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THE COMMONWEALTH OF MASSACHUSETTS <br /> ��s� �� � FEE <br /> , , <br /> ................................ <br /> .................9------------------------------------------------------ <br /> (city or town) <br /> APPLICATION FOR PERMIT TO CONDUCT RAFFLES AND BAZAARS <br /> (C. 810, ACTS OF 1969) <br /> Name and address of Nonprofit Organization: <br /> -------------e&'�� <br /> ---------- .......................... . ............. .... <br /> ........... //fs....... Al,*s.h�0,06.L,,7............. -----------0-Z6�i-9........................... <br /> ............................................................I...eLq....................... ............................ <br /> Evidence of Qualification for Permit: <br /> E] (a) Veterans'organization chartered by the Congress of the United States or included in clause (12) <br /> of section five of chapter forty of the General Laws; or, <br /> E] (b) Church or religious organization; or, <br /> ❑ c) Fraternal or fraternal beneflt society; or, <br /> (d) Educational or charitable organization; or, <br /> F1 (e) Civic or service club or organization; or, <br /> E?/(f) Club or organization organized and operated exclusively for pleasure, recreation and other <br /> nonprofit purposes, no part of the net earnings of which inures to the benefit of any member or <br /> shareholder. <br /> Officers or members of organization responsible for operation of raffle or bazaar: <br /> Name Residence Address <br /> �A K FP-1F-:5 I 0-5�t-gj– ............................ <br /> ( kkA"--N)06+ &A <br /> ------------ Da ���sr V----------------- -------------------- <br /> - -------- & <br /> V -RIestjP�T <br /> .................................. .................w....................................... <br /> -----------------------------------------------------------------------------------------------------& <br /> .fm d , <br /> (3) --- ....... .�e <br /> t2c-( 5crrZr- DR' A - <br /> .....................................A4 <br /> Uses to which net proceeds will be applied: J., <br /> .. ........ c <br /> ---------------------------- <br /> ----------- .... ................................................................ ------------------------------------ <br /> ............................................................................................................................. ......................................................... <br /> nature of an horiz i. <br /> .......... .. ................... ... .. . ...... ........................................................ <br /> Application certified to be in (signature of t oriz offic or member of organization) <br /> conformity with C. 810, Acts <br /> of 1969 <br /> City/Town Clerk <br /> PERMIT (ISSUED) (D+Wf$b) <br /> ................................. The applicant (is) (4saaQL) qualified to operate raffles and <br /> (date) bazaars under the provisions of C. 810, Acts of 1969: <br /> Clerk <br /> .... ...... ........ ............................. <br /> Chie of lies <br /> CURTIS W. FRY9 <br /> CHIEF OF POLI" <br /> FORM HOBBS& WARREN, INC. <br />