HomeMy WebLinkAboutApplication 1ao_663/664 5 -t1-61Li5 —oI
of....r TOWN OF YARMO u
V U ,l, 11 Board of
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� �''i 1146 ROUTE 28, SOUTH YARMOUTH,MASSACHUSETTS 02664-24451 -
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, Telephone(508)398-2231,ext. 1241SEB 1 Q 220„Heath
''� Fax(508)760-3472 ivi.inn
HEALTH DEPT.
APPLICATION FOR OPERATION-2020 �4. ,. 1_
SHEEP/GOATS FE `�- ' s.1 F i ' Y ' I.00
9 o Fiore amm $35.00
C.---Renewal
PLEASE COMPLETE ALL QUESTIONS New Application
E-MAIL V--S m 0 a yY, '-../(.Q, -
NAME Sot \\e 6gf3' HOME TEL.NO. cS
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ADDRESS � ' ii � �^I c�S R-_ c�.c�7,-'i.b�I.�-'
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MAI;NG ADDRESS(IF DIFFERENT) 4. Mk 1. ,.` e.)--a...Ili
EMERGENCY CONTACT(NAME/PHONE#)
VETERINARIAN(NAME/PHONE#) 'D „ : Nn 6 hid,n 'c&.c i V 0 D 57) ---q--/-7- 3 3.
TOTAL NUMBER OF ANIMALSg„,t)
PLEASE NOTE: PLEASE DNOT INCREASE THE NUMBER OF ANIMALS
WITHOUT PRIOR PERMISSION OF THE HEALTH DEPARTMENT.
PLEASE LIST EACH SWINE/SHEEP/GOAT SEPARATELY:
ANIMAL NAME(IF APPLICABLE) I - t�VJ t- c-iovee
BREED Llt \A-A. N;.vtr-C S
#YEACOLORS OWNED OA,
4 RAY til v4o.f
SEX Wr�lc�C! Cii"->i1/4
DATE OF RABIES VACCINATION �-"e `v
DATE OF EEE VACCINATION as) t
DATE OF OTHER VACCINATIONS
TYPE OF STABLE/SHELTER ,i1._.)-0b SIZE OF CORRAL AREA p n k%le
(WOOD,CONCRETE,ETC.)
TYPE OF STORAGE FACILITY USED FOR FEED/GRAIN S--C ( boLf Ce. tS
TYPE OF FACILITY USED FOR MANURE STORAGE ('ism! Ei S
METHOD OF DISPOSAL OF MANURE HOW OFTEN
IS CORRAL/PEN AREA ENCLOSED BY FENCING? YES NO TYPE OF FENCING{, Let_ C a il- tit)
OTHER FARM ANI INTAINED AT PREMISES? YE IS2fNO
(PLEASE NOTE: POULTRY, ORSES,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
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DATE —12/30/19 --1I �