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BUSINESS CERTIFICATE # V�D //'.06 S <br /> THE COAlillOrVFVF_fILTH OF illASSACHUSETTS <br /> TO FViV OF MASHPEE <br /> DATE <br /> • Expiration 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 /> Business \'ante/DBA: Corporation Name. is conducted at <br /> Business Location: /iy0�/�5i7e��llg2 OAYl <br /> Business Mailing Address: ✓/ l'Xr`�`/ � � /fD7 Odi�i'`f'� <br /> Business Type /45551 L�V Business Telephone: :,,Oluff <br /> Home Phone: Entail Address: <br /> by the following named persons: <br /> Owner Narne Owner Residence <br /> I certify under the penalties of perjury that 1, to the best of my knowledge and belief, have filed all state tax returns and paid all state <br /> taxes as require i er law. <br /> a77 _4t1O 4- 37A <br /> gnaauthorized agent "Social Security\'umber(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 <br /> NAME: ;aL /r!D/ZC�'�J TELEPHONE NUMBER: �OP/47z /� 4 <br /> .Alarm Company: <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 63C,Section 49A. <br /> The Commonwealth ofHassachusetts' r�p. <br /> BryIL\'STABLE ss � DATE o�v26t( <br /> Personally appeared before me the above-named r9GA/1/ 4VZFZ and made oath tha 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 there, er so long as such business shall be conducted and shall lapse and be void unless so renewed. <br /> Signed <br /> i <br /> iNoiary Public <br /> • SEAL w� <br /> ��d <br /> sCommission Expires: <br /> NOTAW ft" <br />