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t! <br /> - Date of State of Date qualified to do business in <br /> d. incorp orad on: u _-19_ 0 e. incorporation: Iii �. the ommonwealth oU.Massachusetts:.-June. 1 <br /> (attach a copy of approved certificate at organi ati n <br /> 6, If applicant is a club, association, limited partnership, or other type of organization: <br /> a. List for each principal officer. (Note.- Each association member who signs-this application must ahsw'et- this"gbestion)+ <br /> TI TLE FULL NAME HOME ADDRIESS TELEPHONE 14UMBER ` <br /> i <br /> . Trade, firm or business n e: <br /> Add res s: Telephone no. <br /> (if applicant has a d/b/a. applicant must include a copy' of the certificate of doing business, required under Massachusetts <br /> General Law Chap. 110. Sect. S. regardless of whi h name i I I appear on the licensed -. - <br /> , . State name, address and telephone.number of a person who can be contacted concerning this application. - f <br /> Constantinos +Ii a _.„_ 101 Crowell -Road, Te t rmo_ ,.._MA1 <br /> Ir <br /> .,:.Address and telephone of premises to be licensed: <br /> ' - 1 i ghma .r (Rnji t 1 1 r ;q- to P_ Mil - __ _ - _-_�•_ _,.._ - '+l <br /> 9 <br /> . r full and c rrrpl t deiriptio r of the Ore ntis s•.to he license&, including location of-all entrances' and d kits; �k <br /> • f., - o � {. - , * '#++ i�.�* -. .i .t ” ,_ . - Y, - - t*e f i + . ' 7` 1# r ? . .. •*a -+: T 3 L � ' -• <br /> fiSe`e`iketch1800 square feete more <br /> . of first floor space <br /> _..shown "Tenant #1" -on attached ket . <br /> 10, a. bili there be any major remodeling, redecorating or building on the premises in preparation for acquWtlon of this license? <br /> 0Yes ZIf Yes, complete b, c, d, and e. . <br /> .. <br /> Give a brief description of the planned changes: <br /> �. Estimate schedule, ... .�._,. <br /> c. Estimated costs: d. construction <br /> .�_ . state all sources of financing: _ <br /> 11. a. Does the applicant own the premises to be licensed? Yes R]No If no, state; <br /> .. 1.,Names, addresses and telephone number of owners; - - - <br /> ofPond Center ate <br /> 101 C.=Kgl]L Rnad , west Yarmouth- mA,--02673 - _4508) 211- } <br /> k <br /> 2. <br /> F <br /> Indicate whether applicant will be a EXILessee ElSublessee DAssignee or �0 ther <br /> Specify other: <br />