 HEALTH DEPT