Laserfiche WebLink
i <br /> THE COMMONWEALTH OF MASSACHUSETTS <br /> FEE <br /> Zane._o�.h?ao ................................................................... <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 /> ..__m _ --C�--•-•-•----•-•....•-•-•••----•'•--••••---•.._._...••---....._... <br /> ------------•-•------'-----•....................................................................._...... <br /> Evidence of Qualification for Permit: <br /> ❑ (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 /> ❑ (b) Church or religious organization; or, <br /> ❑ (c) Fraternal or fraternal benefit society; or, <br /> ❑ (d) Educational or charitable organization; or, <br /> [� (e) Civic or service club or organization; or, <br /> ❑ (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 /> 1 '�I <br /> Officers or members of organization responsible for operation of raffle or bazaar: <br /> Name Residence Address <br /> L. P"L D . agcun 14ve. r1aah&w--er Ma. 026 r°0' a <br /> (2) ...1lZt.Lic m.iU. MLLta S e--- ryech.Y 1 U <br /> _ ,-- � �-�n�t.. ?�..-r.taafi�_e,__l�laaa__L126_�9___---_I_o0Ldac._1.d£z...._ ; <br /> fnvrrJz �. gichz Thea,,. rain St. �•'1aehvee Act. 02649 ;V. dox21 4 <br /> i 31 ........ .....t-----.__......._-�---•--------•-..._._.. _....._..._......... .-•--- 1--._...---•----•----------------------------•----•----••-------••---•--•'•--•.._._..... <br /> Uses to which net proceeds will be applied: .2,eeeaAch__ar1,d_ %eZatzd-oao1p�_____________•_____- <br /> (signature of authorized officer or member of organization) <br /> Application certified to be in <br /> conformity with C. 810, Acts <br /> of 1969: <br /> City/Town Clerk I. <br /> i <br /> a <br /> PERMIT (ISSUED) (DENIED) I <br /> The.. ......... ...�-Q_� pp (is) (ia-ked qualified to operate raffles and <br /> (date) Q bazaars under the provisions of C. 810, Acts of 1969: <br /> City/Town Clerk <br /> ...._...._ 4C�hief <br /> oli ' ................ <br /> FORM 810 HOp�9 d; 'NARRF.N, INC. <br />