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BUSINESS CERTIFICATE# D- 45 THE COMMONWEALTH OF MASSACHUSETTS TO I11A'OF MASHPEE ` I DATE • Expiration Date: 3 3 In conformity with the provisions of Chapter one hundred and ten, Section five of the General Laws, as amended, the undersigned hereby declaie(s) that a business undet/r,fheltitle of ' Business Name/llBA: / ` ✓" Corporation Name: is conducted at Business Location: I �GU• 4J 1 LA-e� Commercial_ esidential_ Business Mailing /Addres--s: W✓I'0- 04 C" N L - I nn lM1�� /h¢�1 L d rti Business Telephone: vd !"/� —N /� Business'1' cai P / _ n Business Phone to Phone: 5t)b- -1 q d bL1 Email Address: C Q�j' e G�IiN JOro- • `° by the following named persot : JOT - by Na ie ( Os� er Residence ,,^ Q�� A/� JG14 iF+ 2 � Got/`L Q Ct�'1 //il'�' /V1CqLn(- 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 -es as requir d and ' aw. of authorized agent ""Social Security Number(Voluntary) ,:g1na_rure or Federal Identification Number *This license will not be issued unless this certification is signed by applicant In case of emergency NAME: TELEPHONE- NUMBER: Alarm Company: "Your social security number will be furnished to the Massachusetts Department of Revenue to determine whether you have met tax filing or tax payment obligations. Licensees who fail to correct their non-filing or delinquency will he subject to license suspension or revocation. This request is made under the authority of Massachusetts General Law,Chapter 62C,Section 49A. The Commonwealth of Massachusetts BA121VS'fABLE ss � DATE Personally appeared before me the above-named � P '�w') 'd made oath that the foregoing statement is true. A certificate issued in accordance with this section shall be in force and effect for fou years from the date of issue and shall be renewed each four years thereaf er so long as such business shall be✓conducted and shall lapse and be void unless so renewed. Signed_-��t� Notary Pub SEAL Deborah Omni Commission Expires: NOTARY PUBLIC r• Comtttonvteeltltotmassaidwsm my Cormidaion WON Jtl1y 29.2018 .