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BUSINESS CERTIFICATE#07 a <br /> THE COMMONWEALTH OF MASSACHUSETTS <br /> • TOWN OF MASHPEE b <br /> DATE �.Jlv—G ( 1 Z 00� <br /> Expiration Date: December 31, 2011 <br /> In conformity with the provisions of Chapter one hundred and ten, Section five of the General Laws, as amended, the <br /> undggsigned hereby declare(s)that a business under the title of <br /> �AaJ ne 'C/2SS DBA�Ct�e h ( � ( is conducted at <br /> Business Location: ST. - <br /> Business Mailing Address: � 3 ++ C2 ar S �(: J 7P� �7, o,-z6 qC <br /> Business Type: �dh cto y— Business Telephone: g - ,31/' y J 0 Ce I <br /> by the following named persons: <br /> L ZnFUL <br /> a'� 1_L NSE RF�IDENCE <br /> vtV�e�ytS( 1 Cedtct� S VV las ��ee <br /> Vyl 0a6 `I C\. <br /> Home Phone: 5-03- <br /> I certify under the pen ties 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 uire u law. <br /> *Sign o thorizy agent *Signature of authorized agent <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 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 DATE t2 — 19 <br /> BARNSTABLE ss r <br /> IP <br /> fo e e ab a-named ZoMy <br /> E 11 h eS'( �j and made oath that the foregoing statement is <br /> true. <br /> - ce with this sectice and effect for four years from the date of issue and shall be renewed <br /> each fousuch business Il be ll lapse and be void unless so renewed. <br /> Si ned <br /> Deborah F. Dami <br /> < NOTARY PUBLI Notary Publimonwealth of Massachusetts <br /> mmission Expires July 24,2009 Commission Expires: <br />