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BUSINESS CERTIFICATE#07 3 d <br /> THE COMMONWEALTH OF MASSACHUSETTS <br /> TOWN OF MASHPEE <br /> DATE / <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 /> �) f!SQQ-X DBA /�/ G jE/Z 124 Sou i A is conducted at <br /> ! <br /> Business Location: 70. 'C A�08.7D R A'1 A 5 H h-L Ad 4 <br /> Business Mailing Address: S 17it 44� t <br /> Business Type: d I()7 /1ll t, Business Telephone: ,5j0`I- <br /> - 77^ I -7 <br /> by the following named persons: <br /> FULL NAME RESENCE <br /> /Jc�w ID <br /> 7 o C AypE 4 9, M R <br /> Home Phone: _,5 - P77 5/17 , <br /> A&ertify 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 /> s as required under law. <br /> .*Signature of authorized agent *Signature of authorized agent <br /> **Social Security Number(Voluntary) <br /> or Federal Identification Number <br /> In case of emergency CC <br /> NAME: Cg4l 4 TELEPHONE NUMBER: <br /> Alarm Company: <br /> *This license will not be 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 <br /> Personally appeared before me the above-named 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 /> �ed ���— <br /> D, JOSEPH L.MA7ZPubUc <br /> U NELt1, <br /> COMMONWEALTTM pF <br /> TtWtWires <br /> SEAL.ZOf3 <br /> Commission Expires: <br />