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09 - <br /> BUSINESS CERTIFICATE#98- (7�1 <br /> THE COMMONWEALTH OF MASSACHUSETTS <br /> TOWN OF MASHPEE <br /> DATE�� <br /> Expiration Date:December 31, 204:.2o 13 <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 p <br /> k()AEVCE J� 6�1ZLfF_1A/ ZY— DBA �J"l�.L�t-Z71/ �(��1�/G% is conducted at <br /> Business Location: -1-9#5HOEA;o /11,* ®Z6Ny <br /> Business Mailing Address: Al,+A/Gy `A71/C LW��/ M# 407tH'7 <br /> Business Type: t1'13A15(A,7-AA11_ Business Telephone: 60Ff_27146C'A® <br /> by the following named persons: <br /> FULL NAME RESIDENCE <br /> Home Phone: qw- Kl a/-1467 <br /> I certify under the penalties of per ju that I, to the best of my knowledge and belief, have filed all state tax returns and paid all state <br /> taxes as required under law. <br /> *Signature of autbofi7cd agent �y *Signature of authorized agent <br /> �o?3-GS- s-? 9/ <br /> **Social Security Number(Voluntary) <br /> or Federal Identification Number <br /> In case of emergency �7 <br /> NAME: CASE y !5� FGLN _ TELEPHONE NUMBER: <br /> Alarm Company:��i� <br /> *This license will not be issued unless this certification is signed by applicant <br /> **Your social security number will be famished 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 /' �/� -�j� DATE 2 e C00 9 <br /> Personally appeared before me the above-named �r E C \� 1 t-h n-H-'- 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 st h business shall be conducted and shall lapse and be void unless so renewed. <br /> Signed <br /> • - otary Public <br /> � <br /> SEAL Margaret C. Santos <br /> 9 ay Arlo <br /> NOTARY PUBLIC Commission Expires: <br /> Commonwealth of Massachusetts <br /> my Commission Expires Sept.24,2010 <br />