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� � TOWN OF YARMOUTH �.,._
�s � Board of
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= 1146 ROUTE 28, SOUTH YARMOUTH, MASSACHUSETTS 02664- 4451 �
� M�ITTACNEESE
'"�°' Telephone(508)398-2231,ext. 1241 JAN 0����� s
FaY(508) 760-3472 �
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APPLICATION FOR OPERATION-2017 ;� . : �21�� ';
STABLE
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PLEASE COMPLETE ALL OUESTIONS E-MAIL
NAME �S i�I��� �. „�,fN S'a.-✓ HOME TEL.NO.�d� .3-�T ��'P �L
� STABLE ADDRESS ���? �s����.��Gsc->✓� r�-���� �rr�3���L�c�c�ou� ,, �
MAILING ADDRESS(IF DIFFERENT)
EMERGENCY CONTACT(NAME/PHONE#)
VETERINARIAN(NP.ME/PHONE#) .�p � ,���"� � �G
TOTAL NUMBER OF HORSES/PONIES_� TOTAL NUMBER OF STALLS y!-�n �/�u�
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 �'»o yI�C C��
BREED y
' #YEARS OWNED ��
COLOR � i�'i�
SEX �2.�►0.�� ti .�it� �L
DATE OF RABIES VACCINATION :�—/' i� s-/i /��
DATE OF EEE VACCINATION �r -�
DATE OF OTHER VACCINATIONS �� i
TYPE OF STABLE/SHELTER W�.:��/ .�.�'�-z SIZE OF CORRAL AREA ,'��17,/��Ns,t.o_L!d fj--L�
(WO CONCRETE,ETC.)
NUMBER OF HOSE BIB WATER OUTLETS J DRAINS_��4�--i WATER TROUGHS �`r,!�1�Z-�-S'
TYPE OF STORAGE FACILITY USED FOR FEED/GRAIN d�,�ac���G S -- 'T�i��s��
TYPE OF FACILITY USED FOR MANURE STORAGE r`�J' ��
METHOD OF MANURE DISPOSAL�A���,�rs.�T ,+��se�t h'�S FREQUENCY �U�-rU�r;�,s,:.�
CORRAL/PEN AREA ENCLOSED BY WHAT TYPE OF FENCING? W��n �' �L�-��`�-� -a
OTHER FARM ANIMALS MAINTAINED AT PREMISES? YES NO i�
(PLEASE NOTE: 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 paidp�w r to renewal or issuance of your permits.
Please check appropriately if paid: Yes t/ No
SIGNATURE � DATE f'o�-/�G�/G
FEES: STABLE& 1 HOR 30.00(+$5.00 each additional horse/animal) TOTAL DUE:$ 6�.Q Q
12/12/16
uP T� '� �S� p�Zo�c� ypp.