HomeMy WebLinkAboutPOULTRY APPLICATION & LICENSE - 2006C]
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TOWN OF YARMOUTH E?b.
1I46 ROUTE 28 SOUTI{ YARMOUTH IUASsACI IUSETI. S 026644451
Telephone (508) 398-2231, Ext. 241' - 'liax (50SJ 760 3472
BoARD oF Hrrirn
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APPLICATION FOR OPERATION - 2006
POULTRY
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.5f,'a-fi03Ner,o fl o..leJ 611"r, L o-IJOME TEI- NO
I,OCATION ADDRESS (hrll La',l Pf .}rlJ
NUMBER OF FOWL J5 NUIIBER OII PENSiCOOPS 3
MAILTNC ADDRESS (tr DIFFERE}.IT)
TYPE OF SI IEt,l'ER
(wooD, coNCRxTE, rTC.)
NUMBER oli wATERourLETS J
TYPE OF STORAGE FACILITY USED !-OR FEED/GRAIN
TYPE OF FACILITY USED FOR MANURE STORAGE
M,IMBER OF ROOSTERS
SZE OF YARI)/PEN AREA lyS - 3,qovc)
WATER TROI]GHS J
cr
METHoD oF DrsposAt- o!- MANTTRE Da r lv &ir-,HowoFTEN ,\r lvT
SED BY WIIAT TYPE OI- I'I]NCING??usl + Bai I , /rlP,rA nii" l/r,d,PEN AREA ENCI-O
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I
NLW AI'}'I,ICATION.IF NEW APPLICATION, PLEASE AMACH A COPY OF PLOT PLAI\ SHOWING TI)T
LIltf,S AIID I-TOCATION Of STABLE, PEN, f,TC., AI{D ALL ENCII}SIJRES. ALSO, A
WRITTEN LETTER OR STATEMENT, SIGI'ED BY ALL ABUTTERS TO PROPERTY.
To*n of Yarmouth taxes and liens must b" pr/prio, to *,"wa I or issuance of your permits.
Please check appropriately ifpaid: YesV No_
IiIGNATT]RE
FEES:
-POULTRY
-
ROOSTER
TOTALDUE: S 35.OO
DATE I*D
TIIE FULL POULTRY COUNT IS NOT EXCEED THE AMOUNT OF PRIOR YEAR'S TOTAL
$25.00
(NOTE: SPECIAL APPROVAL REQUIRED FOR ROOSTERS)
tr/04
Lfl Printed on
Recycled
Paper
PLEASE COMPLETE ALL OUESTIONS
THE COMMONWEALTH OF MASSACHUSETTS
TOWN OFYARMOUTH
BOARD OF IIEALTH
PERMIT NUMBER: #06-004 FEE: $25.00
This is to Certify that Charles Bilezikian
88 Mill Lane- Yarmouthoort. MA
IS IJER.EBY GRANTED A LICENSE
GRANTED IN AC RDANCE WITH PROVISIONS OF MASSA ]SETTS GENERAL
I,AWS - CHAPTER 1 1 1 - SECTIONS 155 AND 3I .
PLEASE POST LICENSE ON PREMISES.
'ltris.Sanitary C.ode of The Commonwealti of Massachusens, andor revoKeG.
Jaluary 13. 2006 ROARD oF I{IIAI,TH
R
Bruce G
Dirc.ctor
MPH, R.S., CHOof
For POULTRY LICENSE. ALLOWED TO IIAVE 25 CHICKENS AT ABOVE ADDRESS.
S.\fr\e Aom:rrontuwllIl d Sazzwlpillx
DEPARTMENT OF AGRICULTURAL RESOURCES
b \\
BUREAU OF ANIMAL HEALTH
INSPECTOR'S COPV *..ir-i\"r'.-r' - N\ \'. r'--
(Orvner's Name)(Farm Name)
l
(To!vn) (ap code)
Dealer: Yes !
1. Cattle (Adult = 2 years & over)
Dairy
Beef
Steers / Oxen
2. Goats (Adult = 1 year & over)
3. Sheep (Adult = 1 year & over)
4. Swine: Breeders
[eeders
5. Llamas ,/ Alpacas
6. Equines: Horses / Ponies
Donkeys ,/ Mules
(Phone number)
Young
Stable use:
7. Poultry
Private Boarding_
chickens L}-.)1-
Ratites (Ostrich, Emu)_ Waterfowl Gamebirds_
8. Rabbitsq. other -\--\1-:l-l-' ,
10. Do animals listed appear to be fr6e from contagious disease?-
11. fue accommodations adequate with reference to , cleanliness,
ventilation and water supply? (explain briefl
I hereby certify that I have this day
conditions under which are
and the
I:L
of
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