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°� r TOWN OF AROUTBoard of
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�i1146 ROUTE 28, SOUTH YARMOUTH, MASSACHUSETTS 02664-24451
Telephone(508)398-2231,ext. 1241 Ji N i; a 9
Fax(508) 760-3472 ,� "�'
APPLICATION FOR OPERATION.$019&._ w
SHEEP/GOATS FEE: 1-8 animals $30.0 I
9 or ore animals $35.00
enewal
PLEASE COMPLETE ALL QUESTIONS New Application
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NAME 1,c2.14.A.9._ DovJ
47' �S —ck1 HOME TEL.NO. 56Y-30 — LI 1/) 10
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ADDRESS /g P'An. ¢.., Ai
MAILING ADDRESS(IF DIFFERENT)
EMERGENCY CONTACT(NAME/PHONE#)
VETERINARIAN(NAME/PHONE#) die J1jA1 N a ('.,ynr
TOTAL NUMBER OF ANIMALS 3
PLEASE NOTE: PLEASE DO NOT INCREASE THE NUMBER OF ANIMALS
WITHOUT PRIOR PERMISSION OF THE HEALTH DEPARTMENT.
PLEASE LIST EACH SWINE/SHEEP/GOAT SEPARATELY:
ANIMAL NAME(IF APPLICABLE) IA.,/1 bur
BREED kiwi of, .1=P-. 1.- G,O j f-3- -
#YEARS OWNED R 1/ /lgp_ / r.
COLOR B.leck ..J4e Loh,, Bly ' 6/hile 4MU
SEX it' . 411,
DATE OF RABIES VACCINATION triffert 8
DATE OF EEE VACCINATION ti� #e2
DATE OF OTHER VACCINATIONS V /ci' $7//i, 0 , r
fRA
TYPE OF STABLE/SHELTER l,utrOd i ulr f`t. SIZE OF CORRAL AREA (22O t X act
(WOOD,CONCRETE,ETC.) ,',,/
TYPE OF STORAGE FACILITY USED FOR FEED/GRAIN S 4'l 1V C C,A S d— (44..10e1 -Via
TYPE OF FACILITY USED-FOR MANURE STORAGE e_01100
METHOD OF DISPOSAL OF MANUREHOW OFTEN itv0 Al
IS CORRAL/PEN AREA ENCLOSED BY FENCING? YE NO TYPE OF FENCING Lloyd s Teel cal?
OTHER FARM ANIMALS MAINTAINED AT PREMISES? YES NO0(
(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
.11111111=7.------SIGNATURE _. DATE f —/3 —/7
11/07/18