HomeMy WebLinkAbout2023 App-License The Commonwealth of Massachusetts Fee
Town of Yarmouth $30.00
Poultry License
Number: BOHP-15-2041-05 Issue Date: 1/1/2023
Mailing Address: Location Address:
JESSE HAGOPIAN 95 ROUTE 6A
95 ROUTE 6A YARMOUTH PORT. 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 9 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
°F.�...4: TOWN OF YARMOUTH
;r Board of
a ■ g Health
'1. --A- _i 1 146 ROUTE 28, SOUTH YARMOUTH,MASSACHUSETTS 02664-24451 -
MATTACHEESE=__ �.�„�,a Telephone(508)398-2231,ext. 1241 Health
Fax(508)760-3472 Division
APPLICATION FOR OPERATION-2023
POULTRY
PLEASE COMPLETE ALL QUESTIONS ,
E-MAIL j t..S 5Z. k o p i cave i ma;I. W r n
NAME J.;s— [±MM 3 0 1' I Pr\ HOME TEL.NO. 7 7—i - el c) `-1 - 3 19 I
LOCATION ADDRESS R 5 k o v.-l-e (0,6( y a.r rno.+h. P o r--
MAILING ADDRESS(IF DIFFERENT)
NUMBER OF FOWL Y0 NUMBER OF PENS/COOPS I NUMBER OF ROOSTERS O
PLEASE NOTE: PLEASE DO NOT INCREASE THE NUMBER OF FOWL
WITHOUT PRIOR PERMISSION OF THE HEALTH DEPARTMENT.
TYPE OF SHELTER V\!o 0 C\ SIZE OF YARD/PEN AREA a 1 Pro X 100 Sca P4.
(WOOD,CONCRETE,ETC.)
NUMBER OF WATER OUTLETS 1.- WATER TROUGHS 1
TYPE OF STORAGE FACILITY USED FOR FEED/GRAIN 'emu 10
TYPE OF FACILITY USED FOR MANURE STORAGE C c m F o S f"
METHOD OF DISPOSAL OF MANURE O o:ne.o s'f' HOW OFTEN O F+en
PEN AREA ENCLOSED BY WHAT TYPE OF FENCING? cki c4e-' IAA(€-
✓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
4_SIGNATURE ;`4 DATE
THE FULL POOUL Y CO 'T 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 DUE: $ '0
12/30/19 APR 0 7 2023
HEALTH DEPT.