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THE COMMONWEALTH OF MASSACHUSETTS <br /> FEE <br /> TOWN OF PIASHPEE $10.00 <br /> ----------------------------------------------------------------------------------------------------------- <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 /> J. <br /> --- <br /> MASI�PE�E--'P�I�IQRhAL-----POST__#5489� ------y.F_..W..-----------................................................. I <br /> ----- ' <br /> P 0. BOX 207, TiASHPEE ......A._ 02649------------- -- - <br /> Evidence of Qualification for Permit: <br /> XX (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 /> Officers or members of organization responsible for operation of raffle or bazaar: <br /> Name Residence Address <br /> (1) <br /> ...C-QWANDER.---JOHN--.E.4----DAM!--------------------CAPPAWACK--RD,-, MASHPEE.1viA.. 02649 <br /> (2) _-. R,.--Vl E-_COMMANDER-_FREDERI.CK PETERS RTE 103,PIASHPEEtM. 02649 <br /> (3) ...QUAR.TERIWk R---QUITIS--W. FRYE-- 34---AUTUMN DR._)... dTASHPEZ, IIIA. 02649 <br /> Uses to which net proceeds will be applied: -----Vete2 ans--b-12-ilding---fund--------------------------------------------- i <br /> ---------------------------------------------------------------------------------------------------------------------------------------------------------------------- ----------------------- <br /> - --------- <br /> ------------- ---------------------------C;)............ <br /> M�Yr�---------------------------------- <br /> ture of authorized officer o member of organization) <br /> Application certified to be in <br /> conformity with C. 810, Acts <br /> of 1969: <br /> City/Town Clerk <br /> PERMIT (ISSUED) (DENIED) <br /> The applicant (is) (is not) qualified to A ope e raffles and <br /> (date) bazaars under the provisions of C. 810, is o 969: <br /> City/Town Clerk A�,� <br /> �?Q ��'"" '�---4ioiic--e <br /> -- -----•-- --•- <br /> P AYChief <br /> FORM 810 HOBBS &WARREN, INC, <br />