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BUSINESS CERTIFICATE#07 `7 <br /> THE COMMONWEALTH OF MASSACHUSETTS <br /> TOWN OF MASHPEE <br /> DATE /� "7/ a <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 /> undersigned eby declare(s) that a business under the title of _ - <br /> Jys h U DBA is conducted at <br /> Business Location: '5_9 A'd 0 Vib L)h �(� M 0 4 ,rklI"i QP4(_J <br /> Business Mai i gddree�s's,.� -e :� - _ "0 Vey p <br /> Business Type: 5 �� d- I GICOLI 1Zi;[ Business Telephone: <br /> by the following named persons: <br /> MCAXI' iZ�F N O IDE CE o <br /> ct�. tee_ <br /> /��n A °ao)`�� <br /> Home Phone: 7 V 15—' Ll 3�9_ ea o�.� <br /> I 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 /> 0s as required under law. <br /> *Signature of authorized agent *Signature of authorized agent <br /> 5l- 0y3- � , - al ( <br /> **Social Security Num er(Voluntary) <br /> or Federal Identification Number <br /> In case of emergency Q <br /> NAME: a n U)o , �—jPil TELEPHONE NUMBER: <br /> Alarm Company: n a <br /> *This license will not be issued unless this certification is signed by applicant <br /> "Your social security number will be fumished 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 <br /> BARNSTABLE ss DATE /0.a aOo7 <br /> Personally appeared before me the above-named M VLZ me LA.)O�VS�e+ 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 thereafter so long as such usiness shall be conducted and shall lapse and be void unless so renewed. <br /> ed <br /> SL-AL Notary Pub is <br /> Margaret C. Santos <br /> Q air-aol o <br /> NOTARY PUBLIC " <br /> Goinniiinviealth of Massachusetts Commission Expires: <br /> my Commission Rpires-Sept.24,2010 <br />