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HomeMy WebLinkAbout2023 The Commonwealth of Massachusetts Fee Town of Yarmouth $60.00 Stables License Number: BOHS-15-1248-08 Issue Date: 1/1/2023 Mailing Address: Location Address: BRENDA FELLOWS 307 NORTH MAIN ST 307 NORTH MAIN STREET SOUTH YARMOUTH. MA 02664 SOUTH YARMOUTH, MA 02664 IS HEREBY GRANTED A 2023 LICENSE This license is granted in conformity with the statutes and ordinances relating thereto, and expires December 31, 2023 unless sooner suspended or revoked and is not transferable. Conditions Allowed to have up to a total of 7 horses 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, R. ., /James G. Gardiner Health Director/Assistant Health Director 444 TOWN OF YARMOUTH Board of VI Health .41 21 1146 ROUTE 28, SOUTH YARMOUTH, MASSACHUSETTS 02664-24451 - _ NEE ,°'' Telephone(508)398-2231, ext. 1241 Health Fax(508)760-3472 Division APPLICATION FOR OPERATION-2023 STABLE PLEASE COMPLETE ALL QUESTIONS E-MAILI TJ' V "'"- \� cam NAME d(tc`v\Q ct..\\Q`.N. . _ _HOME TEL.NO.`tea C) _ -3I •n (p STABLE ADDRESS t'Cati� . _1� �� MAILING ADDRESS(IF DIFFERENT) EMERGENCY CONTACT(NAME/PHONE#1 )1St.,c'CN�Q,c.,t\ � SUB •� c �J 9� �J VETERINARIAN(.NAME/PHONE#) :N.NV13,, C_t.: ►C 5 a� �j ROCS "l YR3 , T r ' l I TOTAL NUMBER OF HORSES/PONIES L TOTAL NUMBER OF STALLS FEB 1 3 2023 , PLEASE NOTE: PLEASE DO NOT INCREASE THE NUMBER OF ANIMALS WITHOUT PRIOR PERMISSION OF THE HEALTH DEPARTMENT. HEALTH DEPT. PLEASE LIST EACH HORSE/PONY/DONKEY/COW SEPARATELY: ANIMAL NAME(IF APPLICABLE) Qs`Nvl - , \ Sclx1 10(Kl `ES BREED cy.k C .c �Gc.N Q^\\CGCSEr \\c.I- � 9C3O" ) YEAR ACQUIRED COLOR haicct> C3.xkcNc\ ca\;m�,� ce\ cxcNO rSEX %t� ��NrSNC ,c .Ct. C DATE OF RABIES VACCINATION '"5.'n `5.'� �j ''a • DATE OF EEE VACCINATION 5 iz a, 5 as 5•-,a 5=a.a 5• as DATE OF OTHER VACCINATIONS S-a.'a 5. .-Q 5--",� `5•'aa S- .= TYPE OF STABLE/SHELTER�c'r\- CC�CY`Ccr. 1_ SIZE OF CORRAL AREA'c \ \\ (WOOD,CONCRETE,ETC.) NUMBER OF HOSE BIB WATER OUTLETS \Q DRAINS \Q WATER TROUGHS I TYPE OF STORAGE FACILITY USED FOR FEED/GRAIN c'(\t„ )O.SS _WS W\�� \\cam TYPE OF FACILITY USED FOR MANURE STORAGE ^�'Tic�I .‹- METHOD OF MANURE DISPOSAll �` _ }c-N `�(.'L„ FREQUENCY , W U..,\cr CORRAL/PEN AREA ENCLOSED BY WHAT TYPE OF FENCING? .)� t\r e\ \ .- OTHER FARM ANIMALS MAINTAINED AT PREMISES? YES NO (PLEASE NOTE: POULTRY, SWINE, SHEEP, CATTLE, GOATS REQUIRE SEPARATE LICENSURE.) X RENEWAL NEW APPLICATION- 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 p jor to renewal or issuance of your permits. Please check appropriately if paid: No SIGNATURE � DATE-4 qi_�o FEES: S ' • B '& 1 HI-SE $30.00(+$5.00 each additional horse/animal) TOTAL DUE:$ (cc) 12/30/19 /' .e../vvzrd,L b'^ (p G dt S I11,,Lvl ( CGw