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BUSINESS CERTIFICATE# / " r�r` <br /> y7� <br /> THE COMMONWEALTH OF MASSACHUSETTS p <br /> TOWN OF MASHPEE T <br /> • DATE <br /> Expiration Date: Z 3! <br /> 46 1 <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 /> Business Name/DBA:Down .b 44, (n(ounAS Corporation Name: is conducted at <br /> Business Location: 300 (IG4�^a.� •2(( •S �t,vY <br /> Business Mailing Address: 30 G n G C h e \ i S h G�x JPO <br /> Business Type: M(CC f cu C o -f•i'PP R OeSiI�9Business Telephone: S el $ 6 'r 8 <br /> Home Phone: Sd O 6 If 00 Email Address: 001) nl 1 0 IN ;e St o VN-0. <br /> by the following named persons: <br /> Owner Name Owner Residence <br /> I") C' 1ne )A Zgpo I(\ g cryk e I ( t`S hlw�. l.ai rj6 <br /> M Sy Q•e trt c o a b 4 <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 /> taxes as required under law. <br /> �— <br /> lWignature of authorized agent **Social Security Number(Voluntary) <br /> or Federal Identification Number <br /> *This license will not be issued unless this certification is signed by applicant <br /> In case of emergency 7 <br /> NAME: W-tA-Yhe cS- ARS TELEPHONE NUMBER: Stasi' <br /> Alarm Company: <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 -)-q -z9610 <br /> Personally appeared before me the above-named lS.."nC R !SX,-n4a S 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 /> Signed 6hL— A <br /> • ' (J Notary Public <br /> SEAL <br /> Margaret C. Santos `� ?q- <br /> NOTARY PUBLIC Commission Expires: <br /> =!e <br /> }� Commonwealth of Massachusetts <br /> My Commission Expires Sept.24,2010 <br />