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- •v <br /> BUSINESS CERTIFICATE#08 <br /> THE COMMONWEALTH OF MASSACHUSETTS <br /> • TOWN OF MASHPEE <br /> DATE <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 �f <br /> �>0 yrl i7C C_ 'p—P-00(7 DBA 15C C �r1..-�-rQ.,C�'�irJ 1 is conducted at <br /> Business Location: c?'2 ---jV� Ho(Leu-) LL7 %'1 0� rn QS.bLp�� (Yl A, <br /> Business Mailing Address: SSSS --P–>--y t_ p(_ (Ito 6A,–),P - ✓t a-5��E–� iynA <br /> BusinessType:,,_an _sa E' MQSO%'lry Business Telephone: <br /> by the following named persons: <br /> FULL NAME. RESIDENCE <br /> -siamoe-LCarl, iZE_Lc'Cv a 7rY t4n(-Lnw <br /> Mosinpt?(2,, MA <br /> Home Phone. ` <br /> 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 /> es as required under law. <br /> *Signature of authorized agent *Signature of authorized agent <br /> **Social Security Number(Voluntary) <br /> or Federal Identification Number <br /> In case of emergency <br /> TELEPHONE NUMBER 50� In 4� y l Com <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 <br /> Personally appeared before me the above-named 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 such business shall be conducted and shall lapse and be void unless so renewed. <br /> ed <br /> Notary Public <br /> SEAL <br /> Commission Expires: <br />