HomeMy WebLinkAboutSTABLE APPLICATION&LICENSE - 2006o
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TO\UTN OF YARMOdITH
I 146 ROUTE 28 SOUTH YARMOUTI{ MASSACI{USETTS 02664445I
Telephone (508) 39&2231, Ext.241 -'Fax (508) 760'3472
BOARD OF HEALTH
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APPLICATION FOR OPERATION - 2006
STABLE * +S Serso'of"'b''l!
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NAME Cho.l. s B,l.r, lao,*I.toME',r'ril,. No ,o8 - 3u, DPZ
STABLE ADDRT]SS , il Lan f A 615
MAILING ADDRESS (rF Dll liLRENr )
EMERGI]NCY CONI'ACT (NAME/PI]ONE #), ir>t Dc-.\re 3 { t- }/d3
VETERINARTAN (}.IAME/PI IONE #)DQ- Le",A
ToTAI N1IMIlllR OF I{ORSIISiPONIIIS
PI,I]ASE I,IST ]IACH IIORSE/I'ONY/DONKI]Y/COW SEPARATFT,Y
TYPE OF STABLE/SI {LLTER /rte-l
TOTAI NUMBER OF STALLS
SY-E OIT CORRA]- AREA P,>c
DITA]NS WA'IER'TROIJGI]S d
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N1JMBER OF HOSE BIB WATER OUTLETS J
,TYPE OF STORAGE I]ACII,ITY USED FOR I-EED/GRAIN
TYPE OF FACII,ITY USED FOR MANT'RE STORAGE
METHOD OF IViAiiURi' DiSPOSAL 3, T t
CORRAL/PEN AREA ENCLOSED BY WI]A'T TYPE OF FIINCING?
IIREQi;]]NCY t)a t
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OT'IER FARM ANIMALS MAIN'I'AINED AT PREMISES? YES ,'/NO
TPLEASE NOTE: POULTRY, SWNE. SHE|':P. CArrLE. GOATS RFQUIRE SEPARATE I'ICENSURE.)
V RENEwAL
NEW APPLICA ION. IT NEW APPLICATION, PLEASE ATIACH A COPY OF PLOT PI,AN SHOWING I,OT
LINES AND LOCATION OF STABLE, PEN, ETC., AND ALL ENCI,'OSURES. AI,SO' A
WRITTEN LETTER OR STATEMENT, SIGIYED BY ALL ABUTIERS TO PROPERTY.
or to renewal or issuance ofyour permits.
No
Town of Yarmouth taxes and licns must be paid Bni
Please check appropriately i-fpard: Yesll
ANIMAL NAME G APPLICABLE)fh,+h{"/tro'niq \*ar ?"!t" C', I [',, r lor <'" A
I]REED It't t o'r ',.t ..
# YEAIiS OWNED Rlo r\r-Slnr ill,.^ J Rlart t
coLoli rJ tl tl L -L
SEX I I (r
DATE OF RABIES VACCINATION lt lo<Ir loS It lo.J tt loS
DAIE OF EEE VACCINATION ll ' oS t,tos ,tt 03'ilog
DATE OT OTIIER VACCINATIONS Ur,l. lt 1o5 ie,L r Ls rh".t. bs c,i,
SIGNA'II'RE DATE IE
TOTALDUE: $59.OO
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Printed on
RecycledFEES: STABL|I $25.00 (+ $5.00 each tional hone/animal)
Papet
PLEASE COMPLETE ALL OTJESTIONS
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THE COMMONWEALTH OF MASSACHUSETTS
TOWNOFYARMOUTH
BOARD OF HEALTII
PERMITNLIMBER: #06-006 FEE: $55.00
This is to Certify that Charles Bilezikian
88 Mill Lane. Yarmouthport. MA
IS HEREBY GRANTED A LICENSE
For STABLING OF - 5 MIMATURE HORSES I COW. I DONKEY
AT
MASSACHUSETTS GENERAL LAWS-CHAPTER 1 I 1-SECTIONS 1 55 AND 3 1.
PLEASE POST LICENSE ON PREMISES.
This. permit lE gran(ed t[ podqn,rty WII Article VI of t-hg $anitary fde of The Commonwea.lth of Massachusetts, andexpres uecelnDer J I . lt rc uruess soonsr susPenoeq or teYoKm.
Jmuary I9.2006 BOARD oF I{EALTH B"ri*t* 5. @il.r, 11.5., @otaaaa
Jlalon Sral+ RJV., Ulce eAci4ao'
Robf .]. Biorri4 el"rrb
Paf,ri.A fiab"^aot
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Director of