HomeMy WebLinkAbout2023 App-License The Commonwealth of Massachusetts Fee
Town of Yarmouth $30.00
.441
Stables License
Number: BOHS-15-1252-08 Issue Date: 1/1/2023
Mailing Address: Location Address:
ROBIN JOLY, DVM 154 SUMMER ST
P.O. BOX 219 YARMOUTH PORT. MA 02675
YARMOUTHPORT, MA 02675
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 2 horses at above address.
PLEASE POST LICENSE ON PREMISES.
Board Hillard Boskey, M.D., Chairman
Mary Craig, Vice Chairman
of Charles T. Holway, Clerk
Eric Weston
Health
Jam Cr. Gardiner
Health Director
' TOWN OF YARMOUTH Board of
g f Health
• =la - _I 1 146 ROUTE 28, SOUTH YARMOUTH,MASSACHUSETTS 02664-24451 Health
MATTACNEESE
' E Telephone(508)398-2231, ext. 1241
Fax(508)760-3472 Division
APPLICATION FOR OPERATION -2023
STABLE
PLEASE COMPLETE ALL QUESTIONS E-MAIL f S3 w m C MecoCL �-
NAME 0 b + Yk �O ( � �V 11\ 1 HOME TEL.NO,50f —3 6 a- n of
STABLE ADDRESS 1 5(4 Su...YY`fYM€X S-+ cp t-m O RO r'- OISo15 3 ( �A
MAILING ADDRESS(IF DIFFERENT) 6 I l c> - CAA,W Pork- 0WD-1'5
EMERGENCY CONTACT(NAME/PHONE#) n —30( 5OTr -ail it 7 -7 C 1 C lee(
VETERINARIAN(NAME/PHONE#) O b i p (O I t. i)V IM Ab O V' . Ph or1F n V&A h('r
TOTAL NUMBER OF HORSES/PONIES al e TOTAL NUMBER OF STALLS; 3
PLEASE NOTE: PLEASE DO NOT INCREASE THE NUMBER OF ANIMAileeeiV D
WITHOUT PRIOR PERMISSION OF THE HEALTH DEPARTMENT.
PLEASE LIST EACH HORSE/PONY/DONKEY/COW SEPARATELY: MAR 1 0 2023
ANIMAL NAME(IF APPLICABLE) -I-►5��10� HEALTH DEp.,-
BREED Prseo• b (AO YEAR ACQUIRED d n 3
COLOR 6\,1-€_,u`
SEX A _
DATE OF RABIES VACCINATION �
DATE OF EEE VACCINATION /
DATE OF OTHER VACCINATIONS 5/ a3
TYPE OF STABLE/SHELTER c o t) b
1 SIZE OF CORRAL AREA '30 x 11
swoon,CON -� -�
NUMBER OF HOSE BIB WATER OUTLETS DRAINS WATER TROUGHS
TYPE OF STORAGE FACILITY USED FOR FEED/GRAIN G"YGL'`(\ 1 iJ
TYPE OF FACILITY USED FOR MANURE STORAGE f p(gyp 61 0.x ( 'Y\S
METHOD OF MANURE DISPOSAL \ —& 1 FREQUENCY U, ear
Q aC CORRAL/PEN AREA ENCLOSED BY WHAT TYPE OF FENCING? c -k- ‘ l`-'�
OTHER FARM ANIMALS MAINTAINED AT PREMISES? YES NO
(PLEASE NOTE: POULTRY, SWINE, SHEEP, CATTLE, GOATS REQUIRE SEPARATE LICENSURE.)
1,7 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 No
SIGNATURE Cam` , S S. 'p� T DATE 3-5 — 9:6
oc
FEES: STABLE& 1 HORSE $30.00(+$5.00 each additional horse/animal) TOTAL DUE:$ 0
12/30/19