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aO' --- - BUSINESS CERTIFICATE#08 <br />— -- TIIECOMMONFVEAL7WOFMASSA CHUSETTS <br /> TOWN OF MASHPEL^ <br /> DATE <br /> Expiration Date: DCCeinheY 31, 2012 <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 /> DBA is conducted at <br /> Business Location: �✓ � QuASNN�I �OF{a7ASfIP� � <br /> Business Mailing Address: SAM G7 <br /> Business Type: r-- c�rlfcl O R� Business Telephone: -4-0,B 'Lt 7 7-S8 73 <br /> by the following framed persons: _ <br /> FULL NAMES�qq RESIDENCE <br /> jgICHaEL L / ItRTO JAMC <br /> Home Phone: .SOS-LP 7-3 2 3 4 <br /> *it' <br /> t of my knowledge and belief, have filed all state tax returns and paid all state <br /> s as re uued under law. <br /> *Signature of authorized agent *Signature of authorized agent <br /> **Social Security 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 fail to correct their non-filing or delinquency will be subiect 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 � ' R' 0 <br /> Personally appeared before me the above-named IVI 1 c- o-I Ht IA�6 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 /> wed - <br /> _ Notary Pu lie <br /> -Sent <br /> WM <br /> Deborah F. DamiNOTARY PUSIIC <br /> Commonwealth of Massachusetts Commission Expires: <br /> y Commission Expires July 24,2009 <br />