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o� °fe, <br /> BUSINESS CERTIFICATE#'08' <br /> THE COMMONWEALTH OF MASSACHUSETTS <br /> • TOWN OF MASHPEE �y <br /> DATE <br /> Expiration Date: December 31, 2012 <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 n' <br /> � ^DBATVICAN �Ctithyl�S 1 °IyLLCL is conducted at <br /> Business Location:Iq! 11/l lEB 0t' ? lk— 0-P <br /> Business Mailing Address: �®(, C.IOj 0kDee- AA rk-- DJU '49 <br /> Business Type: 4 Business Telephone: $ 5bcl -- al OSI <br /> by the following named persons: <br /> LL NAME RESIDENCE <br /> s l two_ 4f nc11Ye!¢.S I� 7�J A3 k MA­8(tepee `titles <br /> eft �w <br /> Home Phone: <br /> I certify 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 required under law. <br /> *Signature of authorized agent *Signature of authorized agent <br /> ab - 366 g%4 s� <br /> **Social Security Number(Voluntary) <br /> or Federal Identification Number <br /> In case of emergency <br /> NAME: TELEPHONE NUMBER: <br /> Alarm Company: <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 determinewhether 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 10 <br /> Personally appeared before me the above-namedV`` iN�4Q t4 S V "L and made oath that the foregoing statement is <br /> true. <br /> A certificate issued in accordance with this section shall be in force and ffect for four years from the date of issue and shall be renewed <br /> each four ylearars_thhereafteei so long as such business shall be conducted and shall lapse and be void unless renewed. <br /> �nedGZ <br /> WAC l.. Cx^pv�I <br /> an x u SSIMU100rAW <br /> SEAL 3snHOVSSV"40 H11UMNOWN00 <br /> o /J810N <br /> dr'ma roil+ Rpt <br />