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BUSINESS CERTIFICATE# 261 <br /> THE COMMONWEALTH OF MASSACHUSETTS <br /> TOWN OF MASHPEE <br /> DATE— <br /> Expiration <br /> � <br /> • Expiration Date: 3 �/ / <br /> 10 <br /> In conformity with the provisions of Chapter one hundred and len, Section five of the General Laws, as amended, the <br /> undersigned hereby declare(s) that a business under the title of <br /> FtM 0 P14P - A Piz N - tBC <br /> Business Name/DBA: 9,14te, :�try a Corporation Name: <br /> is conducted at <br /> Business Location: c S�pte Sk o ✓1 I1" a o / mei <br /> Business Mailing Address: -0M4LS v`f�2 M cc <br /> Business Type:/ Ps:} a /n,a A i, YMen4.11 {oto/business Telephone: :2 7 Y — aZ3 P <br /> Home Phone: Email Address: <br /> by the following named persons: <br /> Owner Name Owner Residence 9W <br /> l7 519 //ING/�, <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 required under law. <br /> 6�- <br /> nature of authorized 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 <br /> NAME: TELEPHONE NUMBER: <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 subiecl to license suspension or revocation. This <br /> request is made under the authority of Massachusetts General Law,Chapter 62C, Section 49A. <br /> The Commonwealth of Massachusetts <br /> BARNSTABLE ss rr � / DATE 'y <br /> Personally appeared before me the above-named K R-TIk✓ �W/� !24Q4-- and made oath that the foregoing statement <br /> is 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 thereafter so long as such business shall be conducted and shall lapse and be void unless so renewed. <br /> Signed Ili= ��l/V AZA"- <br /> ruv o0 <br /> sa,Wx3 uassuawoal ary Pu <br /> • SEAL 81138fggvSSvwdJ0 I AVION NOnt10J <br /> a!IWd h+aloN <br /> dr'lt <br />