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APPLICATION FOR A NEW LICENSE <br /> 6A. INTEREST IN AN ALCOHOLIC BEVERAGES LICENSE <br /> Does any individual or entity identified in question 6,and,applicable attachments, have any direct or indirect,beneficial or financial <br /> interest in any other license to sell alcoholic beverages? Yes [x:] No If yes,list in table below.Attach additional pages,if <br /> necessary,utilizing the table format below. <br /> Name License Type License Name Municipality <br /> Jan Aggerbeck All alcoholic Cape Cod Coffee LLC Barnstable <br /> 613. PREVIOUSLY LD INTEREST'IN AN ALCOHOLIC BEVERAGES LICENSE <br /> Has any individual or entity identified in questio n 6,and applicable attachments,ever held a direct or indirect,beneficial or financial <br /> interest in a license to sell alcoholic beverages,which is not presently held? Yes No <br /> If yes,list in table below.Attach additional pages,if necessary,utilizing the table format below. <br /> Name License Type License Name Municipality <br /> 6C DISCLOSURE OF LICENSE DISCIPLINARY ACTION <br /> Have any of the disclosed licenses listed in question 6Aor 6B ever been suspended,revoked or cancelled? <br /> Yes 0 No N If yes,list in table below.Attach additional pages,if necessary,utilizing the table format below. <br /> Date of Action Name of License city Reason for suspension,revocation or cancellation <br /> 7. OCCUPANCY OF PREMISES <br /> IPlease complete all fields in this section. Please provide proof of legal occupancy of the premises. <br /> if the applicant entity owns the,premises,a deed is required. <br /> If leasing or renting the premises,a signed copy of the lease is required. <br /> If the lease is contingent on the approval of this license,and a signed lease is not available,a copy of the unsigned lease and a letter <br /> of intent to lease,signed by the applicant and the landlord,is required. <br /> If the real estate and business are owned by the same individuals listed in question 6, either individually or through separate <br /> business entities,a signed copy of a lease between the two entities is required. <br /> Please indicate by what means the ap plicant will occupy the premises Lease <br /> Landlord Name Modi LLC <br /> Landlord Phone Landlord Email <br /> Landlord Address hpee MA 02649 <br /> Lease Beginning Date May 1,20,20 Rent per Month 2215,00.00 <br /> Lease Ending Date April 30,2025 Rent peir Year 270,000.00 <br /> Will the Landlord receive revenue based on percentage of alcohol sales.? C Yes ('o No 3 <br />