TOWN OF MEDWAY
APPLICATION FOR A PERMIT TO KEEP FARM ANIMALS
INCLUDING BUT NOT LIMITED TO: EQUINE, COWS, SWINE, POULTRY, GOATS, SHEEP, DOMESTIC BIRDS, RABBITS,
LLAMAS, ALPACAS, RHEAS, OSTRICH, EMUS, BEES, and ANY OTHER DOMESTIC FARM ANIMALS & EXOTIC ANIMALS
Name of Applicant:________________________________________________owner/renter*
*renters MUST have written permission from landlord
(circle one)
Address: _______________________________________________________
(Where animals are to be housed)
Mailing address: _________________________________________________
(If different)
Email address: _____________________________________Phone #__________________________
Total Acreage: __________________***please note if you live within zoning district AR II and have less than
44,000 square feet of land you are PROHIBITED by zoning bylaws to have ANY type of livestock or poultry.
Livestock/ poultry to be on the property:
(Please note total number of each animal you wish to house at the above listed property)
Horses______ Donkeys______ Mules ______ Ponies______Cows______
Goats______ Sheep ______ Swine ______ Rabbits ______
Chickens* ______ Ducks ______ Geese ______ Emus, Ostrich, Rhea ______
(Hens only)
Turkey ______ Game Birds______
*please note ROOSTERS are not allowed in ANY residential area only industrial zoned areas with setbacks-please
see Board of Health Rules & Regulations adopted on 6-16-1999.
By signing the application below, I certify that I have obtained all permits and permissions from any and all Boards
or Departments regarding building structures, setbacks, fencing and wetland issues.
I also certify that I have obtained and read the Medway Board of Health’s “Regulations of domesticated or exotic
animals, reptiles and apiaries” adopted on June 16, 1999, and understand that my permit must be renewed yearly,
and that IF a permit is issued the Board of Health MUST be notified of any and all changes to the amount of
animals or kind of animals housed on the property at the time of the change, and agree to abide by the provisions
set forth within the regulations.
_____________________________________________
Signature of applicant
_____________________
Date
BARNS WILL BE INSPECTED ANNUALLY BY THE ANIMAL INSPECTOR.
Failure to allow an inspection shall be cause for permit revocation.
ALL PERMITS EXPIRE ON DECEMBER 31st.