HomeMy WebLinkAboutBOPL-24-2°f YAZ The Commonwealth of Massachusetts
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Town of Yarmouth, MA
Poultry License
Permit No. BOPL-24-2 Issue Date: January 1, 2024
Applicant's Mailing Address: Location Address:
Carole Emerson 15 HIGGINS CROWELL RD
15 Higgins Crowell Road WEST YARMOUTH, MA 02673
West Yarmouth, MA 02673
IS HEREBY GRANTED A 2024 LICENSE
is license is granted in conformity with the statutes and ordinances relating thereto, and
Aires December 31, 2024 unless sooner suspended or revoked and is not transferable.
No Roosters
Post License on Premises
Board Hillard Boskey, M.D„ Chairman
Mary Craig, Vice Chairman
of Charles T. Holway. Clerk
Eric Weston
Health Laurance Venezia, DVM
A,', '�,- c,,i--:-
James G. Gar 'ner
Hea ctor
TOWN OF YARMOUTH Board of
Health
1146 ROUTE 28, SOUTH YARMOUTH, MASSACHUSETTS 02664-24451 -
Telephone (508) 398-2231, ext. 1241 Health
Fax (508) 760-3472 Division
APPLICATION FOR OPERATION — 2024 h gym+APPLYONW..
POULTRY ,�t>,ma.,°,,,1e°V corn
PLEASE COMPLETE ALL OUESTIONS
E-MAIL �a %✓a
NAME i - , p/✓ HOME TEL. NO., �O '7/ (o S' / 7
LOCATION ADDRESS 3
MAILING ADDRESS (IF DIFFERENT)
NUMBER OF FOWL_�..f- _— NUMBER OF PENS/COOPS 3 NUMBER OF ROOSTERS
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
(WOOD, CONCRETE, ETC)
NUMBER OF WATER OUTLETS
TYPE OF STORAGE FACILITY USED FOR FEED/GRAIN
TYPE OF FACILITY USED FOR MANURE STORAGE
WATER TROUGHS
METHOD OF DISPOSAL OF MANURE - C _HOWOFTEN
PEN AREA ENCLOSED BY WHAT TYPE OF FENCING? Gc11.1rL
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 prior to renewal or issuance of your permits.
Please check appropriately if paid: Yes. J f No
SIGNATURE C"a--Z�_ 107 zDATE
THE FULL POULTRY COUNT IS NOT TO EXCEED THE AMOUNT OF PRIOR YEAR'S TOTAL.
FEES: 'POULTRY: 1-9 chickens 3 0 RE('e��V�i�
10 or more Chickens
_ ✓_ ROOSTER (NOTE: SPECIAL APPROVAL REQUIRED FOR ROOSTERS) �fiC,
NO ROOSTER 15 2023
TOTAL DUE: $ °HEAL1 H DEpr
12/30;19
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