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i <br /> � I <br /> THE COMMONWEALTH OF MASSACHUSETTS. <br /> FEE a 6 <br /> ( ....................... <br /> city or wn) <br /> APPLICATION FOR PERMIT TO CONDUCT RAFFLES AND BAZAARS <br /> (C. 810, ACTS OF 1969) <br /> Name and address of Nonprofit Organiza 'on: <br /> I. <br /> I <br /> I' ------------------••-••----.._.._...... -----------------------------...............----------------------•---••-----------......-----.......------......_............ <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 /> Officers or members of organization responsible for operation of rate or bazaar: <br /> Name' Residence Address <br /> (1) -- -ti- -- _ p--- ------ ------ X113..--- L7 <br /> , <br /> ---------------------R(3) -- a ut -._.......— ............ <br /> - <br /> I <br /> - ------------------ ---------------------------- <br /> Uses to which net proceeds will be applied- ---------------------------------------•----•-•--------------•----.......-------------•------------------------- <br /> ` Qf 'Q — p lel). _h.._... J_E.1�.Q — ---------------•------------------------------------_--------— <br /> authorized officer or member of organization) <br /> (signature o i <br /> Application certified to be in <br /> conformity with C. 810, Acts <br /> of 1969 <br /> 4---n <br /> City/Town Clerk <br /> PERMIT (ISSUED) (DENIED), <br /> TS1N. y'.:k1.9 �b---- ' <br /> .......:...... The applicant (is) (ie�et) qualified to operate rakes and <br /> (dite> ` ' t, bazaars under the provisions of C. 810, Acts of 1960: <br /> 1 <br /> City/Town Clerk. <br /> �------------------------ <br /> CURTiS W. FRYE <br /> CHIEF OF POLICE <br /> FORM 810 HOBBS & WARREN, <br />