HomeMy WebLinkAbout2022 App & License The Commonwealth of Massachusetts Fee
Town of Yarmouth $30.00
Sheep Goats License
Number: BOHSG-19-0149-03 Issue Date: 1/1/2022
Mailing Address: Location Address:
SALLY HELMAN 20 NICK-EM WY
P.O. BOX 875 YARMOUTH. MA 02675
HARWICH, MA 02645
IS HEREBY GRANTED A 2022 LICENSE
This license is granted in conformity with the statutes and ordinances relating thereto,
and expires December 31, 2022 unless sooner suspended or revoked and is not
transferable.
Conditions
Allowed to have up to a total of two (2) goats at above address.
PLEASE POST LICENSE ON PREMISES.
Board Hillard Boskey, M.D., Chairman
Mary Craig, Vice Chairman
Of Charles T. Holway, Clerk
Debra Bruinooge
Health Eric Weston
Bruce G. Murphy, MPH, .S., CHO/James G. Gardiner
Health Director/Assistant Health Director
r "= TOWN OF YARMOUTH
Board of
• V Health
`''` = 1146 ROUTE 28, SOUTH YARMOUTH,MASSACHUSETTS 02664-24451 -
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MA.ACHEE8E Health
Division
Telephone(508)398-2231,ext. 1241
==' = Fax(508)760-3472 I)ivision
I,v n rl 2oLL APPLICATION FOR OPERATION-2022
SHEEPiGOATS FEE: 1-8 animals $30.00
HEALTH DEPT. 9 or more animals $35.00
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PLEASE COMPLETE ALL QUESTIONS - Neeeww Application
ry
E-MAIL 1�\SS-(/Y�e-C-- f'dP'7x ..-
NAME < Clj It 14e,f MA,/I HOME TEL.NO. ,�'d g�aA -3 1 o2
ADDRESS S r
MAILING ADDRESS(IF DIFFERENT) o _ 6,5 y F 5 C
EMERGENCY CONTACT(NAME/PHONE#)
VETERINARIAN(NAME/PHONE#) ei)Z 1414A/y1,-0--. S 0-1` -3 4 =.= S.Cfl.
TOTAL NUMBER OF ANIMALS S aztScut-
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) y ' - J C1,6 004_, 6 Jed a 1
BREED t
#YEARS OWNED n �431 C 1
COLOR
SEX 1 V 6 aw/l Cot ()c :i Ckci C L.
DATE OF RABIES VACCINATION , - (
DATE OF EEE VACCINATION _,ta, Q L j e iU -
1
DATE OF OTHER VACCINATIONS / Yk -V Q� CS t all IS
.- -'�� 1 t L p2p .�
TYPE OF STABLE/SHELTER X SIZE OF CORRAL AREA -I±t10 e_` CerSek,�
(WOOD,CONCRETE,ETC.)
TYPE OF STORAGE FACILITY USED FOR FEED/GRAIN i
TYPE OF FACILITY USED FOR MANURE STORAGE ( 111k
8�
METHOD OF DISPOSAL OF MANURE HOW OFTEN
IS CORRAL/PEN AREA ENCLOSED BY FENCING? YES NO TYPE OF FENCING
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 Abilrff 111 i /
n �
12/30/19 -(t e1 DATE �� (l -