HomeMy WebLinkAboutSTABLE APPLICATION&LICENSE - 2001#cr-cob
TOWN OF YARMOU
I lr() R()t-fI -ts sorTll \.\lt\toL'TH
Tclcphone (i{)ii) .}9S llll. Ext 2-i1
CIEOVEE
c262000
APPLICATION FOR OPERATION - 2OO1
STABLE
\ t A ss.\ ( rL 's ET"l's 0l
l'i\ (508) j9S-216i
ITOARD OF HEALTH
HEALTH DEPT
youerw.No.36Z - 6?8s
PLEASE COMPLETE ALL QUESTIONS
NAME ChaQ,rcs Srlezr(rrrrj
ADDRESS 88 lr,tl LAp<-Vi'l2rrauIA ToRi Oz6rl 5
MAILING ADDRESS (IF DIFFEREN
NUMBER OF HORSES/PONIES
BR-EED OF EACH HORSE
NO. OF YEARS OWNED
REGISTRATION NUMBER
ryPE OF STABLE/SHELTER
,J NuMtsLK ut st ALLS f"l\uNrbEl( t,r I E/\t15 v w,\f-u
*qtl)y) #s#l
#t
#l
L1 t I #2fl)al n rl)Nt
#3A#48 #5
#3 t4 #5
ttooJIWMD.
'dERETE.
ETC)
NUMBER oF HosE BIB wATER ourLETS 2-
TYPE OF SToRAGE FACTLITy usED FoR FEEolcnarN /z dll /
TYPE OF FACILITY USED FOR MANURE STORAGE COHPOS'TCd 69 S )fE
DRAINS
srzEoFCORRAL exr1 /t ae29
METHOD OF DISPOSAL OF MANURE n^nPas't,l o*9 tTe
OTHER FARM ANIMALS MAINTAINED AT PREMISES (please indicate numbers)>otult
nO*oaru5 Drrrl
CORRA L/PEN AREA ENCLOSED BY WHAT TYPE OF FENCINC? 4,,,OA1
DATE OF LAST INNOCULATION(S)Tee ,Lao o
VETIRiNARIAN DP- kncl^"
TYPE(S)
RENEWAL
NEW APPLICATION .
ENCEPHALITIS TEC ?60 z)
RABIES
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 oFYarmouth taxes and liens musr be pai{prior to renewal or issuance ofyour permits.
Please check appropriately if paid: Yes ,/ No-
SIGNATURE LeTl tlca
THE FULL ANIMAL/POULTRY COUNT IS NOT TO EXCEED THE AMOUNT OF PRIOR YEAR'S TOTAL.
FEES:STABLE
TOTAL DUE: $ tl0, o O
$25.00 (+ 55.00 each additional horse)
Lfl Printed on
Recycled
Paper
#2--8-
WATER TROUGHS
DATEDcC 2t, >ooo
THE COMMOIYWEALTH OF' MASSACHUSETTS
TOWNOFYARMOUTH
BOARD OFHEALTII
FEE: $40.00
This is to Certiry Charles Rilezikian
88 Mill Lane. Yarmouthnort. MA
IS HEREBY GRANTED A LICENSE
PLEASE POST LICENSE ON s.
This permit is graated in conformity with Article VI of the Sanitary Code of The Commonwealth of Massachusetts, and
expires December 3l .2001 unless sooner suspended or revoked.
Januarv 23 , 2001 BOARD OF TIEAITH:Ft?lt.?*z etu"aa,.eka*i?. Kd.ltlot ?az ebil,4,44
Rodod ?. e,D4,q, eb,4Ttklad O|4o,.r*t-
ts?eidra. O. Esrho ?11.D.
Bruce G. Murphy, MPH, R.S.. CHO
Director of Health
PERMITNUMBER: #01-006
For STABLING OF - 4 MINIATURE HORSES. I GOAT. I DONKEY
AT ABOVE ADDRESS. GRANTED IN ACCORDANCE WITH PROVISIONS OF
MASSACHUSETTS GENERAI LAWS-CIIAPTER l l I.SECTIONS 155 AND 31.