HomeMy WebLinkAbout2021 App-License The Commonwealth of Massachusetts Fee
Town of Yarmouth $30.00
Sheep Goats License
Number: BOHSG-19-0149-02 Issue Date: 1/1/2021
Mailing Address: Location Address:
SALLY HELMAN 20 NICK-EM WY
P.O. BOX 875 Aka 24 WEST GREAT WESTERN ROAD
HARWICH. MA 02645 YARMOUTH. MA 02675
IS HEREBY GRANTED A 2021 LICENSE
This license is granted in conformity with the statutes and ordinances relating thereto,
and expires December 31, 2021 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
race G. ur . MPH, R.S.. CHO
Health Director
. 1--- TOWN OF YARMOUTH Board of
Itt Health
I `"_ =/ 1146 ROUTE 28, SOUTH YARMOUTH,MASSACHUSETTS 02664-24451 Health
Telephone(508)398-2231,ext. 1241
r)ivisinn
..;;; , :;;... Fax(508)760-3472
APPLICATION FOR OPERATION -2021
SHEEP/GOATS FEE: 1-8 animals $30.00
9 ocmore animals $35.00
Renewal
PLEASE COMPLETE ALL QUESTIONS _ ew Application
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NAME D .P A m Ok r7 HOME TEL.NO. 5 67 - �3 - / 0-7
ADDRESS d ()S"\- G- (`& WPC (A 0 C�
MAILING ADDRESS(IF DIFFERENT) \ 0 E")( V '1 c c&c l u V ) ( O ..10 q J
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VETERINARIAN(NAME/PHONE#) '�1r\,6t(t Pa. Q c D V ✓V\
TOTAL NUMBER OF ANIMALS
PLEASE NOTE: PLEASE DO NOT INCREASE THE NUMBER OF ANIMALS
WITHOUT PRIOR PERMISSION OF THE HEALTH DEPARTMENT. ____-__L
PLEASE LIST EACH SWINE/SHEEP/GOAT SEPARATELY: `.,,Ij O 3 2021
ANIMAL NAME(IF APPLICABLE) —V y Ct(NJ t r f Q,.1, (l
BREED TN' G_ 10�� •_C, )wA T( Aci.,-� ( HEALTH DEPT.
#YEARS OWNED �'
COLOR -L �jr_�pc3\.0 \ -}CC (o1or -kC,n1161 c� r
DATE OF RABIES VACCINATION -7 -I L/ • a, / - I Li . a\ .-Z - I y 0,
DATE OF EEE VACCINATION
DATE OF OTHER VACCINATIONS C qi (lcS T'l-_D << lk << 1\
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TYPE OF STABLE/SHELTER SIZE OF CORRAL AREA
(WOOD,CONCRETE,ETC.)
TYPE OF STORAGE FACILITY USED FOR FEED/GRAINC
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TYPE OF FACILITY USED FOR MANURE STORAGE II I
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 pad prior to renewal or issuance of your permits.
Please check appropriately if paid: Yesl/ No
SIGNATURE DATE -
12/30/19