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THE COMMONWEALTH OF MASSACHUSETTS <br /> FEL •00 <br /> ..---.............'o.�elcy_...0..... l S1fP_.E ............................................... <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 /> a � ... ................ .__.. .... , <br /> I►lee Se►uon �ommuut Btdg. .nea� Neth !?d. No.-l.loafrpee... . <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, „w >�,..•. ,. 7 �,. �. <br /> ❑ (c) Fraternal or fraternal benefit society; or, <br /> ❑ (d) Educational or charitable organization; or, <br /> ',;a (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 j <br /> shareholder. <br /> Officers or members of organization responsible for operation of raffle or bazaar: <br /> Name Residence Address , 4,,4 T�t^•�-Y - <br /> ,..,. r.- a.. ...n t, <br /> x.,,.s`a,�nx�lii:-7 �Y. .f4� �3.�y�s'f�,t t �•� � n .w nP': r �,x s �� � t � `: y:r'-y, n a a;''S""�:. _.. - <br /> ri 1 <br /> (1) Tul Fetae%c . .:4 �53�FTaG�ouh�urt , -2--- <br /> .................................... <br /> (2) . ,...I orad, }----- ---- -- �1_.t7oEi.�. --T.eat tr_ -.02 36._- <br /> Fn f!' 379 m� �. P.D. Box 21� l►1 Aa. 026 9 <br /> (3) �. u�to� Ticeaa. aaft�ee - <br /> ------------------------•- - ---------------• ---a••--- . <br /> ------------------------ eco ........... ............... <br /> Uses to which net proceeds will be applied: ...&e&Aea wh_aid ne fated <br /> .......................... -----------------------------------------•--------------------------------------------------------------------------------------_-----------•------------------- <br /> I. s�7ia�'fr��#C7rr <br /> .- .. _._. ...-. ..... _.. .. <br /> ' (signature of an horized officer or member of organization) <br /> Application certified to be in <br /> conformity with C. 810, Acts <br /> of 19 : <br /> _`�'- _. <br /> City/Town Clerk <br /> f <br /> PERMIT (ISSUED) O <br /> ,�ISJ� vA :Y---�-- -------- The applicant (is) 4toes and <br /> e t�Q �I -f1— <br /> bazaars under the provision9: <br /> City/To Clerk <br /> lc c6 <br /> oc-ao� s� <br /> FORM 810 H0888$WARREN. INC. , <br />