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THE COMMONWEALTH OF MASSACHUSETTS <br /> FEE <br /> MASHPEE $10.00 <br /> ------------------------------------------------------------------- ------------------------------------•-•- <br /> (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 /> G1BrownielrooDumber 738------ --- -- --- <br /> I ; <br /> ------- •-----•------1-0- Edgewate-:'-Rd-.--,----Mashp-e-e-,----Na••••-•--••--••---•---•-•-----••-----•............................. <br /> i <br /> Evidence of Qualification for Permit: <br /> is <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 /> ❑ (c) Fraternal or fraternal benefit society; or, <br /> ❑ (d) Educational or charitable organization; or, <br /> ❑ (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 raffle or bazaar: <br /> Name Residence Address <br /> Veronica Gallagher 10 L'dgewater Rd. , Mashpee, Ma/ <br /> (1) - ------ --------------------------- ------ <br /> Kathrine Jordan 120•_3ayberry_...St-.•,...Mashpeq_, Ma <br /> ------- <br /> Uses to which net proceeds will be applied: ----------------------------------------------------- ------------------- --------------------- -------- <br /> ------------------------------------ -------------------------------------------------------------------------------------------------------------------- --------------------------- <br /> ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- <br /> ---------------------------------------------- <br /> (signature of authoriz officer or member of organization) <br /> Application certified to be in <br /> conformity with C. 810, Acts <br /> of 1969 <br /> —94y,'Town Clerk <br /> PERMIT (ISSUED) { <br /> ------- The applicant (is) (is not) qualified to operate raffles and <br /> (date) bazaars under the provisions of C. 810, Acts of 1969: <br /> -E+L7YTown Clerk <br /> L. <br /> QQ �4r Chief of Poy ee <br /> �., FORM 810 HOBBS & WARREN, INC. <br />