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I <br /> BUSINESS CERTIFICATE#06_ <br /> • THE COMMONWEALTH OF MASSACHUSETTS <br /> TOWN OF MASHPEE <br /> DATE ,� UYtc 1 h 960E' <br /> i <br /> Expiration Date: Decemher 31, 2010 <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 /> 16!pw t. A ( UtooehS DBA 4Aty7y-1&_AJ0 2&2 �a�2��� is conducted at <br /> Business Location: )getZE 4AS-H Per, <br /> Business Mailing Address: RS 6120V'e p <br /> Business Type: 0�(�--x,OGoGj_ >r ta'f6E Business Telephone: <br /> by the following named persons: <br /> FULL NAME RESIDENCE <br /> �t /IolnlF �UCAs llo �ll�WAem Lr��at� �ytpEC <br /> Home Phone:_ 54 Fj - <br /> � <br /> 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 /> es as required under law. <br /> *Signature of authorized agent *Signature of authorized agent <br /> **Social SecurityNumber(Voluntary) <br /> or Federal Identification Number <br /> In case of emergency <br /> 9-AlaNAME: ���[{h t7 TELEPHONENUMBER:fj�S - 119- <br /> Alarm <br /> rm 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 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 Ma ssachusetts <br /> BARNSTABLE ss DATE ,Une kc I adb� <br /> Personally appeared before me the above-named�4 1 Pry)n o �UG,4 S and made oath that the foregoing statement is <br /> [rue. <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 /> J&ed <br /> Margaret C. Santos <br /> NOTARY PUBLIC <br /> SEAL v I Commonwealth of Massachusetts ora y Pnblic <br /> iii ue5 Sept.24,2010 <br /> -- 7 Cofmmmssion Expires: <br />