HomeMy WebLinkAbout2023 App-License The Commonwealth of Massachusetts Fee
Town of Yarmouth $40.00
Poultry License
Number: BOHP-17-3855-06 Issue Date: 1/1/2023
Mailing Address: Location Address:
MICHELLE JUMPER 7 PAINE RD
7 PAINE ROAD SOUTH YARMOUTH. MA 02664
SOUTH YARMOUTH, MA 02664
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 15 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
Eric Weston
Health
es G. Gardiner
Health Director
°F Y�9
is TOWN OF YARMOUTH Board of
Health
~ _/ 1 146 ROUTE 28, SOUTH YARMOUTH, MASSACHUSETTS 02664-24451 - L
ATTKNEESE _ Health
Telephone(508)398-2231,ext. 1241 -_—_----
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Div sion
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- Fax(508)760-3472 Ell-
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APPLICATION FOR OPERATION - 2023
POULTRY HEALTH DEPT.
PLEASE COMPLETE ALL QUESTIONS ���"" tt /�
E-MAIL r't`N }(�(� l d e ( l� 6J 61.0
NAME M % C rl-t k -e _:).M p-e. C HOME TEL.NO. -� `�10r -t-(�`(
ct
LOCATION ADDRESS -4 ?a l r1 e_ eP 8 S • V 4 r vu GU Tv\ tiN4 O Z(o it L(
MAILING ADDRESS(IF DIFFERENT) V"
NUMBER OF FOWL-- NUMBER OF P NS/i OOPS I NUMBER OF ROOSTERS C)
PLEASE NOTE: PLEASE DO NOT INCREASE THE NUMBER OF FOWL
WITHOUT PRIOR PERMISSION OF THE HEALTH DEPARTMENT.
TYPE OF SHELTER (A)00 d SIZE OF YARD/PEN AREA 7.X l O ( ? )
(WOOD,CONCRETE,ETC.)
NUMBER OF WATER OUTLETS 1 tc k ut-)Se)WATER TROUGHS I
TYPE OF STORAGE FACILITY USED FOR FEED/GRAIN ). .:'_t 4\vv� 1;+.)l t.:
TYPE OF FACILITY USED FOR MANURE STORAGE \ p 2 \ i T c
METHOD OF DISPOSAL OF MANURE C 0M a c HOW OFTEN 2-- 3 w k s
PEN AREA ENCLOSED BY WHAT TYPE OF FENCING? Cn 1 ClC-e C' IA.) r-e.
V 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 pald: -Yes sNo - -- —
SIGNATURE 1- 1- i DATE 2 ' r ' 13
THE FULLPOULTRY COUNT IS NOT TO EXCEED THE AMOUNT OF PRIOR YEAR'S TOTAL/
FEES: ✓ POULTRY: 1-9 chickens $30.00
$.10 or more Chickens $40.00
ROOSTER (NOTE: SPECIAL APPROVAL REQUIRED FOR ROOSTERS)
NO ROOSTER
TOTAL
L`'i TOTAL DUE: $ 0
12/30/19