HomeMy WebLinkAboutSTABLE APPLICATION&LICENSE - 2009#oq -oog
TOWN OF YARMO
I146 ROUTE 28, SOUTH YARMOUTH, MASSACHUSETT
Telephone (508) 3 98-2231, ext.24l
Fax (508) 760-3472
APPLICATION FOR OPERATION - 2OO9
STABLE
of
IT
I Icalth
I)ir ision
C-ho-r l<s E, I ezt' l4'a-n HO\{E TEL *o &t iLe-678 3
or 5
/<-a37-/2o
N;\\IE
STABLE ADDRESS
E}IERGENCY CO}.]TACT (NA\IE,PIIONt *llia-
C,L+/'r)OL
MAII-tNG ADDRESS (If DIFFERENI)
vETERTNARTAN (NAME,?HoNE #) V r, J o4tr-t leqc-/'-l 5og-+7 7-332o
TH
DEPT
TOTAL NLANBER OF HORSES,?ONIES TOTAL NTIIVIBER OF STALLS 65
PLEASE LIST EACH HORSE/"oNY/DONKEY,COW SEPARATELY
',../
T\?E oF 'rABLE,''HELTER
k) cod
I
t ::>
el
(wooD. coNcRETE. Erc.)
NLr,\4BER oF HosE BIB WATER ourLETs .)--DRAI}iS ?4WATER TROL:GHS
ryPE OF STORAGE FACII-ITY (:SED FOR FEED GRAIN rnefa*/
TYPE OF FACILITY USED FOR MANURE STORAGE re rrloved-
vErHoD or MANLRE plsposal C n1 led o '-sik
FREQLENCY
CORRAL PEN AREA ENCLOSED BY WHAT TYPE OF FENCT,\iG?os* + r,
OIHER FARV ANMALS MAINTANED AT PRIMISES? YES NO
(PLE.4SE )iOTE: POL;LTRI', Stt'l\E. SHEEP. C.1TTLE. GAITS REOLTRE SE LITE LICENSL.-fuE.),/Y RE^-Ewel
NEw APPLICATION - IF r-EW APPLICATION, PLEASE ATI.{CH A COPY OF PLOT PLAN SHOTV! NG LOT
LINES AND LOCATION OF STABLE, PEN, ETC., AND ALL ENCLOSURES. ALSO. A
1VRITTEN Lf,TTER OR STATE]IIENT. SIGI'ED BY ALL ABUTTERS TO PROPERT}"
Town of Yarmouth taxes and Iiens must be paid prior to renewal or issuurce ofyour permits.
Plea-se check appropriately ifpaid: Yes'_a-l No_
,INIMAL NAME (IF APPIICABLE)Chel*o ( u-vle.,h1o1l)2)"1+d-yfr@\
BREED l1'1 r r-1 t t'y1 t ,'1 t t11l /-'l ,l11it1 I# YEARS O\IT,IED /5 /3
COLOR
___!:Ya r- ta
-
I-15a-zt {acL')Sc,-..-1 6c'^/FtrXz-le,R-ttXtle.sEx Ftttztl-k-tfisl-t-
DATE OF RABIES VACCNATTON /a /an/o+/ 4/2416a / J/t-o /o7 /J,/tz:,/n z
DATE OF EEE VACCINATION
DATE OF OIHER VACCI}JA-IIONS
SIGNATI]RE
FEDS: STABLE & I HORSE S30.00 (+$5.00
5 MtrJt . tloLS€S
DATE J' I
r yoros 2cbg
additional horse/animal)TOTAL DUE: $
r--=--=":---::__:--:--:l-:-_ l
PLEASE COMPLETE ALL OUESTIONS
/')
szE oFCoRRAL eru,e__/S_t /-S
4
l/'
krrtTle,/2.7,,,,L',
-\b THE CONINIO\\\ EALTH OF NIASSACHTiSETTS
TOWN OF YARNIOTITH
BOARD OF HEALTH
FEE: 560.00
This is lo Certifi drar Charles Bilezil<ian
88 Mill Lane. Yarmouthport. MA
IS HEREBY GRANTED A LICE\SE
For STAFII TNG OF - S I\,IINIATI ]RF HORSFq I anw /qFAqoNAI \ r nnNI(Fv
AT ABOVE ADD SS. GRANTED IN ACCORDANCE WITH ROVISIONS OF
IVIASSACHUSETTS GENERAL LAWS.CHAPTER lII.SECTIONS I55 AND 3I.
PLEASE POST LICENSE ON PRIIIISES.
I'l'dr.T::ffls,is$3f}|86u-\;iliLgiil',:,1,'i';*H.;ili'.1?.tsf: "r*e Courmorr*eartrr.r\Iassacrrusens' and
BOARI) OF HEAI-I TI gklzn S frart, fr ."\[., QAatunnt
ehailu 5L gtelliAy, Ake ehsamanfrolql g. fiuun,ebtA
&&fr."\i.
rucc urp }].Drector of Health
PERMIT NUMBER: #09-008
Dcccmber 17. 2008