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BUSINESS CERTIFICATE#07_0 <br /> THE COMMONWEALTH OF MASSACHUSETTS <br /> • TOWN OF MASHPEE <br /> DATE s J� cs�-6 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(ssJ5)that a business under the title of <br /> _De'sg;Se- h40__ /a4AJ ey DBA 11zi6,4IAV, H ilk.0/7 is conducted at <br /> Business Location:_/0Ey✓eP/�/ /��.®QAo{pGrJ &�� ' e�'��� <br /> Business Mailing Address: /0 �rCe_69 /eq_ ® U c�><' AlaI+Aae-,o AAo.�.� <br /> Business Type: SfQtt t S Business Telephone: X02 -'1779-5--:?o <br /> by the following named persons: <br /> FULLJVFu�Ee RESIDEN E <br /> Cqvtfe-61 e_& .r7 C:�!velp <br /> /LLas�i,,vP e 1t e AL<5 YS <br /> Home Phone: <br /> n <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 /> es as required under law. / / <br /> �Ncz2�Gt i Ja<i <br /> *Signature of authorized agent �— *Signature of authorized agent <br /> 09155°9/S��/ <br /> **Social Security Number(Voluntary) <br /> or Federal Identification Number <br /> In case of emergency <br /> TELEPHONE NUMBER: ✓�.?' /7 78.5'.?( <br /> Alarm Company: .A)LIA_ 1,7 <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 1444"0'4_q <br /> / DATE <br /> Personally appeared before me the above-named�al Srz 1444"w'4_q 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 fourYearsthereafter so long as such business shall be conducted and shall.lapse and be void unless so renewed. <br /> Signed ,,' 1 J / <br /> 0 `L-o-is-ti-2- Yom/ Q.tcJ <br /> JOM_ — <br /> SEAL � Re <br /> CO <br />