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THE COMMONWEALTH OF MASSACHUSETTS <br /> FEE 20 . 00 <br /> Mas-tepee <br /> (city or town) <br /> APPLICATION FOR PERMIT TO CONDUCT RAFFLES AND BAZAARS <br /> (C. 810, ACTS OF 1969) <br /> h� <br /> Name and address of Nonprofit Organization: <br /> ---------------------------------------------------P-e_oala...to---Peapla--------------------------------•--•---•---------------------------•------- j <br /> ...................PQ--Box...A-------------------------------- -Lo---New---aeabury-•-•CQ-.---------...Mashpee.,...Ma. 02649 <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 organizations 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 /> (1) ------Lionel LeBlanc_} Pres---------------------•- Gleneagle Drive, Mashpee, MA <br /> .................... ----------------------•-----------------------•---------•--•-------•------------............ <br /> (2) ------Christopher--Burden VPres----------------- ross Road. MashPee, MA <br /> (3) ......patricia-Re-y_nolds-'---Treasurer----. ------ rassie- Way. Mashpee. MA <br /> Uses to which net proceeds will be applied: ---•-------------------•----•---•-•••-----------•------•-•-----•------•--------•--------•---•-•----•-------------- <br /> ...............All_proceeds__will..be-danated..to.Mas- e.e..and/Q-r..Cape..Cod---charities.................... <br /> i <br /> o-- <br /> - ------------------------- <br /> (signatu of aut rite eer or member of ganiza <br /> Application certified to be in <br /> conformity with C. 810, Acts <br /> of 19 <br /> City/Town Clerk <br /> PERMIT (ISSUED) (D ) <br /> - I <br /> -- ..6 �},-_.-..��') 6 The applicant (is) (is nett qualified to operate raffles and <br /> (da bazaars under the provisions of C. 810, Acts of 1969: <br /> ----- --- <br /> -ity /Town Clerk <br /> ---------•-•------ <br /> �` Chief f olive <br /> FORM 810 HOBBS & WARREN, INC. <br />