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... os <br /> BUSINESS CERTIFICATE 9-94=7 <br /> THE COMMONWEALTH OF MASSACHUSETTS <br /> TOWN OF MASHPEE <br /> • DATE Cl -2.�k -o y <br /> aoo5 <br /> Expiration Date: December 31, 2W <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 /> C-.d j4Le-j-1-1A `Mc-y-cc>�Q DBA :P!NAr-- aG�c,gccxpis conducted at <br /> Business Location: :33 O vt %e. EG, '_0 0, A s rz A 1M o syn g e,e rn A O-LG45 <br /> Business Mailing Address: 2a VNA a,s�A f?ee t VVI A, b Z(o L( <br /> Business Type: G_r a S c- �_ Business Telephone: SO a ' S 3gt - 3((o-s <br /> �JJJ B - q - <br /> by the following named persons: 5o S3ck Z' <br /> FULL NAME RESIDENCE ,2� <br /> Ca" ckcce. .d`rlc �L¢ o .4 33 0v'\c,1,L Ecl ,.� w�cks <br /> «Z, MC- c,.s1ADee o7- <br /> Home Phone: S o T - 3 Ck - -26 b� <br /> �ery , g , xrurnsanpaastate <br /> sy <br /> required under]aw. <br /> *Signature of individual By: Corporate Officer <br /> 02$ — SS - \$ t3 010 - -1Z-5rc ) ) <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 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 nor,-filing or delinquency wil!be subiect tc 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 L�L�V l; aGUt <br /> Personally appeared before me the below named &n4'c'e AA C t eorl -e and made oath that theforegoingstatement 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 /> 'c_' w <br /> • OW2 L2 <br /> SEA�� Margaret Ci. $arltt)S Notary Public <br /> �'"tAi 0• NOTARY PUBLIC <br /> to <br /> Expires: <br /> Commonwealth of Massachusetts <br /> ftp!Evires Sept 24,20`10 <br />