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L 1 BUSINESS CERTIFICATE#05=Q3 <br /> THE COMMONWEALTH OF MASSACHUSETTS <br /> TOWN OFMASHFEE n�I LL <br /> DATE �/p(�D/Vn <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 < <br /> declare(s)that a business under the title of <br /> C Cad 15 LAA DBA is conducted at <br /> Business Location: 5L N CCl� S � <br /> Business Mailing Address: II <br /> Business Type: Business Telephone: <br /> by the following named persons: <br /> FULL NAME RESIDENCE <br /> levlcc �wtbrbS 2 Ener �v ,I (orESlda�E �IL{ oz6tl'I <br /> Home Phone: SZS' <br /> 0�rtify under the penalties of perjury that I,to the best of my knowledge and belief,have filed all state tax re h s and paid all state <br /> es as required law. <br /> * ature o ' vidual y: Corporat facer <br /> O+ 3276­ 3 `Iq <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 fumished 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 subject to license suspension or revocation. This request <br /> is made under the authority of Massachusens General Law,Chapter 62C,Section 49A. . <br /> The Commonwealth ofMassaehusetis /1 <br /> BARNSTABLE ss // -- DATE <br /> Personally appeared before me the below named 1-002e AO/ /Jf� 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 /> �S <br /> MerganA C. Sant= Notary Public <br /> SEAL o O*Cir!�E*MW24,2010 <br /> ,NOTARY PUBLIC <br /> Commission Expires: <br />