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F <br /> BUSINESS CERTIFICATE#w7/— <br /> THE COMMONWEALTH OF MASSACHUSETTS <br /> TOWN OF MASHPEE <br /> • DATE A01O J <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 Name/DBA:CMPEwiQ(. 6w1 e'V(k Corporation Name: S�/►'lrr' is conducted at <br /> Business Location: ) S3 r aMM _✓\ L S( <br /> Business Mailing Address: 54n-)C <br /> Business Type: CC.W��ny CT l qrVgu ' ess Telephone S0Y9 .( Zci3 T 0 ZPi <br /> f TC <br /> G;r4 - 7x.11(31/c-b <br /> Home Phone: T-r?u Z 3 Email Address: 1 ? (di foCr boec-, n' Co/Yl <br /> Svg Soo ae q Z jo/o6 VVC&U LSC C ,Ji E✓LIfvtlC-F- CCD/n <br /> by the following named persons: w(-I- rT m4vt— <br /> 0 vner�N'X9 N G,n /1 / ,, / Owner Residence <br /> 0` C �`/tY� C x11 C E#/ ref - 17 z to ! GQ►�k.1.J� Go r v <br /> 'TJA,oTvvdc.0-vv+ <br /> .Togo � tvcquF( e ft <br /> I certify and 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 re red under law. <br /> Z'009Cf06A-) <br /> •na re of th tzed agent "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 q <br /> NAME: 3-6/ -c> Tcm,X ()C`um TELEPHONENUMBER:Sys ` S SaS <br /> Alarm Company: S?A S l V2C /I"cp"r-[ /Yi <br /> "Your social security number will be fumished 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 62C,Section 49A. <br /> The Common ivealth of Massachusetts <br /> BARNSTABLE ss DATE�� <br /> Personally eared before me the above-named�J -ll , J N Q U 1�l (2Y1-- and made oath that the foregoing statement is <br /> true. <br /> A cc., is c 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 year th cafter so long as such business a conducted and shall lapse and be void unless so renewed. <br /> Signed ( // <br /> VE Notary Public <br /> COMMOMV <br /> JOS PM 4 <br /> F <br /> MY CamtiseimtdbFomites <br /> oolmass.2ma• <br />