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APPLICANTS STATEMENT <br /> LORRAINE J COFFEv : � o e proprietor; partner; �corporate principal; ❑ LLC LLP manager <br /> 1, the. s l p p p � p p p � g <br /> Authorized Signatory <br /> of NEW SEABURY RESOURCES MANAGEMENT, <br /> Name of the Entity/Corporation <br /> hereby submit this application(hereinafter the 'Application"),to the local licensing authority(the"LLA")and the Alcoholic, <br /> Beverages Control Commission (the"ABCC"and together with the LLA collectively the"Licensing Authorities")for approval. <br /> I do hereby declare under the pains and penalties of perjury that I have personal knowledge of the information submitted in the <br /> Application,and as such affirm that all statements and representations therein are true to the best of my knowledge and belief. <br /> I further submit-the following to be tr'ue and accurate; <br /> (1) 1 understand that each representation in this Application is material to the Licensing Authorities'decision on the <br /> Application and that the Licensing Authorities will rely on each and every answer in the Application and accompanying <br /> documents In reaching its decision; <br /> (2) 1 state that the location and description of the proposed licensed premises are In compliance with state <br /> and local laws and regulations; 3 <br /> (B) i understand that while the Application Is pending,I must notify the Licensing Authorities of any change In the <br /> Information submitted therein. I understand that failure to give such notice to the Licensing Authorities may result In <br /> disapproval of the Application; <br /> (4) 1 understand that upon approval of the Application, I must notify the Licensing Authorities of any change in the <br /> ownership as approved by the Licensing Authorities. l understand that failure to give such notice to the <br /> Licensing Authoritles may result in sanctions including revocation of any license for which this Application is submitted; <br /> (5) 1 understand that the licensee will be bound by the statements and representations made in the Application,including, <br /> but not limited to the identity of persons with an ownership or financial interest in the license; <br /> (6) 1 understand that all statements and representations made become conditions-of the license; <br /> (7) 1 understand that any physical alterations to or changes to the size of the area used for the sale,delivery,storage,or <br /> consumption of alcoholic beverages, must be reported to the Licensing Authorities and may require the prior approval <br /> of the Licensing Authorities; <br /> (S) 1 understand that the licensee's failure to operate the licensed premises In accordance with the statements and <br /> representations made in the Application may result In sanctions,including the revocation of any license for which the <br /> Application was submitted;and <br /> (9) 1 understand that any false statement or misrepresentation will constitute cause for disapproval of the Application or <br /> sanctions including revocation of any license for which this Application Is submitted. <br /> '(10) 1 confirm that the applicant corporation and each individual listed in the ownership section of the application is in <br /> good standing with the Massachusetts Department of Revenue and has complied with all laws of the Commonwealth <br /> relating to taxes,reporting of employees and contractors,and withholding and remitting of child support. <br /> Signature: rly�LJA A Date: 1 1Io4I1 9 <br /> Title; SECRETARY,VP,DIRECTOR <br />