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Town of Mashpee <br /> Application for Entertainment License <br /> Application for En ent License in accordance with Massachusetts general Laws,Chapter 140,Section 183A as amended by <br /> Chapter 694 of 1981. <br /> NAME OF ESTABLISHMENT: <br /> ADDRESS: <br /> Muh=. MA 02642 <br /> TYPE of ENTERT NT: <br /> PLEASE CHECK THE APPROPRIATE B OXES: <br /> 1, G• By Patrons By Entertainers No Dancing <br /> 2. ME SlC'p Recorded Jule Box--2L- Live <br /> Number of Musicians Amplification System No Music <br /> 3. Theatre Movies Floor Show <br /> Light Show No Show <br /> 4. OTHER• <br /> r <br /> bt Three M-modtables <br /> I certify that this application contains a true description of the entertainment prodded by this establishment and that I have <br /> complied with M.G.L. Chapter 140, Section 183A,Paragraph 3,by stating whether as part of the concert,dance exhibition, <br /> cabaret and public show any person will be permitted to appear on the premises m any manner or attire as to expose to <br /> public view any portion of the pubic area, anus,or genitals,or any simulation thereof,or whether any female person will be <br /> permitted to appear on the premises in any manner or attire as to expose to public view any portion of the breast below the <br /> top of the areola,or any simulation thereof. <br /> 9/2619 <br /> Signature of Owner,Manager or Authorized Agent <br /> The Licensing Board reserves the right to request the applicant to fitrnish additional information in accordance with <br /> Chapter 594 of the Acts of 1981. <br /> Date Board of Selectmen <br />