HomeMy WebLinkAbout2023 The Commonwealth of Massachusetts Fee
Town of Yarmouth $40.00
Poultry License
Number: BOHP-15-1203-08 Issue Date: 1/1/2023
Mailing Address: Location Address:
SANDY RUBENSTEIN 79 WHITE ROCK RD
CAMP WINGATE*KIRKLAND Yarmouth Port. MA 02675
79 WHITE ROCK ROAD
YARMOUTHPORT, MA 02675
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 a total of 17 chickens at above address.
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, MPH, .S., C amen G. Gardiner
Health Director/Assis ant Health Director
TOWN OF YARMOUTH Board of
Health
1146 ROUTE 28, SOUTH YARMOUTH, MASSACHUSETTS 02.64-24451
Telephone(508)398-2231,ext. 1241IslAO V 1iYlsion
Fax(508)760-3472
FEB 13 2023
APPLICATION FOR OPERATION- 2023 HEALTHDEPT.POULTRY
PLEASE COMPLETE ALL QUESTIONS
E-MAIL HEYSANDY@CAMPWK.COM
NAME CAMP WINGATE KIRKLAND HOME TEL.NO. 508-362-3798
LOCATION ADDRESS 20 LINNELL LANE YARMOUTH PORT, MA 02675
MAILING ADDRESS(IF DIFFERENT) 79 WHITE ROCK ROAD YARMOUTH PORT, MA 02675
NUMBER OF FOWL 16 NUMBER OF PENS/COOPS 1 NUMBER OF ROOSTERS 0
PLEASE NOTE: PLEASE DO NOT INCREASE THE NUMBER OF FOWL
WITHOUT PRIOR PERMISSION OF THE HEALTH DEPARTMENT.
TYPE OF SHELTER WOOD SHED/KIDS PLAYHOUSE SIZE OF YARD/PEN AREA 20'X 20'
(WOOD.CONCRETE.ETC.)
NUMBER OF WATER OUTLETS WATER TROUGHS 1
TYPE OF STORAGE FACILITY USED FOR FEED/GRAIN FEED STORED IN METAL TRASH CAN IN GARAGE
TYPE OF FACILITY USED FOR MANURE STORAGE
METHOD OF DISPOSAL OF MANURE COMPOST OR TRASH HOW OFTEN EVERY 2 WEEKS
PEN AREA ENCLOSED BY WHAT TYPE OF FENCING? WIRE SCREEN FENCING
X 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 ,�1 "� DATE FEBRUARY 8, 2023
THE FULL POU `RY COUNT IS NOT TO EXCEED THE AMOUNT OF PRIOR YEAR'S TOTAL.
FEES: 16 POULTRY: 1-9 chickens 30.00
10 or more Chickens $40.00
ROOSTER (NOTE: SPECIAL APPROVAL REQUIRED FOR ROOSTERS)
NO ROOSTER
TOTAL DUE:$ 40.00
12/30/19
1