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BUSINESS CERTIFICATE#07 3 3 <br /> • THE COMMONWEALTH OF MASSACHUSETTS <br /> TOWN OF MASHPEE <br /> DATE <br /> /-67 <br /> Expiration Date: December 31, 2011 <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 <br /> p (p7 <br /> ID I ke� 2JA C_ DBAl Zq C' is conducted at <br /> Business Location: M 7 /jfQ�,t�,,Qa{_, 67& S <br /> Business Mailing Address:: <br /> Business Type: 131 14 19 �( Nia l Business Telephone: <br /> by the following named persons: <br /> /! FULL AM'En RE IDEN() <br /> Home Phone: Tr", SY' as�lTL-. .eyAJt.• ,¢'e�b' '7/—Y9Y7 <br /> I certify 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 /> ired under law. <br /> #-sulYll <br /> 33 <br /> *Sign of uthorized agent *Signature of authorized agent <br /> 5s o20 - S$-5737 <br /> **Social Security Number(Voluntary) <br /> or Federal Identification Number - S"r7 jd-Q�� <br /> In case of emergency <br /> NAME: I Wkw TELEPHONE NUMBER:507—y77/riga <br /> Alarm Company: <br /> *This license will not a issued unless this certification is signed by applicant <br /> **Your social security number will be furnished 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 Massachusetts General Law,Chapter 62C,Section 49A. <br /> The Commonwealth of Massachusetts <br /> BARNSTABLE ss DATE U U e-7 <br /> true. (and Personally appeared before me the above-named _ de oath that the foregoing statement its <br /> A cert ic�te 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 year .t ereafter so long as such business shall be conducted and shall lapse and be void unless so renewed. <br /> i <br /> ed <br /> JOSEPH L MAfi <br /> con+t�%WAA u0 AL MyCoiri Octobe <br /> ommission xpires: <br />