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2006
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11/17/2016 3:10:00 PM
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Box 037
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BUSINESS CERTIFICATE#06 '(7i�' <br /> THE COMMONWEALTH OF MASSACHUSETTS <br /> TOWN OF MASHPEE <br /> • DATE 1/3/06 <br /> Expiration Date: December 31, 2010 <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 /> Slavinsky & Sanicki, Inc. DBA is conducted at <br /> Business Location: 800 Falmouth Road, Suite 301C, Mashpee, MA 02649 <br /> Business Mailing Address: same <br /> Business Type: Engineering Business Telephone: 508-477-7272 <br /> by the following named persons: <br /> FULL NAME RESIDENCE <br /> John P. Slavinsky 170 Whistleberry Drive, Marstons Mills, MA,. 02649 <br /> David C Sanicki 39 Pitch Pine Lane, E Falmouth, MA 02536 <br /> Home Phone: 508-548-5434 <br /> I certify under thq pallies of perjury that I, to the best of my knowledge and belief, have filed all state tax returns and paid all state . <br /> e equir er law. <br /> ture of authorized agent *Signature of authorized agent <br /> 04-3251103 <br /> **Social Security Number(Voluntary) <br /> or Federal Identification Number <br /> t �-�1 / In case of emergency <br /> NAME: h�L`Ur lel�ff C e TELEPHONE NUMBER: 6117- 96 Xf <br /> *This license will not be issued unless this certification is signed by applicant <br /> "Your social security number will be famished 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 subiect to license suspension or revocation. This request <br /> is made under the authority of Massachusetts General Law,Chapter 62C,Section 49A. <br /> The Commonwealth of Massachusetts <br /> BARNSTABLE ssII DATE I'.� O G <br /> Personally appeared before me the above-named J Uh n 1?SG(/+n S6 and made oath that the foregoing statement is <br /> tme. <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 /> Signed � p <br /> • Margaret C. Santos otaryPublic <br /> SEAL °„1 <br /> IVI�VNOTARY PUBLIC <br /> Commonwealth of Massachusetts Commission Expires: <br /> My Commission Expires Sept.24,2010 <br />
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