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BUSINESS CERTIFICATE#09- <br /> THE COMMONWEALTH OF MASSACHUSETTS <br /> TOWN OF MASHPEE DATE 6/ /4 121 ,09 <br /> Expiration Date: December 31, 2013 <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 /> (� <br /> K't�Ai1QJ EF '� 1kfa 'A DBA IiT6NNML.S �ESI 6-N is conducted at <br /> Business Location: II /� R1VeRVICW 4VENUt r rya 3HPce - MH — 02649 <br /> Business Mailing Address: G R I V cn VIE tnf Ay'C Al V C , IN t/YS 11'(J E L' - h14 - 02 6A? <br /> Business Type: k/EB GR&11 t G g CS I w Business Telephone: S�& - .2-7 - 2 2 6 2 <br /> by the following named persons: <br /> FULL NAME O RESIDENCE <br /> Pi�'1W-5-tTf C#Vplep 116- AIV6ZVtEW AYC0y6/ 1t11nOfeF - "A-6266ej <br /> Home Phone: <br /> I certify under the penalties of perjury that 1, to the best of my knowledge and belief, have filed all state tax returns and paid all state <br /> taxes as required u r law. <br /> atme of autho;Tzed agent *Signature of authorized agent <br /> 621 - -44 - 8796 <br /> **Social Security Number(Voluntary) <br /> or Federal Identification Number <br /> �t In case of emergency <br /> J <br /> NAME: Iff G fl"G H c h't Pgfl TELEPHONE NUMBER: SV g - 22 1 -?9� 6 <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 /> L The Commonwealth of Massachusetts <br /> BARNSTABLE s�t 'y � DATE <br /> Personally appeared before me the above-named A' P WW ILSE-ET Chore. 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 yeais thereafte o long as such business shall be conducted and shall lapse and be void unless so renewed. <br /> Signed <br /> Margaret C. Santos — 4omryPublic <br /> SEAL ° NOTARY PUBLIC <br /> Commonwealth of Massachusetts 9 lb <br /> Vly Commission Expires Sept.24,2010 Commission Expires: <br />