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BUSINESS CERTIFICATE#08 <br /> • THE COMMONWEALTH OF MASSACHUSETTS <br /> TOWN OF MASHPEE <br /> DATE S �30 /o S <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 /> undersigned hereby declare(s)that a business under the title of <br /> _DBA is conducted at <br /> Business Location: 5 a C)r .. 200.U N)a 1. /Yl A O -16 t/ 9 <br /> Business Mailing Address: Sal Or l2n M5asj,a « 14 ck <br /> Business Type: 2n Tbr.�LT Murko�:� Business Telephone: S08 Q'46 —,6 -701 <br /> by the following named persons: <br /> FULL NAME RESIDENCE <br /> �ar. So.cr.v+a nr. Ste, drtq n /eoe.,e� /Y1p.S l.e rMFF <br /> o.a649 <br /> Home Phone: SOS S29-006a <br /> ertify 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 /> xes as required under law. <br /> *Signature of authorized agent *Signature of authorized agent <br /> 13� - 6w- / ash <br /> **Social Security Number(Voluntary) - <br /> or Federal Identification Number <br /> In case of emergency <br /> NAME: Dar o4-Ly SFar� TELEPHONE NUMBER: Sog 36'7-0o1_, <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-Sling 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 DATE S Q Q <br /> BARNSTABLE ss ,�t O � / <br /> Personally appeared before me the above-named s- Q� 9h ,\M Ao N 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 /> 0igned <br /> u }teary PLI)k <br /> SEAL- Of UASShtAtO <br /> t - mmicsanEwp� <br /> mmission <br />