HomeMy WebLinkAboutSTABLE APPLICATION&LICENSE - 2004o
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TO\TN OF
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YARMOUTH
1146 ROUTE 28 SOUTH YARMOUTH
Telephone (508) 398 2231, Ext. 241
MASSACHUSEfiS O
- Fax (508) 398-2365
HEALTHBOARD OF
APPLICATION FOR OPERATION - 2OO4
STABLE
NOV 0 ti Zool
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HEALTH DEPT.
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@etfl\u6ePLEASE COMPLETE ALL OIIESTIONS T
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NAME t HOME TEL. NO
ADDRESS fDr \t Lq *
NUMBER OF HORSES/PONIES 5 NUMBEROF STALLS b NUMBER oF YEARs owNED
qr p\a.t\o',,\crc{t,\
MAILING ADDRESS (IF DIFFERENT)
Y.',^', #4 fh,\\ #5#1 YII rnr #2 Irttn r #3
#r lt #z \1 #3 I"l #4 Lj- #s
BREED OF EACH HORSE
NO. OF YEARS OWNED
REGISTRATION NUMBER
ryPE OF STABLE/SIIELTER
#l #4 #5
ETC.)
NUMBER OF HOSE BIB WATER OUTLETS DRAINS
TYPE OF STORAGE FACILITY USED FOR FEED/GRAIN -r- If'h elq I
TYPE OF FACILITY USED FOR MANURE STORAGE d)t)
WATER TROT]GHS
At
METHoD oF DtsPosAL oF MANURE Oo e W OFTEN
OTHER FARM ANIMALS MAINTAINED AT PREMISES (please indicate numbers)
orll
CORRAI,?EN AREA ENCLOSED BY WHAT ryPE OF FENCING?
DATE OF LAST INOCULATION(S)Nou I )oo3
VE
NEW APPLICATION .
I + (2o',1 t
TYPE(S)A
Dr
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Drt- sohro l-so ,h ENCHPHALITIS
RABIF,S
TF NEW APPLICATION, PLEASE AT'TACH A COPY OF PLOT PLAN SHOWING LOT LINES
AND LOCATION OF STABLE, PEN, f,TC. AND ALL ENCLOSURES. ALSO, A WRITTEN
LETTER OR STATf,MENT, SIGNf,D BY ALL ABUTTERS TO PROPERTY.
Town of Yarmouth taxes and liens must be paid prior to rene\xal or issuance ofyour permits.
Please check appropriately ifpaid: Yes +No
DArE rr/ I /os
rr, .rry' nn,rnrr*o
Ff,ES: V STABLE
SIGNATURE
*;Jilrror^rULTRY COUNT IS NOT TO f,XCEED THE AMOUNT OF P
$25.00 (+ $5.00 each additional horse)
Lfl Printed on
Recycled
Paper
- (tP.1
RLE /afer
szEoFcoRRALanee )5x r5
#2 #3
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RENEWAL
rorAl DUE: s 4S.OO
TEE COMMOFIWEALTH OF MASSACHUSETTS
TOWNOFYARMOUTH
BOARDOFHEALTE
FEE: $45.00
This is to Certify that Charles
88 Mill Lane- Yarmouthoort. MA
IS EE'REBY GRANTEI} A LICENSf,
For STABLING F -5MTNTATI]REHORSES 1 COW I DONKEY
MAS S GENERAL LAWS-CHAPTER I 1 I-SECTI 155 AND 3 I
PLEASE POST IICENSE ON PREMISES.
lSr"W$"?r#&3uw"?#:
Novernber 19.2003 BOARD OF HEALTH:
ofThe Commonwealth of Massachusetts, and
B..P-t- 5. fuilor, lA.$., ehrraaa
P"lir"l l4obcno , %a %u*a*
RolBat4, Brorr*, Ao^Aebe 9la/+ eJV.
Director of
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PERMIT NUMBER: #04-003
AT ABOVE ADDRESS. GRANTED IN ACCORDANCE WITH PROVTSTONS OF'
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