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r <br /> BUSINESS CERTIFICATE#0513 <br /> THE COMMONWEALTH OF MASSACHUSETTS <br /> TOWN OF MASHPEE <br /> DATE 4- - 7- 05� — 7— 05 <br /> Expiration Date: December 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 x p yt v p t� <br /> C A?C- COD CONVehjOnJ QGNTC-R 1 NC , _DBA ec r \Ct i I 1s 1 U 6 is conducted at <br /> Business Location: 100 GR eAT ,�E�\ 'ROAD D NORTH <br /> Business Mailing Address: \oo G?`A T 1 'k E-l- Q/pf Y ' lO R T t1 <br /> Business Type: xl r, N T C'I-OB �" �ES T' Business Telephone: 508- +-77 — 1 90 0 <br /> by the following named persons: <br /> FULL NAME RESIDENCE <br /> RIeNRRZ_� Al � ER�I 1DO G1��a4T Nc ql "(Rn NOR i MRSA ft <br /> MR o26+ ,9 <br /> Home Phone: -508- 4 ly7— 6 0 0 0 <br /> rtify 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 /> *This license will not be issued unless this certification is signed by applicant <br /> **Your social security number will be fumished 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 sub'ect 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 � I,� Q DATE � /Z <br /> Personally appeared before me the above-named 1C tG, Kurd Q. V 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 <br /> • 1 :SA ' <br /> ' r - Deborah F Da1111 Nota P ]ic <br /> SEAL <br /> NOTARY PUBLIC <br /> Commonwealth of Massachusetts <br /> My Commission Bores July 24,2009 Commission Expires: <br />