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� ` TOWN OF ARMOUTH Boazdof
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a = 1146 ROUTE 28, SOUTH YARMOUTH,MASSACHUSETTS �J266�=�#��i- -
1 �a Telephone(508)398-2231,ext. 1241 + Hea h
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� Fax(508) 760-3472 �
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� APPLICATION FOR OPERATION -2015 "�
STABLE
PLEASE COMPLETE ALL OUESTIONS E-MAIL NIG l►')�� �(�Cut'YiCGi 5� , �?�'
NAME��r-'� 8/�Qr./ f"GY.T� HOME TEL.NO, -�35 —g¢d7
STABLE ADDRESS !U� ��'�ZU �Q.('M ._ �, . UGt,!'i(�1 !.�v��O I"'� v�o-?S
MAILING ADDRESS(IF DIFFERENT) Y f�. �t"ix la�
�( n�c--� c�r i�c-r /1�Ur-fIr��u-��"
EMERGENCY CONTACT(NAME/PHONE#) Do h X �-�-f'nn r �� �Ln�rl�e ���-737�G7�� �'c�- 258�oL/���
VETERINARIAN(NAME/PHONE#) / /[G�`1 d1G� C�SC�-I- �a�5'— 3!o Z - ��o`-�Co�
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TOTAL NUMBER OF HORSES/PONIES� TOTAL NUMBER OF STALLS 2 �n5
PLEASE NOTE: PLEASE DO NOT INCREASE THE NUMBER OF ANIMALS
I
WITHOUT PRIOR PERMISSION OF THE HEALTH DEPARTMENT.
PLEASE LIST EACH HORSE/PONY/DONKEY/COW SEPARATELY:
ANIMAL NAME IF APPLICABLE .Scv - o �.
BREED cc-I'. , 5 c=.� I�tr• v� o v�
#YEARS OWNED 2 2 rj '7 ') rs
COLOR k �v ^ r� �
SEX
DATE OF RABIES VACCINATION �'!¢ i ' 1 `
DATE OF EEE VACCINATION k « K � ,.�i
DATE OF OTHER VACCINATIONS �`
��r:v� .y t.'..0 :
TYPE OF STABLE/SHELTER Gci a�cI SIZE OF CORRAL AREA�Io_��s 2o x�
(WOOD,CONCRETE,ETC.)
NUMBER OF HOSE BIB WATER OUTLETS �+ DRAINS WATER TROUGHS z
TYPE OF STORAGE FACILITY USED FOR FEED/GRAIN_ �pc,c� �7�r1 ��' �1c�/Z�� L�d.('r� I
TYPE OF FACILITY USED FOR MANURE STORAGE G�rt[�,�-/'
METHOD DF MANURE DISPOSAL �►'�l1�'(�.� �Gs.�� FREQUENCY c�/1 9 z�t✓I 4
1 LciwS �SC� �t;.�/�
CORRAL/PEN AREA ENCLOSED BY WHAT TYPE OF FENCING? �U�'c-I� � �cr� ����_ ��,,,r.�
OTHER FARM ATTIMALS MAINTAINED AT PREMISES? YES�� NO
(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 Yarmouth taxes and liens must be paid prior to renewal or issuance of your permits.� /�
Please check appropriately if paid: Yes No l
SIGNATURE ✓� '�� /c ` DATE/u� Y /l ZE�
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FEES: STABLE& 1 HORSE $30.00(+$5.00 each additional horse/animal) TOTAL DUE:$ �`-j�00
11/03/]4 ,,r `r
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