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v( BUSINESS CERTIFICATE# �� ^ <br /> THE COMMONWEALTH OF MASSACHUSETTS <br /> TOWN OF MASHPEE / <br /> . DATE <br /> Expiration Date: z <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: Eif 16 .: } C-">-1 Corporation Name: is conducted at <br /> Business Location: 3SS��r�c} R� UN•k 2A' MAs�Qee MA. 02-6'�M <br /> Business Mailing Address: �•0, BOX 2"r 2 Mc,s17pee� pll�. Q29 <br /> 6V <br /> Business Type: F,bI.:An eq�+Jp+n�f- Business Telephone: 9Nq- 39S- 2_g92 <br /> Home Phone: °I4g- �`IS" 2�I9 Z Email Address: <br /> by the following named persons: <br /> (� Ovxner�Name �s Owner Residence, 7 <br /> �.A rw,Qe(p N ``��r•n. A'j��r,r.t} RG V N I' -A <br /> IrwS� ptee l Ma, 02449 <br /> ticertify 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 /> tax as required under law. <br /> � Gjo2 - og- N78`I <br /> gnature 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 subiect to license suspension or revocation. This <br /> iequest is made under the authority of Massachusetts General Law,Chapter,62C,Section 49A. <br /> f The Commonwealth of Massachusetts /2 <br /> B%ARNSTABLE ss / DATE —I <br /> -•qn Personally appeared before me the above-namedtpArOete -'t �-'l/ 7-ey— and made oath that the foregoing statement <br /> , <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 yes thereafter so long as such business shall be conducted and shall lapse and be void unless so renewed. <br /> Signed 4 <br /> • SEALJOSEPH L.MAZZUCCHELLI,JR <br /> e <br /> Notary Public <br /> COMBMYf+P 1619`8HusEns <br /> My Cornrmsson ret <br /> Ccftw 25,2013 <br />