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BUSINESS CERTIFICATE#07_:�a7 <br /> • THE COMMONWEALTH OF MASSACHUSETTS <br /> TOWN OF MASHPEE <br /> DATE S�)Cu , ay: a667 <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 /> undvT <br /> ersigned hereby declare(s)that a business under the title of _ <br /> l\ boa f 14 6d j1e o ,G DBA J-fI 1 6oyerg' -Ilal9 e �dhABvvYv*is conducted <br /> ucted at <br /> Business Location: /t./ TUS m a J t r_J nn,43h P e—e /?�y 6 yam. <br /> Business Mailing Address: Pl) l�t)X go 3 1)14S k p Lo 'e //il/� D Z 6 �S <br /> Business Type: !lOMe- IM 1Business Telephone: <br /> by the following named persons: <br /> FUL NAME o RESIDENCE <br /> yhP2>< �rJL// .12 ip,gdv[ tv <br /> Home Phone: S� I' <br /> � <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 /> s a red under law. <br /> '*Signature of authorized agent *Signature of authorized agent <br /> 02YYz _'2Y <br /> **Social Security Number(Voluntary) <br /> or Federal Identification Number <br /> In case of emergency <br /> NAME:_ d� �U�a� ''G TELEPHONE NUMBER: s1�, � ��1 �dPv <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 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 <br /> Personally appeared before me the above-named' 1"\(�J f�- IV Lei 00h 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 yearss tthh rafter so long as such business shall be conducted and shall lapse and be void unless so renewed. <br /> ed <br /> Q Margaret C. Santos ' ntary p <br /> SEAL NOTARY PUBLIC <br /> Commonwealth of Massachusetts Q -a y- a0 l b <br /> Vy Commission Expires Sept.24,2010 Commission Expires: <br />