HomeMy WebLinkAboutBHSG-24-3 2024The Commonwealth of Massachusetts
Town of Yarmouth, MA Fee
Sheep / Goats License
Permit No. BHSG-24-3 Issue Date: January 1, 2024
pplicant's Mailing Address: Location Address:
ally Heiman 20 NICK-EM WAY
4 West Great Western Rd YARMOUTH PORT, MA 02675
outh Yarmouth, MA 02664
IS HEREBY GRANTED A 2024 LICENSE
This license is granted in conformity with the statutes and ordinances relating
hereto, and expires December 31, 2024 unless sooner suspended or revoked and is not
ransferable.
to have up to three (3) goats
Post License on Premises
Board Hillard Boskey, M.D., Chairman
Mary Craig, Vice Chairman
of Charles T. Holway. Clerk
Laurance Venezia, DVM
Health Eric Weston
James G. Gardiner
Health Director
TOWN OF YARMOUTH Board of
Health
1146 ROUTE 28, SOUTH YARMOUTH, MASSACHUSETTS 02664-24451 -
Telephone (508) 398-2231, ext. 1241 Health
Fax (508) 760-3472 Division
APPLICATION FOR OPERATION - 2024
SHEEP/GOATS FEE: 1-8 animals $30 00
PLEASE COMPLETE ALL QUESTIONS
N
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ADDRESS ;�C)
MAILING ADDRESS (IF DIFFERENT)
EMERGENCY CONTACT (NAME/PHONE
VETERINARIAN (NAME/PHONE #)
TOTAL NUMBER OF ANIMALS
PLEASE NOTE: PLEASkDO
9 or mo nimals $35.00
Renewal
New Application
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NOT INCREASE THE NUMBER OF ANIMALS
WITHOUT PRIOR PERMISSION OF THE HEALTH DEPARTMENT.
PLEASE LIST EACH SWINE/SHEEP.lGOAT SEPARATELY:
ANIMAL NAME (IF APPLICABLE) w J a
BREED rt., l is fI ck
# YEARS OWNED
COLOR
SEX
DATE OF RABIES VACCINATION
DATE OF EEE VACCINATION _
DATE OF OTHER VACCINATIONS CID,
TYPE OF STABLE/SHELTER co c q2� SIZE OF CORRAL AREA
(WOOD, CONCRETE. ETC.)
TYPE OF STORAGE FACILITY USED FOR FEED/GRAINu31 Lk
TYPE OF FACILITY USED FOR MANURE STORAGE i� p
METHOD OF DISPOSAL OF MANURE HOW OFTEN
IS CORRALIPEN AREA ENCLOSED BY FENCING? YES /No TYPE OF FENCING 2�
OTHER FARM ANIXAL3-hf,4'flA;TAINED AT PREMISES? YFS/ NO
(PLEASE NOT16r POULTRY, RSES, PONIES, DONKIES REQUIRE SEPARATE LICENSURE.)
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 pa' prior to renewal or issuance of your permits.
Please check appropriately if paid: Yes No
SIGNATURE -N DATE r'124
119