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BUSINESS CERTIFICATE#07 106 <br /> THE COMMONWEALTH OF MASSACHUSETTS <br /> • TOWN OF MASHPEE <br /> DATE Cr d u <br /> Expiration bate: 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 hereby declare(s)that a business tinder the title of <br /> DBA/ is conducted at <br /> BusinessLocation: <br /> _ <br /> Business Mailing Address: Z2 �L/f C �/G L/12��� � i��/�/�� /'✓/� t�1 lily <br /> Business Type:�r(/i(//�wty�gL' S�?Yic�.L BusinessTelephone: ��— �j�j9— mzc� <br /> by the following named persons: <br /> L / UI L NAME RESIDENCE/! �( v <br /> r/tS'�/`R<—/2G2yL `/ /rG�G // �/�G�/ 7 <br /> Home Phone: <br /> I certify er ties of perjury that I, to the best of my knowledge:and belief, have filed all tax returns and paid all state <br /> taxes a+ der,law. <br /> n of authorized a nt *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 fumished to the Massachusetts Department of Revenue to determine whether you have met tax filingortar <br /> payment obligations. Licensees who fail to correct their non-filing of 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 %P- <br /> Personally appeared before me the above-named ��� t p 41 r 51h ber e rL and made oath that the foregoing statement is - <br /> true. I <br /> A certifi a ssued in ace ante 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 / - i <br /> a so I a ch business shall be conducted and shall lapse and be void unless so renewed. - <br /> Signed <br /> MargAt tgaret C. Santos Notary Public <br /> SEAL °� NO !NOTARY PUBLIC <br /> EDmmonu+e,�hrwealth of Massachusetts <br /> y�j.gorytn s9iQn 41onEXPIre3 Sept.24,2010 Commission Expires: <br />