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- <br /> F ' <br /> BUSINESS CERTIFICATE#06 -� 3 <br /> • THE COMMONWEALTH OF MASSACHUSETTS <br /> TOWN OF MASHPEE <br /> DATE <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 /> undersigned hereby declare(s)that a business under the title of n�t <br /> IOYvt�11s1Y15 Annyalswl �e.v✓1c.L , [tJU DBA l,Ope- O CFXjVC M0`8 �Ut is conducted at <br /> L n <br /> Business Location: �q�� �Ot �l,"W-1 �^ I`.( itCt S���l-c._ K� ^1\ I M AS(WfLL_ MA 0ZGL(rl <br /> Business Mailing Address:BusinessType: QQo1 � &'Th is Business Telephone: <br /> by the following named persons: <br /> FULL NAM*F RESIDENCE <br /> :31o,cc_&Wk l�a �u�c �l�wiP�►^� 1C3 '1�ebb� fare / ���k ,i�+wl�. >M 025_6� <br /> Home Phone: <br /> 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 /> xes as required un r I w. <br /> *Sigr�ttre of authorized agent *Signature of authorized agent <br /> 21- oo9S 1cMl <br /> **Social Security Number(Voluntary) <br /> or Federal Identification Number <br /> In case of emergency <br /> NAME: `U N1 TELEPHONE NUMBER: J -0 UlI <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 subiect to license suspension or revocation. Thisrequest <br /> is made under the authority of Massachusetts General Law,Chapter 62C,Section 49A. <br /> The Commonwealth of Massachusetts <br /> BARNSTABLE ss DATE <br /> true. l O <br /> Personally appeared before me the,above-named 2ccCp Ue 5 r- 1yl S and made oath that the foregoing statement is <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 Ion such business shall be conducted and shall lapse and be void unless so renewed. <br /> �ed L Ma Met C. Santos <br /> �r NOTARY PUBLIC <br /> ' Commonweahfiof,Massachusetts- otary Public <br /> SEAL 'Ay Commission Expires Sepl.24,2010 <br /> Commission Expires: <br />