HomeMy WebLinkAbout2023 App-License The Commonwealth of Massachusetts Fee
Town of Yarmouth $30.00
Poultry License
Number: BOHP-15-1221-08 Issue Date: 1/1/2023
Mailing Address: Location Address:
DOUGLAS & LAURA SHERMAN 18 PINNACLE LN
18 PINNACLE LANE YARMOUTH. MA 02675
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 25 chickens at above address.
PLEASE POST LICENSE ON PREMISES.
Board Hillard Boskey, M.D.,Chairman
Mary Craig, Vice Chairman
of Charles T. Holway, Clerk
Eric Weston
Health
James . Gardiner
Health Director
... r�9 = TOWN OF YARMOUTH Board of
g Health
_I 1 146 ROUTE 28, SOUTH YARMOUTH,MASSACHUSETTS 02664-24451 -
MATTACHEESE Telephone(508)398-2231,ext. 1241 Health
Division
------;;;-*;if''" Fax(508)760-3472
APPLICATION FOR OPERATION- 2023
POULTRY
PLEASE COMPLETE ALL QUESTIONS ��� Chip// E-MAIL 1/4/ [J
/
NAME J Vj IC(S ` I-4 Lite-.. c/l Q 0/}/4,—) HOME TEL.NO. 77y-'99 2.3 p� , 0.7,4-
LOCATION ADDRESS /, P'/v il/A C ter h4.-4__
MAILING ADDRESS(IF DIFFERENT) ��/ -Q--
NUMBER OF FOWL 5 NUMBER OF PENS/COOPS C ROOSTERS
PLEASE NOTE: PLEASE DO NOT INCREASE THE NUM 'R OF FOWL
WITHOUT PRIOR PERMISSION OF THE HEALTH DEPARTMENT.������(/&�)t 0 OJ( /—
TYPE OF SHELTER Lit:, i SIZE OF YARD/PEN AREA ' '1 ' i''II/ ' +
(W OD,CONCRETE,ETC.)
NUMBER OF WATER OUTLETS / WATER TROUGHS
TYPE OF STORAGE FACILITY USED FOR FEED/GRAIN 11N CCcNS )0'-- Lt 'vJ
TYPE OF FACILITY USED FOR MANURE STORAGE tivalvdd (Mood
METHOD OF DISPOSAL OF MANURE �,o6'S/' HOW OFTEN 6 M o('4 S
PEN AREA ENCLOSED BY WHAT TYPE OF FENCING? �1 re../`..0 ad
Or\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 pr' r to renewal or issuance of your permits.
Please check appropriately if paid: Yes No
SIGNATURE d' , at----------- DATE 2——/� 2 c Z,S
THE FULL POU RY COUNT IS NOT TO EXCEED THE AMOUNT OF PRIOR YEAR'S TOTAL.
FEES: POULTRY: 10 1-9or chickemore Cnshickens $340.000.00
ROOSTER (NOTE: SPECIAL APPROVAL REQUIRED FOR ROOSTERS)
NO ROOSTER
TOTAL DUE: $ 3
12/30/19
The Commonwealth of Massachusetts Fee
Town of Yarmouth $30.00
Sheep Goats License
Number: BOHSG-15-1244-08 Issue Date: 1/1/2023
Mailing Address: Location Address:
DOUGLAS & LAURA SHERMAN 18 PINNACLE LN
18 PINNACLE LANE YARMOUTH, MA 02675
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 3 goats 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,MP R. ,CHO/James G.Gardiner
Health Director Assistant Health Director
°F r49�-_ TOWN OF YARMOUTH
g` Board of
So+ Health
= 1146 ROUTE 28, SOUTH YARMOUTH,MASSACHUSETTS 02664-24451 -
.ATTACHEESE Health
{ Telephone(508)398-2231, ext. 1241
` Fax(508)760-3472 Division
APPLICATION FOR OPERATION - 2023
S FEE: 1-8 animals $30.00
,;' 9 or ore animals $35.00
FEB 21 2023 INRenewal
PLEASE COMPLETE ALL QUESTIONS n New Application
(
HEALTH DEPT.E- IL mho lud foe fo atMdiy//Py-
NAME tocyQj()s -t- �a ,cam. Skp kri —1 HOME TEL.NO. 77 1¢y-333.)._,
ADDRESS 1 iNA. MR._ kd<� yr..m.nolifie
MAILING ADDRESS(IF DIFFERENT) (1/ /'Nn'AtI t LL4..e._ ycon-p iZ?
EMERGENCY CONTACT(NAME/PHONE#) 72 4-4 y 7333 L
VETERINARIAN(NAME/PHONE#) DP . 'why A- C'PS,-C�".
TOTAL NUMBER OF ANIMALS
PLEASE NOTE: PLEASE DO NOT INCREASE THE NUMBER OF ANIMALS
WITHOUT PRIOR PERMISSION OF THE HEALTH DEPARTMENT.
PLEASE LIST EACH SWINE/SHEEP/GO S II9.TELY: ale.2(1 \
ANIMAL NAME(IF APPLICABLE) jq4��ill;d,,,r jam. �j (Lk>I I OUT `
BREED J
#YEARS OWNED 1 6 5 . Z— /
COLOR / rtliiegerd6- I A
DATE OF RABIES VACCINATION S/dpd a. SA.MO
DATE OF EEE VACCINATION 67a,0 ,- S -
DATE OF OTHER VACCINATIONS & J7oZZ
TYPE OF STABLE/SHELTER C.-0 C22 I l,W,(i SIZE OF CORRAL AREA 3.5 'e x jc
(WOO ,CONCRETE, C.)
TYPE OF STORAGE FACILITY USED FOR FEED/GRAIN 1 N oU
TYPE OF FACILITY USED FOR MANURE STORAGE COM D os 1- A-0 c d
METHOD OF DISPOSAL OF MANURE 00..44/c.,s l' HOW OFTEN b /P/a/WAS
IS CORRAL/PEN AREA ENCLOSED BY FENCING? YES NO TYPE OF FENCING
OTHER FARM ANIMALS MAINTAINED AT PREMISES? YES NO
(PLEASE NOTE: POULTRY, HORSES, PONIES, DONKIES REQUIRE SEPARATE LICENSURE.)
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 V No
SIGNATURE DATE 0.2`,(J wa 3 12/30/19