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BUSINESS CERTIFICATE# 10-_0 <br /> THE COMMONWEALTH OF MASSACHUSETTS <br /> • TO FVN OF MASHPEE <br /> DATE ��� '7-1 r7 <br /> Expiation Date: <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 iyr� riT /d /a JAtyr/ DBA N+TT✓�% y�p�� . i.ip is conducted at <br /> Business Location: ��r A4 0 ✓9.N' Rd <br /> Business Mailing Address: <br /> Business Type: Ileo,"C Business Telephone: Jr�y3- %77- Y-��S <br /> Home Phone: ��LL( se" <br /> by the following named persons: ... <br /> FULL NAME RESIDENCE <br /> A4 r, ./ 7 cJ 1,z Sri..✓(e./1 7-7 /�T/,is.t�r 4&.4e <br /> —/�R Rfi�/- ,✓ion Sn� t /a Y/h <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 /> •es as required under law. <br /> , <br /> *Signature of authorized agent *Signature of authorized agent <br /> **Social Security Number(Voluntary) <br /> or Federal Identification Number <br /> In case of emergency <br /> NAME: TELEPHONE NUMBER: <br /> Alarm Company: <br /> *'Phis 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 /> The Commonwealth ofMassachuserrs <br /> BARA'STABLE ss DATE L/ G <br /> Personally appeared before me the above-named —0—v i, nC2Il 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 years thereafter so long as such business shall be conducted and shall lapse and be void unless so renewed. <br /> gned� I <br /> ;Margaret C. Santos C" r 6c.. A C.Cc<Jt <br /> NOTARY PUBLIC tary Public <br /> SEAL + MY Commission Expires Sept.24,2010 <br /> .� .... ash x610 <br /> Commission Expires: <br />