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• BUSINESS CERTIFICATE 0,912) <br /> TOWN OF MASHPEE <br /> • Date: <br /> Expiration Date: <br /> In conformity with the provisions of Chapter 110, §5 of the Massachusetts General Laws, as amended, the <br /> undersigned hereby declare(s) that a business under the title of <br /> Business Name/DBA: The Yarn Basket Corporation Name: <br /> is conducted at Business Location: 681 Falmouth Road, #D26 Certificate No. 2011-018 <br /> Business Type: Retail Store <br /> WNew [] RenewalxCommercialYResidential [ ] Email Address: dS14 (&YI-,Z(7 h <br /> Business Mailing Address: 681 Falmouth Road,#D26 Mashpee, MA 02649 <br /> Business Telephone: 508-477-0858 Home [X] Cell [ ] Phone: 508-548-0305 <br /> by the following named persons: <br /> Owner Name Owner Residence <br /> Dorothy Studley 39 Bayview Road Mashpee MA 02649 <br /> •1 certify under the penalties of perjury that I, to the best of my knowledge and belief, have filed all state tax returns and paid <br /> all sta taxes as required nder w. <br /> 0��� Zoo-c�yy�7�Gy <br /> *Signature of a horized agent **Social Security Number <br /> *This license will not be issued unless this certification is signed by applicant O e eral Identification <br /> umber(Required) <br /> In case of emergency <br /> NAME: /V tT&&44;e,�&&44;e, TELEPHONE NUMBERAj—_y. —D <br /> L <br /> Alarm Company: <br /> "Your social security number will be furnished to the Massachusetts Department of Revenue to determine whether you have met tax <br /> filing or tax payment obligations. Licensees who fail to correct their non-filing or delinquency will be subject to license suspension or <br /> revocation. This request is made under the authority of Chapter 62C,§49A Massachusetts General Laws <br /> The Commonwealth of Massachusetts <br /> BARNSTABLE: ss DATE <br /> Personally appeared before me the above-named and made oath that the foregoing <br /> statement is 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 <br /> renewed eao four years thereafter so long as such business shall be conducted and shall lapse annyyd,,be void unless so renewed. <br /> •Signed Notary Public i4;-AiL'iR ✓ .2)EmA/LE.S7— <br /> Commission Expires <br /> �' PATRICIAJ. DEMAREST <br /> NOTARY PUBLIC <br /> COMVaWEA:TH OF 6uSSACHUSEITS <br /> My Comm.Fires Apt.26,2019 . <br />