HomeMy WebLinkAbout2021 The Commonwealth of Massachusetts Fee
Town of Yarmouth $60.00
Stables License
Number: BOHS-15-1250-06 Issue Date: 1/1/2021
Mailing Address: Location Address:
STEVEN B JOHNSON 77 SHELBURNE RD
77 SHELBURNE ROAD WEST YARMOUTH, MA 02673
WEST YARMOUTH, MA 02673
IS HEREBY GRANTED A 2021 LICENSE
This license is granted in conformity with the statutes and ordinances relating thereto,
and expires December 31, 2021 unless sooner suspended or revoked and is not
transferable.
Conditions
Allowed to have up to a total of 7 horses at above address.
PLEASE POST LICENSE ON PREMISES.
Board Hillard Boskey,M.D.,Chairman
Mary Craig, Vice Chairman
of Charles T. Holway,Clerk
Debra Bruinooge
Health Eric Weston
Bruce G. urph H,R.S., CHO
Health Director
'° .....Y = TOWN OF YARMOUTH
Board of
Health
YIRTACN[E.E�; 1146 ROUTE 28, SOUTH YARMOUTH,MASSACHUSETTS 02664-24451
`. Telephone(508)398-2231,ext. 1241 -
Division
i=:''' Fax(508)760-3472 __
APPLICATION FOR OPERATION-2021 AUG 0 5 2021
STABLE
PLEASE COMPLETE ALL QUESTIONS E-MAIL HEALTH DEFT.
NAME ,S „lc/t'.c a—" HOME TEL.NO.SGS-3 7F 7 98-Z
STABLE ADDRESS 7 7 '4/"L - .1Lv/1.7 44,1,57 Yi1,20 '1g' rjf 45'f
MAILING ADDRESS(IF DIFFERENT)
EMERGENCY CONTACT(NAME/PHONE#1
VETERINARIAN(NAME/PHONE#)/vi AAA w e L r/JR O V, So L 2 34: Y L
TOTAL NUMBER OF HORSES/PONIES 7 TOTAL NUMBER OF STALLS `Y'^� Y act"-
PLEASE NOTE: PLEASE DO NOT INCREASE THE NUMBER OF ANIMALS
WITHOUT PRIOR PERMISSION OF THE HEALTH DEPARTMENT.
PLEASE LIST EACH HORSE/PONY/DONKEY/COW SEPARATELY:
ANIMAL NAME(IF APPLICABLE) L__
—
BREED yfi6R ow d A'd1,(d2
YEAR ACQUIRED 3 c34
---
COLOR
SEX f eieV4 2
DATE OF RABIES VACCINATION ,>--/s7'z a/
DATE OF EEE VACCINATION
DATE OF OTHER VACCINATIONS 4/
TYPE OF STABLE/SHELTER !N/G°/) Ce-,,✓c-,z."77 C/ >$�G- SIZE OF CORRAL AREA 73)c'/b'o � r�o/ 0
(WOOD'CONCRETE,ETC.)
NUMBER OF HOSE BIB WATER OUTLETS / DRAINS a") WATER TROUGHS /` io"4.5•44 ,41 '
TYPE OF STORAGE FACILITY USED FOR FEED/GRAIN 77GL/s2,0 a' / -✓ /3�/111iLS
TYPE OF FACILITY USED FOR MANURE STORAGE G/°'i�v
METHOD OF MANURE DISPOSAL ti/J Ci�n n j �n-e "I" c "7,-4/
CORRAL/PEN AREA ENCLOSED BY WHAT TYPE OF FENCING? 1-1-/o0'!J 9- 2c z.. -ra't-"
OTHER FARM ANIMALS MAINTAINED AT PREMISES? YES NO 2
(PLEASE NOTE: POULTRY,SWINE,SHEEP, CATTLE, GOATS REQUIRE SEPARATE LICENSURE.)
-/ 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 prior to renewal or issuance of your permits.
Please check appropriately if paid: Yes i/ No
SIGNATURE DATE 7// /Zl Z/
FEES: STABLE& 1 HORSE 0.00(+$5.00 each additional horse/animal) TOTAL DUE:$
12/30/19
•
' /J0.'