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2004
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2004
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Last modified
12/1/2016 8:56:20 PM
Creation date
11/13/2016 10:16:15 PM
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Box 037
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r <br /> p.sCbah���d 3 ay-,20/1Y <br /> Y <br /> 4 BUSINESS CERTIFICATE#05_1,fr <br /> THE COMMONWEALTH OF MASSACHUSETTS <br /> • TOWNOFMASHPEE <br /> DATE I5 — 06H <br /> Expiration Date: December 31, 2009 <br /> In conformity with the provisions of Chapter one hundred and ten, Section five of the General Laws, as amended, the <br /> undersigned hereby declare(s)that a business under the title of p \ <br /> DBA '�/q1 CY-%Ae i SC'S is conducted at <br /> Business Location: ry A t, ke t o I ( o) J /e- ( rcL )G//�� bA/J1e P <br /> Business Mailing Address: y� ! '�)Le✓ 9 D Ue_ C, rcSGC i'))G Shioee <br /> Business Type: l»�GY»GT ynarKG�i n� Business Telephone: A-o8- 177-7(,,61 <br /> by the following named persons: <br /> FULLN ' RESIDENCE <br /> t C \e— 4L . C y 0=(z `/7.� P, t e kEJ Clwe C%1 CiI� <br /> —a . C-6cAe- !/3 10; c% ✓GI rove C <br /> Home Phone: 56L'-/ `]7'S 3 <br /> &rtify under the penalties of perjury that I, to the best of my knowledge and belief, have filed all state tax returns and paid all state <br /> es as required under law. <br /> (-"�".0 <br /> *Signature of individual By: Corporate Officer <br /> 10 -0C4)0_131 ��� �e✓ ��> <br /> **Social Security Number(Voluntary <br /> or Federal Identification Number <br /> *This license will not be issued unless this certification is signed by applicant <br /> **Your social security number will be famished to the Massachusetts Department of Revenue to determine whether you have met tax filing or tax <br /> payment obligations. Licensees who fail to correct their non-filing or delinquency will be subiect to license suspension or revocation. This request <br /> is made under the authority of Massachusetts General Law,Chapter 62C,Section 49A. <br /> The Commonwealth of Massachusetts <br /> BARNSTABLE ss DATE a-30 <br /> Personally appeared before me the below named_L.),=/, -hOelle and made oath that the foregoing statement is <br /> true. <br /> A certificate issued in accordance with this section shall be in force and effect for four years from the date of issue and shall be renewed <br /> each four years thereafter so long as such business shall be conducted and shall lapse and be void unless so renewed. <br /> Signed <br /> o P bl' <br /> SEAL MARIl1 <br /> 6Xom0 <br /> Common"'eahh is <br /> l GY0 <br /> 6 <br /> M% m Commissin Expires: <br />
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