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' BUSINESS CERTIFICATE#WC-7 <br /> THE COMMONWEALTH OFMASSACHUSETTS <br /> TOWN OF MASHPEE <br /> • DATE 2 Feb X03" <br /> Expiration Date: December 31, 2fl1 Bpi I <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 I I p <br /> Doom Aonnt I&II y LLC DBA beam A6ft iecal�i is conducted at <br /> J 1J <br /> Business Location: 4133 FaIn10o4h Q., JS ulrck P14LG 6k / &ik 6 , (nQS{�A�� � M4 <br /> Business Mailing Address: ''``'u Same 7G �• <br /> Business Type: Kea �i5k— Business Telephone: %ii- g3: '- 32(oD <br /> by the following named persons: <br /> FULL NAME RESIDENCE <br /> t�Ivtd FtlsanD t Maw htsano Io6 Pal arts Dewc, a-wsshFxe�, 4oA <br /> Mee.64h 441aa4i,irl- P4 WOOJ -14au1 ad . ✓Yla , fn <br /> Home Phone: <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 /> tax e as required under law. <br /> 111111011nature of authorized agen �,Pd fy�_.�,/,_ *Signature of authorized agent <br /> **Social Security Number(Voluntary) <br /> or Federal Identification Number <br /> In case of emergency <br /> NAME: Kcn /oc-c.t TELEPHONE NUMBER: X81 -cj'b/- VN? <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 tae 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 <br /> request is made under the authority of Massachusetts General Law,Chapter 62C, Section 49A. <br /> The Commonwealth ofMassaekusetts <br /> BARNSTABLE ss ff DATE <br /> Personally appeared before me the above-named �IY�E'C'B �""1 'Cc l/X�.�C:c k- 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 so ess shall be conducted and shall lapse and be void unless so renewed. <br /> Signed <br /> G <br /> • - otary Public <br /> SEAL .Q� Margaret.C. Santos _ <br /> NOTARY PUBLIC 9 Y <br /> Commonwealth of Massachusetts Commission Expires: <br /> Hy Commission Expires Sept.24,2010 <br />