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fay R� <br /> BUSINESS CERTIFICATE#05_1;7 <br /> THE COMMONWEALTH OF MASSACHUSETTS <br /> • TOWN OF MASHPEE <br /> DATE 31a 1 os <br /> — <br /> Expiration Date: Decemher 31, 2009 <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 /> �ZW S�bU o r L! C DBA T0 c)n e_SS� l� hrl is conducted at <br /> Business Location: a Shore.. Dr; y'-_' (hc3..o-�,,bs_8 OL. c)'a4.'qCJ__ <br /> a5� ert� C?�uf <br /> Business Mailing Address: r 1 r tt>-.4-+���.{,�-�_2__ )7Zt� <br /> Business Type: I v�wx _ Business Telephone: b Og - g3 QI " 8 350 <br /> by the following named persons: <br /> FULL NAME RESIDENCE <br /> Home Phone: "W 63'- 3L9L -CSS) <br /> lartify 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 /> s as required under law. <br /> *Signat rr�orized� *Signature of authorized agent <br /> ! 3- yoogi93 <br /> **Social Security Number(Voluntary) <br /> or Federal Identification Number <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 VlC jp dl l 4Av v r"' 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 WAYNE L.SPENCER <br /> N Public <br /> Common <br /> wea ealN of Massachusetts <br /> .�, WAYNE L.SPENCER my Comm'sa'onPypirwc <br /> Notary Public Notaryh odi0R,2010 <br /> 4.1 Commonweat of Massachuset <br /> My Commission Expires <br /> April 9, 2010 Commission Expires: <br />