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,APPLICATION FOR ALCOHOL-IC BEVERAG LICENSE _ The Commonwealth of Massachusetts <br /> *i <br /> ALCOHOLIC B EVERAGES CONTROL COMMISSION <br /> a. <br /> G ?lerl questions to be answered by all applicants. <br /> Please type or print I gihly in irk. Fee <br /> I ffRestadrant­_7--F- <br /> e of alcoholic beverages license: check only ONE) <br /> l uran - omerial� lOV. � nnhbider -enraOrPrepit-e . 11Taii'ern lub =- <br /> • . <br /> ­.. <br /> Package Goods Store F10ther(specify): <br /> .2. Class of license: DAIJ Alcoholic Beverages lWine and Malt Beverages <br /> x <br /> Applicant is an Individual �Palrtnerihip �Limited Partnershs'p E113usiness Corporation <br /> lion-profit Corporation E]Other (specify) - ... _ <br /> .-.--If applicant. is an individual, partnership,general partnership or limited partnership, state the following in a, b,and <br /> For each person - FALL NAME HOME ADDRESS SOCIAL SECUOITY, <br /> I <br /> 1 <br /> 2 <br /> --b. Firm or trade name, address and telephone no: <br /> c. Business name d/h/a) if different <br /> Address: Telephone no; <br /> If applicant has a d/b/a, applicant musr in ude a copy of the c r i#icate of doing business, required under Massachusetts General <br /> �rwr <br /> Law Chap I 10. Sect..5, regard fess of whi h name ii I appear on the Il en e 4 <br /> S It app I i can t i s a corp prat i on: <br /> a. List the titles of all officers, the manager, and,all-members of the board directors. Below-these list all.stockholders. ass <br /> I <br /> defined in the instruction sheet). Tien give{ h full name,hom "addre s'and'the number of shares of-stock for each: <br /> _ <br /> K0.-0 F SHARES OF <br /> -T-1 T L E FULL NAME ., - .. ,. �,.t'„_..�'I E A00RESS SOCIAL SECURITY.STOCK OWNED OR <br /> CQUIEDL-LECLIE ANY <br /> t <br /> + e 3 r x Mi r Crowell Road �_.._. ._...- None .. <br /> --Treasurer, _.,.. .. __.:, T Yarmouth, MA - - <br /> .,il.l <br /> _ Director'-, Manager <br /> 1 ,' �I__q____r.5. -'.Y�gilii PII �+ _—,Y_� __ _ 1 ■■ ISI <br /> TTT - <br /> 101 Crowell Road Director - <br /> None <br /> 101 Crowell R6ad - <br /> gixe Alexander Mitr a Lest-, rm . <br /> �t _ 2 None <br /> — — �+ilar,rr.rrr�_5�r+i, -— Y ,i.19h�Y4 <br /> 1 <br /> ShareholderMountain illage =' i ed Partnership <br /> t <br /> Alexander irons Crowell I. Road shares <br /> �liil�llI.. <br /> Genegal ar raer- .. - - Kest.;Yarmouth,_' MA 02673 - <br /> b. Corporation name: Barnstable Piz alta Inc. <br /> Address 401 Nathan n Ellis icr a (Route I 1_) Maghpee Telephone no. <br /> c. Business name (d/b/a) if different: ��1a�� �T ' <br /> al_. Ykw� <br /> Address 401 Nathan han llis Highway, Masi ee r SLA Telephone no. <br /> (if applicant has a d b/a, applicant must include a copy of the certificate of,deing business required under Massachusetts <br /> Gen era I Lai+ Chap, I 10. Se cc. 5. regardless of which name will appear ori the license) <br /> HOBBS & WAAREN, INC. FORM 985 - 1983 <br />