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0 <br /> BUSINESS CERTIFICATE#09---o co <br /> THE COMMONWEALTH OF MASSACHUSETTS <br /> ( TOWN OF MASHPEE DATE <br /> r1� r1 z <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 /> llBA- /� is conduced at <br /> '� <br /> AIR _ <br /> Business Location: T- $J�f _O `____ <br /> Business Mailing Address: C�� <br /> �� .�fLY Business Telephone: -1 '-1`-_' <br /> Business Type: <br /> by the following named persons: <br /> 1 ) <br /> FULL NAME RESIDENCE <br /> X��.�. C • �J�_��S-- �1�L�1.�8.� Y t{ice �{l1/e��'�4t(LM MY'� <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 under law. <br /> "Signature of authorized agent Signature of authorized agent <br /> VY3 _$45 OryU <br /> at Security Number(Voluntary) <br /> or Federal Identification Number <br /> -� In case of emergency <br /> NAME: jI,C 'v -ti TELEPHONE NUMBER��� - �� ; <br /> Alarm Company -!�iyG ��ICJr(YDS G' S PJw �`�Z—43 <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 lu determine whether you have mel tax filing or tax <br /> payment obligations. Licensees who fail to correct their nun-tiling 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 tire the above-named Y'-�tC V 14 Z Ir{"'7 md made oath that the foregoing g g:"statement is <br /> true. <br /> A certificate issued in accordance with this section shall be in force and effect for four years hour the date of issue and shall he renexed <br /> each four years thereafter so long as su- usineas.tltaifbe conducted and shall lapse and be void unless so i wedi- - <br /> Signed <br /> SEAL JOSEP - <br />