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J - - - BUSINESS CERTIFICATE#09 <br /> THE COMMONWEALTH OFMASSACHUSETTS <br /> "TOWN OF MASHPEE <br /> DATE " +may <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 /> A Z C) [ 1� 11 �1 G(��1 7\dc.pKDBACil� r C ("y I�"C yl�}"3 is conducted at <br /> e <br /> Business Location: `1 o e }C 6�1R r)06 M'As .l-p�E M Pq 0,)G 4 9 <br /> Business Mailing Address: ,7 r� <br /> Business Type: P Stt-e 9d&3 Business Telephone: .�V 3 �' J 0Q <br /> by the following named persons: <br /> Ft,' LNAME I RESIDENCE <br /> t �cadr.� 1 a1�a�d`t LAn E <br /> e s I 6A"NST09 Ct-; W4 0J G 6'8 <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 /> -- <br /> re o authorized�� *Signature of authorized agent <br /> **Social Securitty-tNumber(Voluntary) <br /> of Federal Identification Number <br /> In case of emergency <br /> NAME: [ TELEPHONE NUMBER: <br /> Alarm Company: <br /> �9GOG`�sf7 a -9 s�3 <br /> *This license will not be issued unless this certi ication is signed by applicant <br /> **Your social security number will be furnished to the Massachusetts Department of Revenue to actennine whet:ar 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 Geneia] Law,Chapter 52C,Section 49A. <br /> The Commonwealth of Massachusetts <br /> BARNSTABLE ss 1 DATE <br /> Personally appeared before me the above-named 7:k-JS�-- e h :?CQC L O\ and iiradc oath that the oregmng statement is <br /> true. <br /> A certificate issued in accordance with this section shall be in force and effect for foul years fi-om the date of issue and shall be renewed <br /> each four YEAQ thereafter so long as such business all be conducted and shall lapse and be void unless so renewed. <br /> Signed <br /> • ¢ B <br /> Margaret C. Santos Notary P«bli - <br /> SEAL NOTARY PUBLIC <br /> Commonwealth of Massachusetts <br /> 091AY <br /> Commission Expires Sept.24,2010 Commission Expires: <br />