Laserfiche WebLink
BUSINESS CERTIFICATE#07 <br /> • THE COMMONWEALTH OF MASSACHUSETTS <br /> TOWN OF MASHPEE <br /> DATE <br /> Expiration Date: December 31, 2011 <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 /> /f ei"I n S®a�L¢ S / DBA �vr7B:+�� L/1//Y�l6S Sours+a, T is conducted at <br /> Business Location: Xp-y 'y/ Lr ter.,e �j/ C �,p,�� g eZ <br /> i <br /> Business Mailing Address: 14' 4. 66X A'K_r '- <br /> Business Type: lit/in Tt Q Business Telephone: 3 3 S• 9PY.Y- <br /> by the following named persons: <br /> FULL NAME RESIDENCE <br /> -5;+v�rf /��J. GAG' A14,.s-�r� ��A,rl,�r� <br /> Home Phone: <br /> 0ertify 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 /> s as required under l/aw. <br /> *Signature of authorized agent *Signature of authorized agent <br /> **Social Security Number(Voluntary) <br /> or Federal Identification Number <br /> In case of emergency <br /> NAME: 5_,Iw 4 TELEPHONE NUMBER: soy OoG C <br /> Alarm Company: <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 BARNSTABLE ss DATE_ � 4)'q 1 d <br /> Personally appeared before me the above-named r� Lli N 1 J U i) L-tr 5 and made oath that the foregoing statement is <br /> true. <br /> A cerci mate issued in accordance with this section shall be in forceandeffect for four years from the date of issue and shall be renewed <br /> each four year reaftei so long as uch business shall be conducted and shall lapse and be void unless so renewed. <br /> •ed <br /> gob �, � _ � tt��., ✓� f�rl <br /> N taryP blit <br /> SEAL JOSEPH L.MAZZUCCHELU, <br /> U Notary Pubic l ] 3 <br /> COMMOMy Comes OF nEvire HUSETT6 My Commission Expires Commission Expires: <br /> October 25,2013 <br />