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BUSINESS CERTIFICATE#07 <br /> THE COMMONWEALTH OF MASSACHUSETTS <br /> • TOWN OF MASHPEE <br /> DATE Z� 7 <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 hereby declare(s)that a business under the title of <br /> J cr f4 Al 1 fl w 6/0 eU DBA Sc✓:'u Q is conducted at <br /> Business Location: IJam. /7/:'/ ES 4,61/C . lnlf.S/IPIrLe 17.4 e`.2Gyy <br /> Business Mailing Address: 7 75 F. FAf-en.oc;7/-/ f/uJ ✓. tt'r2Fl s 'f r4c-,m c u7/a /Y//7 0 3L <br /> Business Type: Jf'er//nE Business Telephone: �Lt — ��7 ' <br /> by the following named persons: <br /> Fye I NAME . RESIDENCE <br /> .,J 0i'l, gN ,� AA/eO /j 6J2ir-s .C .9�uc <br /> Home Phone: <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 /> �xes as required underlaw. <br /> ,,..*Signatitrre of auf£hom"ed Agent *Signature of authorized agent <br /> O ac; yG j sC) <br /> **Social Security Number(Voluntary) _ <br /> or Federal Identification Number <br /> In case of emergency t/ <br /> NAME: TELEPHONE NUMBER: �0 /•��' Z-4 / <br /> Alarm Company: 41Z,4 <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 <br /> BARNSTABLE ss n / DATE ?-a4-aV7 <br /> ar <br /> Personally appeed before me the above-named a"/14f to .�NG= 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 business shall be conducted and shall lapse and be void unless so renewed. <br /> igned C,m���tne� D <br /> Margaret C. Santos ab 4 <br /> n NOTARY PUBLIC otaryPublic <br /> SEAL Commonwealth cl Massachusetts <br /> my Commission Expires Sept.24,2010 47y a6 J U <br /> Commission Expires: <br />