HomeMy WebLinkAboutApplication( � � �cS-ooI go�4 ��-�s�z� -- ;
� °� r TOWN OF YARMOUT r��L��13���
�' � Health
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1146 ROUTE 28, SOUTH YARMOUTH,MASSACHiJSETTS 02664-2 45 _..r'��-�.u---�--�--
�� Telephone(508)398-2231,ext. 1241
l�ivici�n
i Faac(508)760-3472
� APPLICATION FOR OPERATION-2015 ��I���
SHEEP/GOATS FEE: 1-8 animals $30.00
9 or more animals .
_Renewal
PLEASE COMPLETE ALL QUESTIONS New Application
E-��c�✓t-�ire cl / c�.�tc�..��-. ne�
NAME (' I�r- ���-f �(�M HOME TEL.NO.sG� ��3£35-y�7
� 2� n ,I � y `� �� 1
ADDRESS �G� IJ�G�G�.�'�61 KC�'. �l./, �1�vVl c�UT'� �UI l M� 6���
MAILING ADDRESS(IF DIFFERENT) P�� � ���C ��' q �
l�aii��11 Y1 /� C1Yi 1'� �G'f�'`� �"l lj�'' y _ _
EMERGENCY CONTACT(NAME/PHONE#) Sl�B-?�37- a-7C�� Gl SGrr - Z-�f^C%�6�
VETERINARIAN(NAME/PHONE#) ,��Cr�?yj�PSC�.�/ ��'- iG�L-,3b 4�
TOTAL NUMBER OF ANIMALS /
PLEASE NOTE: PLEASE DO NOT INCREASE THE NUMBER OF ANIMALS
WITHOUT PRIOR PERMISSION OF THE HEALTH DEPARTMENT.
PLEASE LIST EACH SWINE/SHEEP/GOAT SEPARATELY:
A1�tIMAL NAME(IF APPLICABLE) vS ��?5�-
BREED /�:[16 c ''v b� u-/�
#YEARS OWNED �. y
COLOR b,-�� �
SEX �.t M F
DATE OF RABIES VACCINATION M �i - +� �
DATE OF EEE VACCINATION
DATE OF OTHER VACCINATIONS
TYPE OF STABLE/SHELTER CcibGY�c`� CD�'I�!'�r�' SIZE OF CORRAL AREA 3 0 �C 3� ��'t.-s��
TYPE OF STORAGE FACILITY USED FOR FE D/GRAIN �7C�.t/�('�'1 � �i��-I�94.�[il 1 ZGc�" D�1'��I
TYPE OF FACILITY USED FOR MANURE STORAGE Ct�i'V1 C 0 St
METHOD OF DISPOSAL OF MANURE 4(_"r.(' /Gv1�('S �Gt,�� HOW OFTEN �<'1 ��Ci�G1�
IS CORRAL/PEN AREA ENCLOSED BY FENCING? YES�NO TYPE OF FENCING �1 ��.
OTHER FARM ATiIMALS MAINTAINED AT PREMISES? YF,�� NO
(PLEASE NOTE: POULTRY, HORSES, PONIES, DONKIES REQUIRE SEPARATE LICENSURE.)
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 ta.xes and liens must be paid prior to renewal or issuance of your permits. A , /�
Please check appropriately if paid: Yes No �`� T�
SIGNATURE � �� DATE ����� �1� � � �
11/03/15
Lynn Mclnyre 5083859407 p.1
Marilyn McIntyre
Town of YQrmouth Animal Inspec�or
103 Bray Farm Road North
Ynrmouth Port, MA 02675
�hone Q�d Fax: 508-385-9407 Cell: 508-737-0768
rA� rl'RANSvIISSI01� C()Vk:R SHEE'l,
Date: March 4, 201 S
� To: HealthDept_ Attn: ?l�faryr�lice
' Fur.• 508-760-3�72
Re: Slzeep
You s!laUld reccivc 2 p�c's; inctudirlg[fus cover s11ce1. II�vou do�,�o�receive aU o/�[hc
P�;�s, pleasc call(5�f�1385-.�1�7.
Snrrl�afiuut lllat. O
Lynn Mclnyre 5083859407 p.2
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