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;r BUSINESS CERTIFICATE#05—c2 y <br /> THE COMMONWEALTH OF MASSACHUSETTS <br /> • TOWN OFMASHPEE <br /> DATE I 7 os- <br /> Expiration <br /> SExpiration 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 p_ / <br /> [< �t„)f.124 {,L� _ Ae I, DnBA 0=YLeq�ULr.LnX7lfT�l�QxJL is conducted at <br /> Business Location: 2j h�S_ ,lA\. ST• �rn`A,St'll�`c.-i_ CDMMoNS YMSk&,i , w� U.2bggi <br /> Business Mailing Address: Cly Wtrkf8t{ K.V. fA9RZ40^lS Al 11's , AAA-, 02642 <br /> Business Type: �f.+tFt L Business Telephone: <br /> by the following named persons: - <br /> \ FULL NAME RESIDENCE <br /> 1ANILt 19W-7�) 71 W+06LI RA aaf q-5? <br /> Home Phone: 2-o - 7l S a <br /> ify edunder 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 requir �undeer law. <br /> *Signature of individual By: Corporate Officer <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 below namedand 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 /> Si�, a . <br /> .M"Wet C. SW*m r Lt <br /> NOTARY PUBLIC. Notary Public <br /> SEAL X101 <br /> C0woa moaEVMW26.2No () 0 <br /> Commission Expires: <br />