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r <br /> BUSINESS CERTIFICATE#08 -S--L <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 /> undersigned hereby declare(s)that a business under the title of - <br /> & i_64ff tgi S// 1,/t/-AC-6RZ5y } DBA is conducted at <br /> Business Location: b y G ,( ,[.,,m •� - 9,t- /&2L1C A e, YYIA <br /> Business MailingAddress:4/�' <br /> Business Type:7- 1% /{t r� �. y "-y 4 Business Telephone: <br /> by the following named persons: <br /> FULL NAME - RE IDENCE <br /> I/{� �1 r� r 5•G /yid �Ci`l9Lb�,, sem' <br /> Home Phone: <br /> � <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 /> required under law. <br /> es . <br /> / /�r/1Yi <br /> ignature o thorn gent *Signature of authorized agent - <br /> **Sona 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 /> **Yow 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 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 fou years from the date of issue and shall be renewed <br /> each four years theicafter so long as such business shall be conducted and shall lapse and be void unless so renewed. <br /> �ed argaret C. Santos <br /> l NOTARY PUBLIC � CIA <br /> / Commonwealth of Massachusetts Notary,Public <br /> SEAL My Commission Expires Sept.24,2010 �1 <br /> aola <br /> Commission Expires: <br />