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BUSINESS CERTIFICATE#07� <br /> THE COMMONWEALTH OF MASSACHUSETTS <br /> • TOWN OF MASHPEE G b <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 /> �VU 1/Ur T,41C DBA is conducted at <br /> Business Location: e7f// // �/�� <br /> Business Mailing Address: 110a 0!5 ,9,X -� <br /> // 7 <br /> i <br /> Business Type: )Te Business Telephone: <br /> by the following named persons: <br /> /' ALL NAM}q S RESIDEE <br /> Homophone: <br /> I certify under the denallies f p rjury t I, to best of my knowledge and belief, have filed all state tax returns and paid all state <br /> ,MjWgxes as requ4itec nd law _ <br /> *Signature of auth a agent *Signature of authorized agent <br /> 0.3 1933 <br /> **Social Security Number(Voluntary) <br /> or Federal Identification Number <br /> In case of emergency <br /> NAME: 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 -2-1910 7 <br /> Personally appeared before me the above-named o and made oath that the foregoing statement is <br /> true. <br /> A certificate iss d in accords ce with thi ection shall be in force and effect for four years from the date of issue and shall be renewed <br /> each four years there fter o long pa, business al e conducted and shall lapse and be void unless so renewed. <br /> Signed/ V l <br /> Notary Public <br /> SEAL <br /> JOSEPH L.MAZZUCCHEL 1 JR <br /> mmission�k�Jjµf@5blic <br /> .l C014S0S WEALTH OF MASSACHUS <br /> My Commission Expires <br /> October 25,2013 <br />