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BUSINESS CERTIFICATE#09-c"4 <br /> THE COMMONWEALTH OF MASSACHUSETTS <br /> TOWN OF MASHPEE <br /> DA'fP. <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 dec e(s)that a business under the title of / L n' ,ryn� <br /> IL6/�G I �nLD,BA �c k 1044) l/ " ' �I� is conducted at <br /> ���J91 ahs/ }LF wee II�� <br /> ()@6q <br /> Business Location: --�—�� <br /> Business Mailing `A�tddress: A�Q61_��Y ,�\Cd3$,L� F7� --/-� �a,I- 2 v <br /> Business Type:� tyl.skcu5knw_ Business Telephone: pXT <br /> by the following named persons: �" "� I 1 1 �" 0 <br /> Yl n 1 P F aeo I i hNC <br /> IN <br /> Home Phoneyay MI-11100— <br /> I <br /> I- 11100I 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 /> .equired under la}v-, <br /> M M Q \J be <br /> atrrre of authorized agent *Signature of authorized agent <br /> j6-1 - 16q' )-�G(:)\ <br /> **Social Security Number(Voluntary) <br /> or Federal Identification Number 50�� 1911-1 1� �tl Q <br /> iIn case of emergency J 7"� �f, 0\0 <br /> NAM i <br /> C_]Y I Q 1 TELEPHONE NUMBER��� <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 /> isinade under the authority of Massachusetts General-Law,-Chapter62C,Section 49A. <br /> The Coinnionwealth of Massachusetts p <br /> BARNSTABLE ss DATE ? V <br /> Personally appeared before me the above-named N/Y�1'� �i L V& 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 fmfour 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 /> Signed 9C' <br /> A <br /> � L RAF t#N1ar <br /> SEAL PublicPublicCOYMONWEALTHiH OF MASSICMUB <br />