HomeMy WebLinkAboutBOPL-24-10 20240 Y'�R
0�( \ o The Commonwealth of Massachusetts
l Town of Yarmouth, MA
Poultry License
Permit No. BOPL-24-10 Issue Date: January 1, 2024
plicant's Mailing Address: Location Address:
lly Holman 20 NICK-EM WAY
West Great Western Road YARMOUTH PORT, MA 02675
uth Yarmouth, MA 02664
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.
to have up to nine (9) chickens.
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
No roosters.
James G. Gardi
Heafth rector
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
POULTRY
PLEASE COMPLETE ALL QUESTIONS
NAME � Q J
LOCATION ADDRES
MAILING ADDRESS (1F
�niA/'\
E-MAIL�� �CS
HOME TEL. NO.,; c3 %
NUMBER OF FOWL NUMBER OF PENS/COOPS NUMBER OF ROOSTERS
PLEASE NOTE: PLEASE DO NOT INCREASE THE NUMBER OF FOWL
WITHOUT PRIOR PERMISSIO OF THE HEALTH DEPARTMENT.
TYPE OF SHELTER 1 ��
�`-' SIZE OF YARD/PEN AREA
(WOOD, CONCRETE, ETC.)
NUMBER OF WATER OUTLETS WATER TROUGHS
TYPE OF STORAGE FACILITY USED FOR FEED/GRAIN vk
TYPE OF FACILITY USED FOR MANURE STORAGE
METHOD OF DISPOSAL OF MANURE
PEN AREA ENCLOSED BY WHAT TYPE OF FENCING? C,
HOW OFTEN
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 pai rior to renewal or issuance of your permits.
Please check appropriately if paid: Yes No
r- \
SIGNATURE
THE FULL 7POU15r
RY
Cti ('- —
DATE pl
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: S
12/30/19