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BUSINESS CER'rIFICA•rE # 10-1,' <br /> 711E COAMIONIVEALTH OF AIASSACHUSETTS <br /> • TO NOF/NASHPEE <br /> D A"f L" <br /> F pi tion tate- Dicpinher 31 2014 - <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 C / ,(p <br /> ��ljfvlwxJ I,OZ.FJ . � ��DBA 4/,,Ay!/',$�J,'47"E C7Y is conducted at <br /> Business Location: 7R' ��� �" '"U£ ' L .511prg' �� 626Y9 <br /> Business N[ailing�iAddcess: O. ��'� 9 7 6 ' / " 'T CJ 1�Gq� <br /> Business Type:/lf 4/2574-79 _ f-5 Business Telephone: <br /> Flom Thune: 5-o7477 7766 <br /> by the following named persons: <br /> tYYA4E RESIDENC <br /> -� R701FUL 'v\l[ �✓ 7A �'i✓�It�I6� I/r, <br /> I certifythe penalties of perjury that I, to the best of my knowledge and belief, have filed all state tax retums and paid all state <br /> taxes equire n'. <br /> • »Sraiahue of authori ed agent `Signature of authorized agent <br /> �- �LW5'75 <br /> "Social Security Number(Voluntary) <br /> or Federal Identification Number <br /> In case of emergency <br /> NAME: 46C".41AAK lJ7�4141_1 TELEPHONENUMBER: 5-of q77 77W6 <br /> Alarm Company: wAAi-,0 <br /> *This license will not be issued unless this certification is signed by applicant <br /> ")'our 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 rail 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 /> BARNSTAI3LE ss <br /> The Commonwealth of Alassaclutserts <br /> Personally appeared before me the above-nam //JJ�JJed / 47E)Al 4p'Ar",/ and made oath that the foregoing statement is <br /> uvc. <br /> A certificate issued in accordance with this section shall be in force and effect for four year n h o issue and shall be renewed <br /> cacha'eur ars thereafter so long as such busine s shall be conducted and shall lapse and be void unles so' ewe AKIN OM <br /> Notary Public <br /> SiQnCd r\ �^` � We <br /> OMMONWFJLLTH OF MA$$AC <br /> 03 <br /> • t9,�i� <br /> � o ary u is <br /> SEAL <br /> Commission Expires: <br /> i <br /> I <br />