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` BUSINESS CERTIFICATE#08_ <br /> �r <br /> THE COMMONWEALTH OF MASSACHUSETTS <br /> • TOWN OF MASHPEE / a <br /> DATE a' � 040 <br /> I <br /> Expiration Date: December 31, 2012 <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 /> N D k Ser vi c e L :Uo DBA is conducted at <br /> Business Location: 364 Sl20r e ID e r"1 AV eeC_ 4 � <br /> Business Mailing Address: 30Y S In G tC i7✓' M A S x ie'c C_ O Z(.4 <br /> Business Type: SAI-. .15-erVsCt- Business Telephone: sd'�1'- S3S- 11J Z <br /> by the following named persons: _ <br /> FULL NAME RESIDENCE <br /> NE�'S&dJ kietstJer 3r,y 51lc,.•e. A,4% Pee- wA/1 <br /> oa4vC� <br /> Home Phone: sob r31- 1) -L <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 /> �ees as required under law. <br /> `Signature of authorized agent *Signature of authorized agent <br /> *"Social Security Number(Voluntary) <br /> or Federal Identification Number <br /> 1 ` n In case of emergency <br /> NAME: C S t C N, (ZU7�\C GIn+I S TELEPHONE NUMBER: <br /> Alarm Company: N tow L <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 L DATE O <br /> Personal lv appeared before me the above-named k)rs L_'b!✓ k t4 S A16 � 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 vears thereafter so long as such business shall be conducted and shall lapse and be void unless so renewed. <br /> Signed tom, <br /> • <br /> SEAL 62t <br /> FAMk4y <br />