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BUSINESS CERTIFICATE#05A9 <br /> THE COMMONWEALTH OF MASSACHUSETTS <br /> • TOWN OF MASHPEE <br /> DATE o? � <br /> a <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 <br /> v <br /> �i� R . I���� DBA �tl �(�h, e, Y f OYI is conducted at <br /> Business Location: 3L <br /> B\U e C A-ST 'DR . `M W ,`h p_e P h 0, C d <br /> E l J p <br /> Business Mailing Address: 3 E k U f4su G �� Dc�P /F ©o/ g <br /> Business Type: Business Telephone: / �- <br /> U <br /> by the following named persons: <br /> /� I FULL NAMERESIDENCE <br /> 2g7 <br /> L��U e ('M 4: 064 0� <br /> Home Phone: SOp — 177—,�33 <br /> 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 /> J re ire fired un <br /> W,, <br /> * nature 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 ��}}--�� ^1 L DATEs� �-„'�_ <br /> Personally appeared before me the below named ��Q` `K . („�J Vg`s \ .� 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 /> S e <br /> -Nota Public <br /> SEAT Deborah F. Dami <br /> NOTARY PUBLIC Commission Expires: <br /> .. .... Commonwealth of Massachusetts <br /> My Commission F.*m MY 24.2009 <br />