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m <br /> s <br /> !,. BUSINESS CERTIFICATE #09 (0 6 <br /> THE COMMONWEALTH OF MASSACHUSETTS <br /> TOWN OF MASHPEE ll 5Q� <br /> . DATE a�V <br /> Expiration Date: December 31, 2013 <br /> In conformity with tilep p <br /> provisions of Chapter one hundred and tell, Section five of the General Laws, as amended, the <br /> undersigned hereby declare(s)that a business under the title of <br /> q lel m) " A M S. , w Q��i1���j is conducted at <br /> Business Location: oOQ pa `'�'�' <br /> Business Mailing Address: `( � n (9t.Q� <br /> Business Type: W6neS5 Business Telephone: ')o� - (OBI - %F)F ) <br /> by the following named persons: <br /> FULL NAME RESIDENCE <br /> S,-u�q M> e M aQ(gggi <br /> Home Phone: 5_C6- 4 11'a-51 <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 /> taxes as required under law. <br /> �ri � 1� <br /> rgnature of authorized a0brit *Signature of authorized agent <br /> **Social Security Number(Voluntary) <br /> or Federal Identification Number <br /> /� In case of emergency <br /> p� <br /> NAME: IVD I T) ii x M0 ( TELEPHONE NUMBER: JOB �77-oDS�oZ <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 1-2-17 <br /> mm �O� <br /> Personally appeared before e the above-naed 6'n4^� 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 shat e c nducted and shall lapse and be void unless so renewed. <br /> Signed 0 <br /> • Margaret C. Santosairy Publ` <br /> SEAL 3 ' NOTARY PUBLIC <br /> '' Commonwealth of Massachusetts <br /> Commission Expires Sept.24,2010 Commission Expires: <br />