Fillable Worcester Police Department Worcester, Massachusetts Animal Control $50.00 (City of Worcester)

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Worcester Police Department Worcester, Massachusetts Animal Control $50.00 (City of Worcester)

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The Worcester Police Department Worcester, Massachusetts Animal Control $50.00 (City of Worcester) form is 2 pages long and contains:

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File type: PDF

U.S.A. forms for City of Worcester

BROWSE CITY OF WORCESTER (MA) FORMS

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$50.00 Permit Processing Fee
APPLICATION for PERMIT to EXHIBIT, RAISE, or KEEP ANIMALS or BIRDS as
DEFINED WITHIN THE CITY OF WORCESTER
1. Full name of applicant: _____________________________________________________________
2. Where were the animals purchased?___________________________________________________
3. Location where animals are to be kept: _________________________________________________
4. Owner of property where animals are to be kept:_________________________________________
5. Name and Address of owner of animals:________________________________________________
________________________________________________________________________________
6. N
umber and description of animals:___________________________________________________
7. For what purpose are the animals kept?_________________________________________________
Date of event: ______________________ (if applicable)
Description of premises where animals are proposed to be kept:
________________________________________________________________________________
8. Location of building on lot: __________________________________________________________
9. Distance of building from lot lines, in feet: N ______ S ______ E ______ W ________
10. Distance of building from dwellings, in feet: N ______ S ______ E ______ W ________
11. Type of construction: ______________________________________________________________
12. What provisions have been made for drainage?__________________________________________
13. Has a building permit been issued?____________________________________________________
14. In what zone is the building located? __________________________________________________
15. Is the building connect to a public sewer?_______________________________________________
16. Is the building fly proof and rodent proof?______________________________________________
17. What means are to be taken to dispose of refuse?_________________________________________
18. Are light and ventilation adequate? ____________________________________________________
Worcester Police Department
Worcester, Massachusetts
Animal Control
The undersigned certifies that the keeping of animals, or the conduct or operation of
the business for which the permit is requested, will not violate any law or ordinance of
the City of Worcester, or any law of the Commonwealth of Massachusetts; that the
premises and establishment where animals are to be kept is maintained in a clean and
sanitary condition; that the applicant has not had a permit revoked within one (1) year
prior to this application:
___________________________________________________________________________________
Name Address
This consent need not be filled in here if the applicant owns the premises; and as owner
of the premises offers no objection to keeping animals or birds.
State whether owner or occupant: __________________________________________.
Signed: ___________________________________________________________________________
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Worcester Police Department Worcester, Massachusetts Animal Control $50.00 (City of Worcester)

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Completed 19 January 2021

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