HomeMy WebLinkAboutPOULTRY APPLICATION & LICENSE - 2001U
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BOARD OF
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APPLICATION FOR OPERATION - 2OOI
POULTRY
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MAILING ADDRESS (IF DIFFERENT)
PLEASE COMPLETE ALL OUESTIONS
NAME C-A|AL es 7tL.7t KtA^)
ADDRESS A8 n)l /.t*c y ll..no'lfx?o,-i Hn oztl)
NUMBER OF FOW s NUMBER OF PENS/COOPS 3 NUMBER OF ROOSTERS /
TYPE OF SHELTER ooJ
NUMBER OF WATER OUTLETS L WATER TROUGHS
TYPE OF STORACE FACILIry USED FOR FEED/CRAIN ,4 4-l, /
METHOD OF DISPOSA L OF MANURE Caa 65;e/o59 gtTt
OTHER FARM ANIMALS MATNTAINED AT PREMISES (please indicate numbers)
TYPE OF FACILIry USED FOR MANURE STORAGE-
HOW OFTEN
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Df{ 2 6 2000
REOE I VED
THDEPT.
PEN AREA ENCLOSED BY WHAT TYPE OF FENCING? 2/CE
-
lrw APPLICA r loN -
DATE OF MOST RECENT INSPECTION OF PREMISES-
/ RENEWAL
INSPECTED BY
ri Ndw AaPLiLnTiOh. iLEASE ATfAcil A COPI'OF PLOT FL."ii SiiJin iiic i,OT
LINES AND LOCATION OF STABLE, PEN, ETC., AND ALL ENCLOSURIS. ALSO' A
WRITTEN LITTER OR STATIMENT, SIGNED BY ALL ABUTTERS TO PROPERTY'
Town of Yarmouth taxes and liens must be paid Ptior to renewal or issuance ofyour permits
Please check appropriately ifpaid: Yes u/ No-
SIGNATURE tAeTA ('/DATE a
THE FULL POULTRY COUNT IS NOT TO EXCEED THE AMOUNT OF PRIOR YEAR'S TOTAL.
FEES:POULTRY
ROOSTER
TOT
s25.00
(NOTE: SPECIAL APPROVAL REQUIRED FOR ROOSTERS)
1l/00
AL DUE: S -L5, D O
2da
Lrl Pri ted on
Recycled
Paper
TOWN OF YARMOU
HoMErEL.No.36L tl; 003
stzE oF YARD/PEN AREA 3ol30
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TIIE COMMONWEALTH OF' MASSACHUSETTS
TOWNOFYARMOUTH
BOARD OF HEALTII
PERMITNUMBER: #01-002 FEE: $25.00
This is to Ceniry that Charles Bilezikian
88 Mill Lane- Y nort. MA
IS HEREBY GRANTED A LICENSE
FoT POULTRY LICENSE: ALLOWED TO HAVE 25 CHICI(ENS AT ABOVE ADDRESS.
I,AWS .CHAPTRR II1-ONS I55AND31.
POST LICENSE ON PRE,MISES.
This permit is granted in conformity with Article YI of the Sanitary_Code of The Commonwealth of Massachusefts, and
expires December 3l - 2001 unless sooner suspended or revoked.
21 , 2001 BOARD OF TIEALTH:
elarut 4rt
.?/C.D.
Bruce G. Mu.phy, MPH, R.S., CHO
Director of Health
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