HomeMy WebLinkAbout2021 App - License The Commonwealth of Massachusetts Fee
Town of Yarmouth $40.00
Poultry License
Number: BOHP-21-3786-01 Issue Date: 6/1/2021
Mailing Address: Location Address:
LUCAN COLQUHOUN 12 ALIJO DR
12 ALIJO DR WEST YARMOUTH. MA 02673
WEST YARMOUTH, MA 02673
IS HEREBY GRANTED A 2021 LICENSE
This license is granted in conformity with the statutes and ordinances relating thereto,
and expires December 31, 2021 unless sooner suspended or revoked and is not
transferable.
Board Hillard Boskey, M.D.,Chairman
Mary Craig, Vice Chairman
of Charles T. Holway, Clerk
Debra Bruinooge
Health Eric Weston
ce G. Murphy, MPH, R.S., CHO/Mallory R. Langler, R.S.
sistant Health Director ��
F„- TOWN OF YARMOUTH
, .r ,'9 _ Board of
Health
t~ = 1146 ROUTE 28, SOUTH YARMOUTH,MASSACHUSETTS 02664-24451 -
YATTACMEESE Health
„a wr Telephone(508)398-2231,ext. 1241
r,.
Division
Fax(508)760-3472
APPLICATION FOR OPERATION -2021
POULTRY
PLEASE COMPLETE ALL QUESTIONS
E-MAI elotiNa 1Glf. Ctu . Cat
NAME LULtAal C641,44coul HOME TEL.NO. So9 360 s-oevc
LOCATION ADDRESS Mit/ �r1✓� \)IGet X AM— MO 13
MAILING ADDRESS(IF DIFFERENT)
NUMBER OF FOWL afar?0 NUMBER OF PENS/COOPS NUMBER OF ROOSTERS 42810.10 G+` Ci-r✓
PLEASE NOTE: PLEASE DO NOT INCREASE THE NUMBER OF FOWL
WITHOUT PRIOR PERMISSION OF THE HEALTH DEPARTMENT.
TYPE OF SHELTER SIZE OF YARD/PEN AREA 0.52. AC%e5S 'T
610,CONCRETE,ETC.)
NUMBER OF WATER OUTLETS 5 WATER TROUGHS 3
TYPE OF STORAGE FACILITY USED FOR FEED/GRAIN /14eird bA t
TYPE OF FACILITY USED FOR MANURE STORAGE (o($J aA Awl &tone Al 'I thva4 eArYed
METHOD OF DISPOSAL OF MANURE 1A 4 01 1"1"yvl HOW OFTEN
PEN AREA ENCLOSED BY WHAT TYPE OF FENCING?
V RENEWAL
VNEW 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 DATE ll12 02(
THE FULL POULTRY COUNT IS NOT TO EXCEED THE AMOUNT OF PRIOR YEAR'S TOTAL.
FEES: POULTRY: 1-910or chickenmoreChickens 40.00s $30.00
ROOSTER (NOTE: SPECIAL APPROVAL REQUIRED FOR ROOSTERS)
NO ROOSTER
TOTAL DUE: $ g�
-. LSID
12/30/19 JUN 01 2021
HEALTH DEPT.
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