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THE COMMONWEALTH OF MASSACHUSETTS <br /> FEE I <br /> f <br /> -------------------------- <br /> Aas �nn ,� / <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 /> � <br /> p�..�... - c -p-1 <br /> .................................................................................................... <br /> i., ------------ <br /> Evidence of Qualification for Permit: <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 /> =�s------------------------------ Cly = �J D _►r��__ h �_mrd <br /> 1 C- <br /> (2) _ _��_�_��1-r� � rY� � i '_� ------------� tT ��• <br /> (3) ,---_(004-0 ------------- <br /> Uses <br /> -----------Uses to which net proceeds will be applied: ___________________________________________________________________________ <br /> -----All---- �� d��-----W-1h----6.L.-��1nc1. C r�[ Irir C� p <br /> ---�'-d---- --=----------------------------------------------------------------------------------------•-------------- <br /> -•-- $ <br /> (signature of authorized offic�Wore�&r'�oi <br /> Application certified to be in <br /> conformity with C. 810, Acts <br /> of 1969 <br /> City/Town Clerk <br /> PERMIT (ISSUED) (DENIED) <br /> 5 C/ <br /> ...... The applicant (is) ( }qualified to operate raffles and <br /> (date) / bazaars under the provisions of C. 810, Acts of 1969: <br /> e rQ • L .�t.� r� <br /> --------------------------............. <br /> City/Town Clerk <br /> -•• ��iief- <br /> Poli <br /> CURTIS W. RYE <br /> rHIEF OF POLICE <br /> MASHPEE, <br /> FORM 810 HOBBS & WARREN, INC. <br /> �.ss' <br />