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f <br /> BUSINESS CERTIFICATE#07 (9q <br /> THE COMMONWEALTH OF MASSACHUSETTS <br /> TOWN OF MASHPEE <br /> DATE G <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 /> C ( f 11 e. <br /> T DBA S l�&,t- e � r(n� C O4.. 1�'r i K�j is conducted at <br /> Business Location: ( �(� n✓ C s etU 4�\>°--7K (�r• MCI <br /> ct.. G k <br /> Business Mailing Address: Y�C), boy / ( Q— \ 1C2 5 fl Q L'� � �Ct '.0 8A 6\.4 <br /> .—�i-+ <br /> Business Type: tial Business Telephone: <br /> by the following named persons: <br /> yh <br /> FULLVE �— c RESIDF�L� <br /> NCE <br /> ria 15 75' �C' Toa e '6 1 . 1"(as�l�e � ' <br /> Home Phone: S3 77_ q3 3 - - <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 /> certify <br /> as equir der law. <br /> I <br /> *Signftuye of authorized agent *Signature of authorized agent <br /> 0 - -o) df�0 <br /> **Social Security Number(Voluntary) <br /> or Federal Identification Number <br /> n In case of emergency <br /> � J�. J � � C� <br /> NAME: k�� t.e-e vN M aYl,°-J \> TELEPHONE NUMBER: C3c' ��� to C) ( G <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 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 DATE <br /> Personally appeared before me the above-named 'I l g{D!7� (<nj !\0S"W-?"S and made oath that the foregoing statement is <br /> true. f _ <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 solongas such business shall be conducted and shall lapse and be void unless so r •ed. <br /> ed <br /> ublic <br /> SEAL JOSEPH L.MAZZUCCHELLI,JR <br /> ke F'*6AeHUSETTS <br /> My Co <br /> tkmber 25, 13hes <br />