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"a <br /> BUSINESS CERTIFICATE#OS -47 <br /> THE COMMONWEALTH OF MASSACHUSETTS <br /> • TOWN OF MASHPEE <br /> DATE <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 // > O ��/ <br /> AV G n/ DBA /r`�n�f/ �r1���Di'/ is conducted at <br /> Business Location: 7 /!� G�S� weFz �y <br /> Business Mailing Address: <br /> Business Type: /i�i1i5/�/it �D/� Business Telephone: Z" Da <br /> by the following named persons: <br /> FULL NAME RESIDENCE <br /> /ei14119272 T/�/o,�8i/•Y.1/ 7/y�Sf�of� /lav �%s,���� <br /> Home Phone: � / �77 J3�o <br /> 0 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 a prize 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 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 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 S a00 S <br /> Personally appeared before me the above-named� \ V�Ge DV R-t7 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 lonvs such business shall be conducted and shall lapse and be void unless so renewed. <br /> Signed <br /> • Margaret C. Santo <br /> NOTARY PUBLIC SU otary Public <br /> SEALCominortweahh of Massachusetts <br /> 1!y'Commission Expires Sept.24,2A19 g—ay- 1 <br /> ri <br /> Commission Expires: <br />