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BUSINESS CERTIFICATE#07LO� <br /> THE COMMONWEALTH OF MASSACHUSETTS <br /> TOWN OF MASHPEE <br /> DATE <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 /> ��4VI/ ) 1021 DBA �rL�✓F.[ �L �,T,u ,� <br /> is conducted at <br /> Business Location: SS T -les✓,v �,� �t.1J�/i�EP /✓/9 da6y� <br /> i <br /> Business Mailing Address: <br /> Business Type: 42?+J✓ia✓v`t/yi Business Telephone: Sod - ?67 - 7c)3SV <br /> by the following named persons: <br /> FULL NAME RESIDENCE <br /> �'�/i� , wt GCS N SS �� 'bio%✓ �.�- 4hi_r,0�0 M9 OiL!9 <br /> Home Phone: <br /> 1 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 /> es as required under law. <br /> 14� <br /> `Sign tore of author' nt *Signature of authorized agent <br /> **Social Security Number(Voluntary) <br /> or Federal Identification Number <br /> In case of emergency <br /> NAME: 'b'c E'it TELEPHONE NUMBER:-S�0+ - <br /> Alarm Company: <br /> *This license will not be issued unless this certification is signed by applicant <br /> "Your social security number will be famished to the Massachusetts Department of Revenue to determine whether you have met tax filing or tar <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 /> BAR,'VSTABLE ss DATE D <br /> true. Personally appeared before me the above-named VALA (}-!I e '14W4-"and <br /> QQ made oath that the foregoing statement is <br /> A certificate is ed 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 vears therea r so long as such business shall be conducted and shall lapse and be void unless so renewed. <br /> Signed <br /> SEAL 1L. MSEPH L.M CHELLI,JR <br /> No Public <br /> _ COMMO j{Ho"1 TTd <br /> MyCOInItYww born <br /> 0*1*23 1013 <br />