HomeMy WebLinkAboutApplication+
�-l�-aa�B��S� ��-f�?-�a-
� °� � TOWN OF YARMOUTH ��Bo�d_of_
� � e - , `���h
;.:
= 1146 ROUTE 28, SOUTH YARMOUTH,MASSACHLTSETTS 0266 24451 -
��4rb„Eo
Telephone(508)398-2231, ext. 1241 JAN U����'
1V1S1(1T1
F�(508) 760-3472
�'wr!�;� �:'�T
APPLICATION FOR OPERATION-2017 . ��t�q�
STABLE
PLEASE COMPLETE ALL UESTIONS E-MAIL �,�r�Q%�e�H'� .,,. itm—
NAlOIE w , , ` y� HOME TEL.NO. �"�'��`���l
STABLE ADDRESS �� � � " �/V4- �:�'Z� s�� -�3Z�'7'3
MAILING ADDRESS(IF DIFFERENT) L�� -' '
EMERGENCY CONTACT(NAME/PHONE#L.!i�..oaZ G���i� ,��ST` ��`'�v 7� 3
w
VETERINARIAN(NAME/PHONE#) ,��+d� ` ��*-►—' �I��� `�` ��' ����
TOTAL NUMBER OF HORSES/PONIES—��"� /TOTAL NUMBER OF STALLS—��—���0� �''�'�"'
PLEASE NOTE: PLEASE DO NOT INCREASE THE NUMBER OF ANIMALS
WITHOUT PRIOR PERMISSION OF THE HEALTH DEPARTMENT.
PLEASE LIST EACH HORSE/PONY/DONKEY/COW SEPARATELY:
ANIMAL NAME IF APPLICABLE
BREED
#YEARS OWNED
COLOR
SEX
DATE OF RABIES VACCINATION
DATE OF EEE VACCINATION
DATE OF OTHER VACCINATIONS
TYPE OF STABLE/SHELTER ��i�� SIZE OF CORRAL AREA
(WOOD, CRE E,ETC.)
NUMBER OF HOSE BIB WATER OUTLETS DRAINS WATER TROUGHS
TYPE OF STORAGE FACILITY USED FOR FEED/GRAIN (/�t,�t�(.'2 `—"
TYPE OF FACILITY USED FOR MANURE STORAGE \���j'ti�-✓��'1
METHOD OF MANURE DISPOSAL �.�yt�'�',C�a2. FREQUENCY � �
CORRAL/PEN AREA ENCLOSED BY WHAT TYPE OF FENCING? v�t
OTHER FARM ANIMALS MAINTAINED AT PREMISES? YES NO
(PLEAS OTE: POULTRY, SWINE, SHEEP, CATTLE, GOATS REQUIRE SEPARATE LICENSURE.)
RENEWAL
NEW APPLICATION- IF NEW APPLICATION, PLEASE ATTACH A COPY OF PLOT PLAN SHOWING LOT
LINES AND LOCATION OF STABLE, PEN, ETC., AND ALL ENCLOSURES. ALSO, A
WRITTEN LETTER OR STATEMENT,SIGNED BY ALL ABUTTERS TO PROPERTY.
Town of Yannouth taxes and liens must be pai or to renewal or issuance of your permits.
Please check appropriat ' paid: Yes No
SIGNATURE DATE� ` � � ��_
FEES: ST BLE& 1 RSE $30.00(+$5.00 each additional horse/animal) TOTAL DUE:$ 60,��
IZ/12/16 Q�C� O�,t �g�� .
Z7�.R) �rv