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` r BUSINESS CERTIFICATE#05A <br /> THE COMMONWEAL TH OF MASSA CHUSETTS <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 ��.tt <br /> 4�_-b � d W Des DBA dl k"R7 �s�_ 02�0 is conducted at <br /> Jt lle_ <br /> Business Location: / 44'7f Dy, A^AX ee, AIX. <br /> Business Mailing Address: �t �p <br /> Business Type: //t Ai�G�It�re I&W4 - Business Telephone: S7)S-" z177 " 71717 <br /> by the following named persons: <br /> FULL NAME RESIDENCE <br /> Home Phone: 67? T 7 4/ L/ <br /> �eerhfy der the penalties of per'ury that I,to the best of my knowledge and belief, have filed all state tax returns and paid all state <br /> A s required under law. <br /> *Signature of indi idual/`(1[ By: Corporate Officer <br /> 03 V .3 3 ?_ '7 <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 subiect 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 BARNSTABLE ss QQ / DATE <br /> 4-4t46dS <br /> Personally appeared before me the below named CCKW O..i/Q 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 /> Sign: <br /> �j <br /> lic <br /> SEAL MA i A SCO TT— <br /> I�etan Public Q�✓CM 9/r 2CJJ(0 <br /> Commomcealth of Massachusetts Commission Expires: <br /> My Commission Expires p <br /> March=I.2006 - <br />