HomeMy WebLinkAboutApplication .....r TOWN OF YA MOUT
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-=,��� 1146 ROUTE 28, SOUTH YARMOUTH, MASSACHUSETTS 02664-24451 ,11 t H�att-hi 1111
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Telephone(508)398-2231, ext. 1241
Fax(508)760-3472 ��V,s,�n
APPLICATION FOR OPERATION -2019 'lv
SHEEP/GOATS FEE: 1-8 animals $30.00
9 or more animals $35.00
Renewal
PLEASE COMPLETE ALL QUESTIONS New Application
E-MAILitI.51U-)ih ' /Mna)*OWl
NAME �a �4)� HOME TEL.NQ.� •. (S �9
ADDRESS O 9 1 31 y 1 (v , yppm6efi) ` P-2A .09477,c
MAILING ADDRESS(IF DIFFERENT) - /3'eaX fr,4 5A'izs-46k017p mil 0645-
EMERGENCY CONTACT(NAME/PHONE#) I-�ege/A) S fill0 iZ (e) „coo`13gio -c.0 6
VETERINARIAN(NAME/PHONE#) `' n , '" c z 3 3( V1g,
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: �,y/Q r
ANIMAL NAME(IF APPLICABLE) vJ tbz. `9 PPT/a5 c7
BREED A,vj � � I�R'✓l'/�'uf
#YEARS OWNED �16 /
COLOR ta.1)/3 ' "Ajki CL J '5I
SEX
DATE OF RABIES VACCINATION L9
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DATE OF EEE VACCINATION �� ��
DATE OF OTHER VACCINATIIONS /
TYPE OF STABLE/SHELTER 61
/t � #� SIZE OF CORRAL AREA 3' X 9� P ay
(WO D,CONCRETE,ETC.) �V
TYPE OF STORAGE FACILITY USED FOR FEED/GRAIN Ff .�ii
TYPE OF FACILITY USED FOR MANURE STORAGE teal ✓v
METHOD OF DISPOSAL OF MANURE 6 YJ -J(I' J HOW OFTEN 71J&
IS CORRAL/PEN AREA ENCLOSED BY FENCING? YESNO T E OF FENCING (Mf&' `�' ai
OTHER FARM ANIMALS MAINTAINED AT PREMISES? YES 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 Yarmouth taxes and liens must be paid prior to renewal or issuance of your permits.
Please check appropriately if paid: Yes No
SIGNATURE Ir 1/ : DATE I fJ-i?/