HomeMy WebLinkAboutPOULTRY APPLICATION & LICENSE - 1999Poourw ?4-Z
TO'W'N OF YARN,IOUTH
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RE@E OVE E
t)EC 2 8 1998
HEALTH DEPTAPPLICATION FOR OPERATION - 1999
POULTRY
PLEASE COMPLETE ,\LL OTIESTIONS
ADDRI]SS t|ill t-^NE '/nPnov'th PoRT 626158B
MAILING ADDRESS (I[- DIFFERENT)-
NIJMBIJR OF FOWL
.TYPE OF SIIELTER
NLIMBER OF WATER OUTLETS 3
]"YPE OF STORAGE FACU,ITY USED FOR FEED/GRAIN H ETTL
TYPE OF FACILITY I]SED FOR MANURE STORAGE 0 bD
METHOD OF DISPO 5AL9FMANURE COHPofTEb oS9 s rTE
OTI IER FARM ANIIVL{LS IUr{INTAINED AT PREMISES (pleasc indicate trumbers)
30 NurvrBER oF pENslcoops 3 NUMBER oF RoosrERs d
l/lJoO Blt R lt SIZT OF YARD,PI]N ARLA 2dx 4D'
WATER TROUGI IS d
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:;low orreN Dilt /
eP(oA7
oN(Ey(t)D
PEN AREA ENCLOSED B'\' WI{AT TYPE OF FENCING?o /ccTr?.(-
DATE OF MOST RECENT INSPECTION OF PREMSES-INSPECTED BY-..........=..--
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-
^lEw aijp*r_tcATloN - IF NEw AppLIcATIoN, pLEAsE ATTAcH A coPY oF PLor PI-AN sHowING Lor
iltss AND '-oceneli cr srAsLE. PrI: :TC.. A:'lE ALL rl:alcsulJg' "'lsc, "'WNTTTTX UTTER OR STATEMENT, SIGhS']D BY ALL ABUTfERS TO PROPERTY.
Town of Yarmouth tares a:rd liens must be paid ;xror to renewal or issuanoe ofyour pennits
Please check appropnatelr ifpaid: Yes y' No-
DATESIGNATURE
FEES;ay/ro*r*',
ROOSTER
$25.00
(NOTE: SPECIAL APPROVAL REQTIIRED FOR ROOSTERS)
TOT ALDUE:s25'oo
r l/98 LA
Prinred on
Reqvcled
Papcr
'1..-",,:
Narc Ch*erES EtLf 2l ]Zt A rJ ttowrr;- No 362- 67t3
THEFULLPoULTRYcoUNTIsNoTToEXCEEDTHEAMoUNToFPBIoRYEAR,SToTAL
TH E COMMONWEALTH OF MASSACH USE'I-I.STOWN OF YARMOUTH
PERMIT NUMBER: 99-2
BOARD OF HEALTH
FEE: $25.00
This is kr Certili
IS IIERf,BY GRANTED A LICENSE
For
This permit is gatrled h cotrformit'| $ithexp[es December 3l .1999 urless
Article VI of the Sanitary(ode of The Commonwealth ofMassachusetts, andsooner suspeuded or rwoked.
i'ebruary,25 I9_99 BoARDoFtrEALrH:
ff#.#lfi6ni u,. ct ",.,,*,
fuit(td,kktH**,
Brucc G. Murphr'. MPH, R.S . CHODircctor of Hcalth
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