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BUSINESS CERTIFICATE#O`Z�3�- <br /> • THE COMMONWEALTH OF MASSACHUSETTS <br /> TOWN OF MASHPEE <br /> DATE a� <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 /> _S°S!n,Q( GOOOVI I DBA p �q� o%jo �i COM rUf_ V-0 conducted at <br /> Business Location: q 4 n nl o j C '1 u oLP ea mc'S k b ey r <br /> f _ L!^j_ O a.( L( r-1 <br /> T _ <br /> Business Mailing Address: ;G IM V_ <br /> Business Type: Cobs+a'uri +tTo✓\ Business Telephone: 5C) $ t{'77 .0095 <br /> by the following named persons: <br /> FULL NAMERESIDENCE <br /> 3'0Sr' Vp\foVx � iyy tUo<sc, dote 12cI <br /> Home Phone: - <br /> * ertify under the penalties f perjury that I, to the best of my knowledge and belief, have filed all state tax returns and paid all state <br /> s required//u�'nd�e�r��. . <br /> S' ature of authorized agent *Signature of authorized agent <br /> **Social Security Number(Voluntary) <br /> or Federal Identification Number <br /> In case of emergency <br /> NAME: & t-&'2p TELEPHONE NUMBER: 15�p$ 400 <br /> Alarm Company: <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 Massachusetts General Law,Chapter 62C,Section 49A. <br /> The Commonwealth of Massachusetts <br /> BARNSTABLE ss DA a app 7 <br /> Personally appeared before me the above-named��hUUO n and made oath that the foregoing statement is <br /> true. <br /> A certific 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 y ar h eafter so long as such b ess shall be conducted and shall lapse and be void unless so renewed. <br /> Ifted <br /> MW V 4C�._ <br /> Margaret C. Santos o <br /> 4 NOTARY PUBLIC Notary Public <br /> Commonwealth of Massachusetts <br /> My Commission Expires Sept.24,2010 0� <br /> Commission Expires: <br />