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BUSINESS CERTIFICATE#06 —q' <br /> • THE COMMONWEALTH OF MASSACHUSETTS <br /> TOWN OF MASHPEE <br /> DATE 3r-S-oZGO�i <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 // / <br /> � (L P_I^f� DBA,/%` Gt r V1 et / �fgOql� is conducted at <br /> Business Location: �� /1 i2-cLy}— ��, �/y/y���L-4)c <br /> Business Mailing Address: S (f: Q ) <br /> Business Type: -/f(Jy &h_'�-s Business Telephone: <br /> by the following named persons: <br /> LDENCE <br /> 197LZ�FULL �SG't <br /> Home Phone: y�5 Ss?S <br /> AlIlLcertify 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 under law. <br /> �Z <br /> A ' <br /> *Signature of auteoriled agent - *Signature oforized agent . <br /> **Social Security Number(Voluntary) <br /> or Federal Identification Number <br /> In case of emergency <br /> NAME: �Ie y[i/2 � 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 coirect 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 / DATE <br /> Personally appeared before me the above-named Cr P I-'t Pt!V 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 caller so long as such business shall be conducted and shall lapse and be void unless so renewed. <br /> `argarettC. Santos n� <br /> ° "NOTARY PUBLIC11 Yl Y <br /> SEAL Cp111mmeab Ol'M2ssachUSCItS Notary Public <br /> Ny COmmission EON Sept.24,2010 <br /> Commission Expires: <br />