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BUSINESS CERTIFICATE# 10-0 <br /> THE COMMONWEALTH OF MASSACHUSETTS Q <br /> • TOWN OF MASHPEE <br /> DATE 707 6 <br /> Expiration Date: ^' -.9trl • -?u' <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 /> F""\, <br /> \ i <br /> L�_(�34'n' DBA 1Y� �� �C /1 is conducted at <br /> Business Location: o��pev�rr ear(\C>� <br /> 5JJ ?,e9 y S 'YaC� Q_11! Yl")Y) <br /> Business Mailing Address: a l��eD,eJn�e 0� �e�YY�� <br /> Business Type: es 2, f Business Telephone: '50'k 1�1' <br /> Honte Phone: mag � -7 <br /> by the following named persons: <br /> c FULL NAME RESIDENCE <br /> CS Fn\�� a �t�, Y1�J D2gL/O <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 /> s as required under law. <br /> Oro�olau�gn- d agent V *Signature of authorized agent <br /> "Social Security Number(Voluntary) <br /> or Federal Identification Number <br /> In case of emergency f� <br /> NAME: Qv4p2r� Y�L� TELEPHONE NUMBER: 30k SyK /IQI <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 /> r The Commonwealth of Massachusetts <br /> BARNSTABLE ss DATE <br /> Personally appeared before me'the above-named M H'L Y L,)g %X-1 and made oath that the foregoing statement is <br /> nue. I <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 shall be conducted and shall lapse and be void unless so renewed. <br /> Si <br /> SEAL CUM WRY Pift <br /> Con-ft iBpmYt1YW1150Y. <br /> IM. <br />