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4 <br /> BUSINESS CERTIFICATE#055 <br /> THE COMMONWEALTH OF MASSACHUSETTS <br /> • TOWN OF MASHPEE <br /> DAT<:�,S_,P, It, ,-d,00 f_ <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 /> undersigg�n'+e'd`hereby declare(s) that a business under the title of �� / / y/ <br /> E-7&. p�fo) n/'^ �7n./ DBA W fcrt(,f,55 (.r{ 1"y is conducted at <br /> Business Location: I I'G5 <br /> L a re <br /> Business Mailing Address: 3 / Lb 4,/ex / 4 <br /> Business Type: ryrelos pX{" Q 2(/L- <br /> Business Telephone: 239— ..7 Y— r/ Y f 7 <br /> by the fo1lll_owv inng n�a�med persons: ET76' <br /> Home Phone: Sob �77` Sl7s <br /> J&ertify 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 requi nder law. <br /> *Signature o utborized 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 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 \\y _ I � ^� ' II__ DA CC a00 S <br /> Personally appeared before me the above-named�2�72.r LAa'/l7�] 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 /> • — "ret C. Santos <br /> M N Tarr Pueuc rIJ <br /> C_OmmM Wies, <br /> SEAL h <br /> Wiles, Z4 201� Notary Public <br /> 3y-eta <br /> Commission Expires: <br />