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BUSINESS CERTIFICATE# 10- 0 c{7 <br /> r f � <br /> THE COMMONWEALTH OF MASSACHUSETTS I <br /> TOWN OF MASHPEE <br /> DATE )—IICJ IU <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 /> (/ Arc'WW,,t . CP"�C, l�C DBA Uv Co,,h� CA is conducted at <br /> Business Location: I C.l l.Q+wsr.�•.Bs^ Sc�yct.-;� 1 ' �• .y�'4- t - <br /> I p q <br /> Business Mailing Address: ILI I oma•-�pw.LL �i 04— Mw+� t <br /> o �1 <br /> Business Type: (rcG 'A ,r.•�� 'Kl!eskyo...J BusinessTelephotic: <br /> Home Phone: <br /> by the following named persons: - <br /> FULL NAME RESIDENCE <br /> i <br /> A" <br /> 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 <br /> s as required under law. <br /> VNV^ �- l/�1 r✓1 <br /> *Signature of authorized ent *Signature of authorized agent <br /> lZS 6566, <br /> **Social Security Number(Voluntary) <br /> or Federal Identification Number <br /> In case of emergency <br /> NAME: UC6011 aL. V s TELEPI-IONE NUMBER: 9 G 3 1—Ot,9 5�(. <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 126�tj <br /> BAIL\'STABLE ss DATE � / /--, `---"— <br /> Personally appeared before me the above-named kl�)l441 U Y OH)OCL)Sl</ 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 fou years ther er so I rlg as suc business hall be conducted and shall lapse and be void unless so renewed. <br /> jt ,1QqFPH1 MA72UQME,WJR1 <br /> cow MASSAC H <br /> .SEAL My Cnnnessim Ewes <br /> ' 1 <br />