HomeMy WebLinkAboutSHEEP,SWINE,GOAT APPLICATION & LICENSE - 2006/oe -oo1
TO\TN OF YARMOUTH
lt46 ROUTE 28 SOUTH YARMOUTH MASSACHUStrTIS 02664-445 t
Telephone (508) 39&2231, Ext.241 - Fae'(508) 760-723
BOARD OF HEALT
APPLICATION FOR OPERATION - 2006
SWINE/SEEEPiGOATS
PLEASE COMPLETE ALL QUESTIONS
NAME Qr L)AL
ADDRF]SS &
EMERGENCY CONTACT (NAME/PHONE #)
ll An +?5
_Renewal
_New Application
IlOMl, 'IIrL. NO 5b&- 36a"6 ),F-?
_rt-36Y -], tMAILING ADDRESS (II DIFFERENT)
ote
VIJI'EIIINARIAN (NAME,PI IONE #)fh Lrp,lu
o 'l
1'O1'AI- NUMtsER OII ANIMALS \
PI,EASE LIST EACH SWINE/SHEEP/GOAI' SEPARATEI-Y
AN]MAL NAME (tr APPLICABLE)B,nl [.lan l-C^t)
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# YEARS OWNED (^-r-r*n /
COLOR JI 'l /'rs I tm7
sBx M:r..Y tl
DATE OF RABIES VACCINA'IION
DATE OF EEE VACCINATION
DATE OF OT}IER VACCINATIONS
,IYPE OF STABI,E/SIIELTER l*o)---lwooD, colrcxrrtr, Erc)
TYPE OF STORAGE FACILITY USED FOR FEED/GRAIN
,TYPE OF FACILITY USED F'OR MANURE STORAGE
METHOD OF DISPOSAL OF MANURE BFr
ar.oJ lllell -(t.c.e 3,,L
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HOW OFTI]N Da,
IS CORRAL/PEN AREA ENCLOSEI) BY FI]NCING? YESXNO TYPE O1.' }-ENCING I 4 un?
OTHER FARM ANIMALS MAiNTAINED AT PREM]SES? YES)a-NO
(PLEASE NOTE: POULTRY, HORSES, PONIES, DONK]ES REQUIRE SEPARATE LICENSURE.)
IF LEW APPLICATION, PLEASE ATTACH A COPY OF PI]OT PLAN SHOWING IrOT LII\ES AflD IOCATION OF STABLE
pEN, f,TC., AND ALL ENCLOSURES. ALSO, A WRTTTEN LEITER OR STATEMENT, SIGNf,D BY ALL ABUTTERS TO
PROPf,RTY.
Town of Yarmouth taxcs and licns must
Please check appropriatcly ifpaid: Y"-O;L",d K a .*ewal or issuance of your permits
Printed on
RecYd6d
Paper
SIGNAI'URE
tN
DATI]lt Lfl
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srzE ot, coRRALARlrA rlP ===-
PERMITNUMBER
THE COMMONWtrALTH OF MASSACHUSETTS
TOWN OF YARIVIOUTH
BOARD OF HEALTH: #06-001 FEE: $25.00
'lhis is to Certily that Charles Bilezikian
88 Mill Lane. Yarmouthoort. MA 0267 5
IS HERf,BY GRANTf,D A LICENSE
GRANTED IN ACCORDANCE OVISIONS OF
This.permit is ganted i! -confaEliry u{itl Article VI of the ganitary Code of The Commonwealth of Massachusetts, andexpifes D&emb€r 3l .2006 -unless sooner suspended or revoked.
January 19- 2006 Bo.i.ar* 5. qar/oq ,1.b,, Olr*vwt.
Robaf 4. Bior.ri, elen&Pe*lilab&
A-.".lt.
Dircctor of
For STABr ING OF - TWO (r) GOATS AT AROVF- AnDRFSS
MASSACHUSETTS GENERAL LAWS-CHAPTER IlI.SECTIONS 155 AND 31.
PLEASE POST LICENSE ON PREMISES.
BOARD OF HEALTI I: