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a i , <br /> BUSINESS CERTIFICATE#06-64 <br /> • THE COMMONWEALTH OF MASSACHUSETTS <br /> TOWN OF MASHPEE <br /> DATET(,� <br /> Expiration Date: December 31, 2010 <br /> In conformity with the provisions of Chapter one hundred and ten, Section five of the General Laws, as amended, the <br /> undersignedherebydeclare(s)that a business under the title of <br /> �� �/` i <br /> /vpp�n ES w leo!eIkL �1 DBAA&M/i&-J5 (f11}0hj/9 ^RC-89eo 14 rl'i's conducted at <br /> Business Location:_ 2 2-3L��7 0 Mf�c p-Q'R1Ifl,✓/�C-�� <br /> Business Mailing Address: ��. . ►oz2�� ( 144 ' M A, <br /> Business Type: A44AKC-T'luk A19W1/4) Business Tele phone: 3 Z- -<300 Z_ <br /> by the following named persons: <br /> FULL NAME RESIDENCaE <br /> 1n� Za An A. ° M A-st��=� <br /> Home Phone: S_z)0� / -7 7 - <br /> * <br /> rtify under the penalties of pe ' 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 authorize, agent *Signature of authorized agent <br /> l0� / -77yA0/ 7-2 <br /> **Social Security Number(Voluntary) <br /> or Federal Identification Number <br /> ^ nn n L In case of emergency y-- <br /> NAME: �i1lfzT"L�f/ TELEPHONE NUMBER: <br /> Alarm Company: &I IA , <br /> *This license will not be issued unless this certification is signed by applicant <br /> **Your social security number will be famished to the Massachusetts Department of Revenue to determine whether you have met tax filing or tax <br /> payment bbligations. 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 p <br /> BARNSTABLE ss DATE I/ (/ <br /> Personally appeared before me the above-named -7/Wl'" J and made oath that the foregoing statement is <br /> true. <br /> A certificate issued in accordance wit is section shall be in force and effect for.four years from the date of issue and shall be renewed <br /> each four years ther so long as such bu ess all be conducted and shall lapse and be void unless so renewed. <br /> Oed C, <br /> Deborah F. DNotary Publi <br /> .icEAJ 4 J <br /> NOTARY PUBLIC <br /> CommonwealM of Massachusetts Commission Expires: <br /> My Commission Expires July 24,2009 <br />