Laserfiche WebLink
BUSINESS CERTIFICATE#06 "60 <br /> • THE COMMONWEALTH OF MASSACHUSETTS <br /> TOWN OF MASHPEE <br /> DATE <br /> Expiration Date: December 31, 2010 <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 /> 601t(S�e/n { , /d DAB is conducted at <br /> Business Location: 3-7 A J 2S /Z /n) <br /> Business Mailin ess: <br /> BusinessT� u/T/n Business Telephone: q_7 7. 'L/IZS <br /> by the following named persons: <br /> FULL NAME RESIDENCE <br /> I)or94 � 91G�'Wtt) b 7 /trYY�S LQ rna <br /> Home Phone: 5D� U <br /> AllLpertify 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 /> es as requ1(rrle�dnunnder law. <br /> *Signature of authorized agen - *Signature of authorized agent <br /> **Social Security Number(Voluntary) <br /> or Federal Identification Number <br /> In case of emergency <br /> NAME: SCDIf �y�/pls<Qtrt TELEPHONE NUMBER: —Z(� 70(Y-33J6 <br /> Alarm Company: lAqI a ✓) /7 tr Ala C(1'1 <br /> *This license will not be issued unless this certification is signed by applicant <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 Commonwealth of Massachusetts <br /> BARNSTABLE ss _� DATE 9-aa i,&6 <br /> Personally appeared before me the above-named ne L�Ci S 1 I and made oath that the foregoing statement is <br /> true. <br /> A cpftificate 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 ye s thereafter so Ion a ch business shall be conducted and shall lapse and be void unless so renewed. <br /> �edMmo _ _ �- <br /> Margaret C. Santos <br /> VVY <br /> NOTARY PUBLIC <br /> ary Public <br /> SEAL Commonwealth of Massachusetts <br /> Commission Expires Sept.24,2010 T // <br /> Commission Expires: <br />