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�A F BUSINESS CERTIFICATE 9 <br /> THF COMATONIVEAL TH OF MASSACHUSETTS <br /> TOIVtV OF N/ASHPEE / <br /> DATE / r ( ( — ZU/l <br /> • Expiration Date: I / ' / <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 /> Business\'arae/DBA: Corporation Name: � I � Lt,'� t alt is conducted at <br /> Business Location: 22,2 Q��� �'� /�G/I t •r( � S�T/ L , a G�C/ <br /> Business D7 ailing Address: <br /> Business Type:Ml—/'/� ��/C^'71n� y /�r�('��' Business Telephone: /�/J��1�•���/ ,f,��F/ j� <br /> Home Phone: " L I- / 7" 7J Email Address: ! /Lr' G' G �'%�/�`'-�' / ✓i ' y�� <br /> by the following named persons: <br /> !(f mer Nn,, tees •n r Resjt� . <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 /> taxes as required dery law. <br /> 'nature of authorized age t **Social Security Number(Voluntary) <br /> or Federal Identification Number <br /> *This license will not be issued unless this certification is signed by applicant <br /> In case of emergency 3 <br /> NAME: N <br /> / ( TELEPHONE U VIBER: 7�� �Z�dG��— <br /> Alarm Company: <br /> i'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 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 /> BARt\'STABLE ss DATE I I <br /> Personally appeared before me the above-named and made oath that the foregoing statement is <br /> true. <br /> A certificate issued in accordance with t ' ction shall be in force and effect for four years from the date of issue and shall be renewed <br /> each four years thereafter so as such busi all be conducted and shall lapse and be void unless so renewed. <br /> Signed <br /> Notary ublic <br /> SEAL <br /> DeboMh OM' <br /> NOTARYPUSUC Commission Expires: <br /> my CCWMh aim E'O t 8 <br />