HomeMy WebLinkAbout2020 App - License never approved The Commonwealth of Massachusetts Fee
Town of Yarmouth $40.00
Poultry License
Number: BOHP-21-3786 Issue Date: 6/1/2020
Mailing Address: Location Address:
LUCAN COLQUHOUN 12 ALIJO DR
12 ALIJO DR WEST YARMOUTH. MA 02673
WEST YARMOUTH, MA 02673
IS HEREBY GRANTED A 2020 LICENSE
This license is granted in conformity with the statutes and ordinances relating thereto,
and expires December 31, 2020 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
Bruce G. Murphy, MPH, R.S., CHO/Mallory R. Langler, R.S.
Health Director/Assistant Health Director
N)CQ`ki( S"\TekA ‘tt
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c rq==_ TOWN OF YARMOUTH Board of
Health
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=ACMa.1EESE 1146 ROUTE 28, SOUTH YARMOUTH,MASSACHUSETTS 02664-24451 Health
_ ..... Telephone(508)398-2231, ext. 1241
Fax(508)760-3472 Division
APPLICATION FOR OPERATION-202Q
POULTRY —
PLEASE COMPLETE ALL QUESTIONS
E-MAIL
NAME LCdpHOME TEL.NO.
LOCATION ADDRESS t Z A U,1 D lor1✓L i) Xt . 4-- tn,67-3
MAILING ADDRESS(IF DIFFERENT)V
NUMBER OF FOWL 10 NUMBER OF PENS/COOPS I NUMBER OF ROOSTERS
PLEASE NOTE: PLEASE DO NOT INCREASE THE NUMBER OF FOWL
WITHOUT PRIOR PERMISSION OF THE HEALTH DEPARTMENT.
TYPE OF SHELTER wa°d rl_>ct'L SIZE OF YARD/PEN AREA D- S AC
(WOOD,CONCRETE,ETC.)
NUMBER OF WATER OUTLETS Z- WATER TROUGHS C
TYPE OF STORAGE FACILITY USED FOR FEED/GRAIN //4e-3-4 pl yV wz bd
TYPE OF FACILITY USED FOR MANURE STORAGE 1sl- LASe4 0-
METHOD OF DISPOSAL OF MANURE c/t. ( ail Fw) HOW OFTEN
PEN AREA ENCLOSED BY WHAT TYPE OF FENCING? L,/•'�
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 i No
SIGNATURE DATE (2S/2D?.,.(
THE FULL POULTR COUNT IS NOT TO EXCEED THE AMOUNT OF PRIOR YEAR'S TOTAL.II
FEES: POULTRY: 10 1-9or chickenmoreCshickens was
ROOSTER (NOTE: SPECIAL APPROVAL REQUIRED FOR ROOSTERS)
NO ROOSTER
TOTAL DUE: $ 41)
12/30/19 JUN 0 1 2021
HEALTH DEPT.