HomeMy WebLinkAboutPOULTRY APPLICATION & LICENSE - 2002o
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TO\TN OF YARMOUTH
I IJ6 ROLITE 28 SOLITH YAR]\IOI.]TH
Telephone (508) 39A-2231. Exr. 211
MASSACHUSEfiS 0266{-.l.Ii I
- Fax (508) 398-2J6i
rtZql )J; oo APPLICATION FOR OPERATION - 2OO2
POULTRY
PLEASE COMPLETE ALL OUESTIONS
t/,ltfram (B,"ezrcr+u s)
HoME rEL. No. fl7l$ A"LQ I f3NAME
ADDRESS VZ r/,// /srtz il, ?a.*rl @63f
MAILING ADDRESS (IF DIFFERENT)Jat u\,5ou @Lb
TYPE OF SFIELTER
NUMBER OF WATER OUTLETS c? WATER TROUCHS -s'
TYPE OF STORAGE FACILITY USED FOR FEED/CRA
]YPE OF FACILIry USED FOR MANURE STORAGE
IN /
/- ,"
METHOD OF DISPOSAL OF MANURE
OTHER FARM ANTMALS MAINTAINED AT PREMISES (please indicate numbers)
HOW OF|EN
PEN AREA ENCLOSED BY WHAT TYPE OF FENCING?
DATE OF MOST RECENT INSPECTION OF PREMISES
/l
-t/u***NEW APPLICATION .
INSPECTED BY
TF NEW APPLICATION, PLEASE ATTACH A COPY OF PLOT PLAN SHOWING LOT
LINES AND LOCATION OF STABLE, PEN, ETC., A]\D ALL ENCLOSURES. ALSO, A
WRTTTEN LETTER OR S'TA'I'EMENT, SIGNED BY ALL ABU TERS TO PROPERTY.
Town of Yarmouth taxes and liens must be paid prior to renewal or issuance ofyour permits
Please check appropriately ifpaid: Yes ,z/ No_
SICNATURE P^* KJ r-DATET
THE FULL P0ULTRY couxr ts ruor t
FEES:
TOTAL DUE: $
l0/01
,,4ou,,*,
ROOSTER
O EXCEED THE AMOUNT OF PRIOR YEAR'S TOTAL
s25.00
(NOTE: SPECIAI APPROVAI REQUIRED FOR ROOSTERS)
Printed on
Recycled
Paper
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R
li-R t!..0 iE ! i/ E ID II nrcr42oor I
| ,rorr* o.rr. I
BOARD OF HEALTH
NUMBER oF Fowt--Jf- NuMBER oF PENslcoops J NUMBER oF RoosrERS -a-
/, ln ", ,./stzE oF YARD/PEU eR-eA .'ld X.i o- (wooD, coNcRETE, ETC.)
/4",/,
THE COMMONWEALTH OF MASSACHUSETTS
TOwl\{OTYARMOUTH
BOARD OF HEALTH
PERMITNUMBER: #01-002 FEE: $25.00
This is to Certi!Chqrlec &Rileziki d/h/a lrlill FatTn
88 ill Lane. Y MA
IS HEREBY GRANTED A LICENSE
For
This permit is granted in conformity with
expires December 3l .2002 unless
Article VI ofthe Sanitary Code ofThe Commonwealth of Massachusetts,and
soorer suspended or revoked.
Februa{Y 7 2002 ?/arta?. Kdlila, t!4ao',,,4,.
Eu*rrrt oD. 60,1r,r, 7rl'O, , ?teRlot?. ai,*. eu*?at*ihltDot*aSlal. P.?r.
H, R.S., CHO
Director of
155 31.
BOARD OF HEALTH: