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~` BUSINESS CERTIFICATE#09 000) <br /> THE COMMONWEALTH OF MASSACHUSETTS <br /> TO WN OF MASHPEE �ti <br /> • DATE <br /> Expiration Date: December 31,.2013 <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 /> s' eQ(7 S'� c DBA_�V�1(�}����(�SS t�i_n���l `�\.(� is conducted at <br /> Business Location: (0 Q \ `(�ilN/,, r`� \l Q, K l t+4P�, s1'1 <br /> Business Mailing Address: "-WC) ���sw+�1 4 V�� LQS <br /> Business Type: ,aQk9'1 I Business Telephone: SQk 5-39 -9(0 Do <br /> r <br /> by the following named persons: <br /> !� FULL NAMF� REBID NCE <br /> \Co-+J a�cQ Vvl � �Ce_C_C�C� l � Q I•.•t I �o� r r\ '(�c� l��a 6hk,of cQ p�aZC1�J <br /> Home Phone: �� ( �-��� - 6�Ct� <br /> I certify under the penalties of perjury that I, to the best of my knowledge and belief, have filed allstatetax returns and paid allstate. - <br /> taxes as require rider law. <br /> �11 1 <br /> riature of authorized agent *Signature of authorized agent <br /> -7S' 3OXaoko <br /> **Social Security Number(Voluntary) <br /> or Federal Identification Number - <br /> In case of emergency <br /> NAME: Qoy-% x CeCLo 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 200q <br /> Personally appeared before me the above-namedf�UlI�.�C 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 asfji chh business shall be conducted and shall lapse and be void unless so renewed. <br /> Signed,L l✓— �-- 1 �, <br /> l � Notary Pub is <br /> SEAL Deborah F. Dami <br /> NOTARY PUBLIC <br /> n <br /> Commonwealth of Massachusetts Commission Expires: <br /> My Commission Expires July 24,2009 <br />