HomeMy WebLinkAboutBHST-24-4-2/14/24, 10:24 AM
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Y`;k^ The Commonwealth of Massachusetts
" C Town of Yarmouth, MA Sso.00
Stable License
No. BHST-24-4 Issue Date: January 1, 2024
plicant's Mailing Address: Location Address:
SHELBURNE RD 77 SHELBURNE RD
WEST YARMOUTH, MA 02673
;ST YARMOUTH, MA 02673
IS HEREBY GRANTED A 2024 LICENSE
> license is granted in conformity with the statutes and ordinances relating thereto, and I
ires December 31, 2024 unless sooner suspended or revoked and is not transferable.
Post License on Premises
Board Hillard Boskey, M.D., Chairman
Mary Craig, Vice Chairman
of Charles T. Holway. Clerk
Eric Weston
Health Laurance Venezia, DVM
7d�� � (j A-I-L
James G. Ga 'ner
Hea Direct
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TOWN OF YARMOUTH Board of
Health
1146 ROUTE 28, SOUTH YARMOUTH, MASSACHUSETTS 02664-24451 Health
Telephone (508) 398-2231, ext. 1241
Fax (508) 760-3472 Division
APPLICATION FOR OPERATION - 2024
STABLE
PLEASE COMPLETE ALL QUESTIONS E-MAIL
NAME .�T�! v1.✓ �. J�">Vay' HOME TEL. NO. .Y d.j
STABLE ADDRESS 7 -2 SI d.}riez.Lc--Tr-') `9A�a r„�7i fi3j
MAILING ADDRESS (IF DIFFERENT)
EMERGENCY CONTACT (NAME/PHONE
VETERINARIAN (NAME/PHONE #)),,oA4-i,y1q se rw q
TOTAL NUMBER OF HORSES/PONIES 7 TOTAL NUMBER OF STALLS
PLEASE NOTE: PLEASE DO NOT INCREASE THE NUMBER OF ANIMALS
WITHOUT PRIOR PERMISSION OF THE HEALTH DEPARTMENT.
PLEASE LIST EACH HORS E/PONY/DON K EY!COW SEPARATELY: - 2-5'zA
Lc.s� re cam, d�
ANIMAL NAME 1F APPLICABLE
BREED
YEAR ACQUIRED
COLOR
SEX
DATE OF RABIES VACCINATION
P
DATE OF EEE VACCINATION
1,a
DATE OF OTHER VACCINATIONS
//
A�
TYPE OF STABLE/SHELTER - , .j r, _ SIZE OF CORRAL AREA7, ;, ,- ,�:,.: i•. ��.
(WOOD, CONCRE: E, ET I_C )
NUMBER OF HOSE BIB WATER OUTLETS_ A' _ DRAINS o /' WATER TROUGHS zr_s
TYPE OF STORAGE FACILITY USED FOR FEED. -'GRAIN
TYPE OF FACILITY USED FOR MANURE STORAGE G
METHOD OF MANURE DISPOSAL FREQUENCY
CORRAL/PEN AREA ENCLOSED BY WHAT TYPE OF FENCING?
OTHER FARM ANIMALS MAINTAINED AT PREMISES? YES NO Z
(PLEASE NOTE. POULTR K 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 ,.) No
SIGNATURE f' _ — DATE r—
FEES: STABLE & I HOROL $30.00 (+ $5.00 each additional horse/animal) TOTAL DUE: $ Z
1J33 IQ iKCi,E1VED
14 2023
HEALTIA DEPT.