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e flu <br /> THE COMMONWEALTH OF MASSACHUSETTS <br /> FEE <br /> -------------- ------------------ <br /> I F. (city or town) <br /> APPLICATION FOR PERMIT TO CONDUCT RAFFLES AND BAZAARS <br /> +; (C. 810, ACTS OF 1969) <br /> Name and address of Nonprofit Organization: <br /> ----------------- _5.H_ .� .--Tl_ � �CJi)_ .. ���-------------------------------- --------------------------- <br /> �--p <br /> --•--------------- -CoF�'T � .22 ' t�.'i �tt.L� (P..1`1"a-1.......M. <br /> Evidence of Qualification for Permit: u4 <br /> ❑ (a) Veterans'organization chartered by the Congress of the United States or included in clause (12) <br /> of section five of chapter forty of the General Laws; or, <br /> ❑ (b) Church or religious organization; or, <br /> GR ❑ (c) Fraternal or fraternal benefit society; or, <br /> f' ❑ (d) Educational or charitable organization; or, <br /> 4 <br /> '4 (e) Civic or service club or organization; or, <br /> (f) Club or organization organized and operated exclusively for pleasure, recreation and other <br /> nonprofit purposes, no part of the net earnings of which inures to the benefit of any member or <br /> shareholder. <br /> Officers or members of organization responsible for,operation of rare or bazaar: <br /> y Name Residence Address <br /> F. <br /> F - <br /> (2) Ws------- ------ <br /> 4 <br /> (3) ......L�`� ��s___....�!2 S_. �'�---- ----------------------------•----------------------- --------�/------------------------------._...----- I <br /> Uses to which net proceeds will be a plied: -_7 ,11 =._ J�1,1_ ___.� �✓��.PA �__... r__-_-agt�o ! <br /> UP-4 <br /> --------------- <br /> ature of aut orized officer or member of org-a- ----------- <br /> nization) <br /> Application certified to be in j <br /> confor *Ty with C. 810, Acts <br /> of69: ---------------------------- <br /> City/Town Clerk <br /> PERMIT (ISSUED) (1 -ED) <br /> 4 ---------------- The applicant (is) (is mot) qualified to operate raffles and <br /> (date) bazaars under the provisions of C. 810, Acts of 1969: <br /> �' N <br /> City/Town Clerk <br /> Chief P <br /> r CURTIS W. FRYE <br /> CHIEF OF POLICE <br /> MASHM <br /> FORM 810 HOBBS & WARREN, INC. - <br /> w�i�x <br />