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HomeMy WebLinkAbout2023 The Commonwealth of Massachusetts Fee Town of Yarmouth $60.00 Stables License Number: BOHS-15-1250-08 Issue Date: 1/1/2023 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 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,MP ,R. ., CHO/James G. Gardiner Health Director/Assistant Health Director TOWN OF YARMOUTH San, Board of -;, Health =i61i = 1146 ROUTE 28, SOUTH YARMOUTH,MASSACHUSETTS 02664-24451 Health MATTACHEESE _ k*■ro•' Telephone(508)398-2231, ext. 1241 Fax(508)760-3472 n ZgOftVn APPLICATION FOR OPERATION -2023 MAR U I Z023 STABLE PLEASE COMPLETE ALL QUESTIONS E-MAIL HEALTH DEPT. NAME S T f2 "2N ✓3: ►r!v /f/✓ S© '✓ HOME TEL.NO. S"? 9 9 - 7 '4 Z STABLE ADDRESS 7 7 .5'i/it A A 4-A/2/4° 4Y W 2,S'? rim-.K Xner MAILING ADDRESS(IF DIFFERENT) EMERGENCY CONTACT(NAME/PHONE#) VETERINARIAN(NAI /FF 01s4E#) r Art-f"021- v91-5 4 TOTAL NUMBER OF HORSES/PONIES 7 TOTAL NUMBER OF STALLS #,- '/ .> "� a 'S"Kir6 '0WMP PLEASE NOTE: PLEASE DO NOT INCREASE THE NUMBER OF ANJMAAS J I'L023 WITHOUT PRIOR PERMISSION OF THE HEALTH DEPARTMENT. HEALTH DEPT. PLEASE LIST EACH HORSE/PONY/DONKEY/COW SEPARATELY: ANIMAL NAME(IF APPLICABLE) 11 n L� rzr�.rs,c BREED 1-4 �' YEAR ACQUIRED .5""" COLOR SEX .4,r4,7<= DATE OF RABIES VACCINATION , /2 Z DATE OF EEE VACCINATION /i DATE OF OTHER VACCINATIONS /I TYPE OF STABLE/SHELTER h/Ua D ,Gfj,J e.4 e i 4 SIZE OF CORRAL AREA (WOOD,CONCRETE,ETC.) NUMBER OF HOSE BIB WATER OUTLETS / DRAINS WATER TROUGHS TYPE OF STORAGE FACILITY USED FOR FEED/GRAIN 14 c//x a a /5/IrZa2/,S TYPE OF FACILITY USED FOR MANURE STORAGE 0 / ✓Z^I METHOD OF MANURE DISPOSAL Y"",''/z FREQUENCY rz� o CORRAL/PEN AREA ENCLOSED BY WHAT TYPE OF FENCING? Ia/G a)✓ l 2 L C 72r OTHER FARM ANIMALS MAINTAINED AT PREMISES? YES NO K/ (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 .2. /Z G / w Z 3 FEES: STABLE& 1 H SE $30.00(+$5.00 each additional horse/animal) TOTAL DUE:$ t f7 12/30/19