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t: <br /> BUSL>\TESS CERTIFICATE#07 /O I <br /> • THE COMMOAriVEALTH OF MASSACHUSETTS <br /> TOWN OF 31ASHPEE <br /> DATE (j'f <br /> Expiration Dace: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 /> Rea 27nyesi'r%g2A,.V�e. DBA is conducted at <br /> . Business Location: vA eMr' �W, '�4_ <br /> Business Mailing Address: Y•6 X a lag <br /> Business Type: Business Telephone: ' <br /> by the following named persons: - - - <br /> FULr=,KAME RESIDENCE <br /> W moyla ty is 'Zac of <br /> Joanne Sj�-eacd Road <br /> Home Phone: <br /> � <br /> er*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 /> es as requireZhunder l—aw. <br /> *Signature of no b ri7ed agent ) *Signature of authorized agent <br /> **Social Srecunty 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 furnished to the Massachusetts Department of Revenue to determine whether you have met tax filing or tax <br /> payment obligations. Licensees who failto 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 n <br /> BARNSTABLE ss DATE -1 — L0C3 <br /> Personally appeared before me the above-named �pq,ry n e- 1`Feil 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 year ereafter so long as suchCss sha2ret <br /> tiered and shall lapse and be void unless so renewed. <br /> ed <br /> C. Santos <br /> I4� NOT RY PUBLIC <br /> Commonwealth of Massachusetts Notary Publi <br /> SEAL Ny Commission Expires Sept.24,2010 <br /> 'at!'a0l 6 <br /> _ Commission Expires: <br />