HomeMy WebLinkAboutPOULTRY APPLICATION & LICENSE - 2005o
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So;'oo1To\UrN OF YARMouriE
N 072005
1146 ROI]TE 28 SOUTH YARMOUTH
Telephone (508) J9tl 2231. Ext. 241
MASSACT rsI11TS o26d1 ,i,ii 1
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BOARD OF HEALTH M
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APPLICATION FOR OPtrRA'I'ION - 2OO5
POULTRY
NAME kro.HOME TEI-, NO %&- 36a -t)83
IF NEW APPIJCATION, PLEASE ATTACH A COPY OF PLOT PI,AN SHOWING LOT
LII{ES A}ID LOCATION OF STABLE, PEN, ETC., AND ALL ENCLOSURf,S. AISO, A
WRII'TEN LETTER OR STATEMENT, SIGIIED BY ALL ABUT'TERS TO PROPERTY.
r
MAILTNC ADDRESS (tr DIFFERENI)
LocATToNADDRESS )t O itt L^n< Yn" ,',.*f!,.r,* .rnf.. olt t!
NI]MBEROFFOWL 05 NUMBER OF PENS/COOPS NLIMBER OII ROOSTERS
,TYPE O}' SHELTEIi Wo"J SZE OF YARD/PEN AREA
(wooD, coNCREI'E, ETC.)
.I'YPE OF STORAGI] FACILITY USED FOR FEED/GR ]N
TYPE OF FACILITY USED FOR MANURE STORAGE
METHoD oF DrsPosAL oF MANLTRE B ( I -uoworren D^11.,
PEN AREA ENCLOSED BY WI]A'I' I'YPE OF FENCING??"cl + Qi,l eiec t!r(t
RENEWAL
NEW APPI,ICATION -
'l'ou,n of Yarmouth taxes and liens must be p
Please check appropriately ifpaid: Yes 11/nrior
to renewal or issuance of your permits
SI(iNATURE DATE I L b
TIIE FULL POULTRY COUNT IS NOT TO CEED TIIE AMOUNT OF PRIOR YEAR'S TOTAL
FEES:
TOTAL DUE: $
,.5 POULTRY
ROOSTER
$25.00
(NOTE: SPECTAL APPROVAL REQUIRED FOR ROOSTERS)b*
Pdflted on
Recycled
Paper
11/04
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PLEASE COMPLETE ALL OUESTIONS
NTTMBER oF wATEn ourrers I wATER TRoucHS a,
THE COMMOIYWEALTII OF MASSACHUSETTS
TOWNOFYARMOUTH
BOARD OF HEALTH
This is to Certify that Charles Bilezikian
88 Mill Lane- Yarmouthoort- MA
IS HEREBY GRANTED A LICENSE
For POULTRYLICENSE: ALLOWED TO 25 CHICKENS AT ABOVE ADDRESS.
GRANTED IN ACCORDANCE WITH PR VISIONS OF MASSACHUSETTS GENERAL
LAWS - CHAPTER I I I - SECTIONS I55 3t.
PLEASE POST LICENSE ON PREMISEs.
This permitfs graated lB cqqhprty,with Article VI of thq Sanilary C,ode of Ttre Commonweal[r of Massachusetts, andexpfes ____!29eglL09L!L!,Z.qUL ui ess sooncr suspeDded or revoked.
Januarv 13, 2005 BOARDOFHEALTH: BI 5.,irf.
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Jldea R
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of Hial0i R.S., CHODtector
PERMIT NUMBER: #05-007 FEE: $25.00