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p' BUSINESS CERTIFICATE# - d_Z-- <br /> THE COMMONWEALTH OF MASSACHUSETTS <br /> TOWN OF MASHPEE <br /> • DATE U1 , d <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: St=;Qr ( A-Q Q SAN PFSIC /JS Corporation Name: <br /> Mp�. 02G4° <br /> is conducted at Business Location: 2`J ' I JW 1�d4SV EE Commercial—Residential K <br /> Business Mailing Address: P—'S �+--_-4 0W v4I.sTI �e �-4 4si-wt_ 1`I A a26,4ck <br /> Business Type: o Business Telephone: 50F,`13-7.012 S <br /> New I v'Renewal I I Home Phone: 74 7- 1 Email Address. q <br /> by the following named persons: R a �l <br /> IewEi4 Re�si`d'eJnce I p� <br /> ".b^ , p. <br /> I certify under the penalties df perjury that I, to the best of my knowledge and belief, have filed all state tax returns and paid all state <br /> taxes as re uired t r law. <br /> 02� t Et a �z <br /> of author ed e t **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 subject to license suspension or revocation. This request <br /> is made under the authority of Massachusetts General Law,Chapter 62C,Section 49A. <br /> The Commotnvea(th of Massachusetts <br /> BARNSTABLE ss DATE <br /> Personally appeared before me the above-named �-- SLS 1,4 #-ff-r.( and made oath that 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 thereafter so Ion as such business shall be conducted and shall lapse and be void unless so renewed. <br /> Signed �� <br /> • SEAL NoteWPlrEGe .rR <br /> Comte <br /> Qetober 29.1013 <br />