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r <br /> BUSINESS CERTIFICATE#08 77 <br /> _7l I <br /> • THE COMMONWEALTH OF MASSACHUSETTS <br /> TOWN OF MASHPEE (� <br /> DATE <br /> Expiration Date: December 31, 2012 <br /> In conformity with the provisions of Chapter one hundred and ten, Section five of the General Laws, as amended, the <br /> underssIigned hereby declare(s)that a bushiness under the title of <br /> SlO <br /> /J[/� L=/�1,� /- DBA �h,C/�/ `/ t1 e. L(J`�n � is conducted at <br /> Business Location: 7 o/,(,// ilk 11/ ) //w' 7I` / <br /> Business Mailing Address: _/ a ��� /// � Y(1 7 <br /> Business Type: K�1VSaw)-/ q6i f d Business Telephone: <br /> by the following named persons: <br /> FU NAMERESID NCE <br /> even Nl�)�e-e- /_277 <br /> 7 M � Gn'S M 'til Ra <br /> Maw 0�6y�_ <br /> Home Phone: <br /> 0ertify 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 /> *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: !L 1 K-e_e- TELEPHONE NUMBER:_(2n <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. q <br /> The Commonwealth of Massachusetts DATE <br /> BARNSTABLE ss <br /> Personally appeared before me the above-named Sr-f_va'd and made oath that the foregoing statement is <br /> nue. <br /> A certifi ate 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 eafter so long as such business shall be conducted and shall lapse and be void unless soren ed. <br /> �ed <br /> SEAL �ftotary Public _ <br /> jJES=EtMAZ1VGCP1W"JR <br /> MTH Of <br /> es: <br />