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JI BUSINESS CERTIFICATE N 1OQCT- <br /> • THE COMMONWEALTH OF MASSACHUSETTS <br /> TOWN OF MASHPEE <br /> DATE a / <br /> Expiration Date: �Pt <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()that <br /> -a/business under the title of <br /> Al <br /> 4e, conducted at <br /> Business Location: '/�-�� �� ��/C ��( 01'X6� <br /> Business Mailing Address: 't �L <br /> Business Type: //� `/S�,/r'�e-/ Business Telephone: 40 <br /> OLS L/ <br /> 7 (J <br /> Home Phone: �3 3 -�{��7 7V G4�r zq-Za 1 <br /> by the following named persons: <br /> FULL NAME ESID NCE <br /> {�/Pi � �9 /fJ2iL7 GUdIJS k'��CQtS �2(i <br /> P <br /> I certify under the penalties of perjury that I, to the best of my knowledge and belief, have filed all slate tax returns and paid all state <br /> Ask taxes as required under law. <br /> _ ���� <br /> tgnatu f authorized agent *Signature of authorized agent <br /> aka�o e; <br /> **Social Security Number(Voluntary) <br /> or Federal Identification Number E-� <br /> In case of emergency NAME:��yC�elt-Q-Q- TELEPHONE NUMBER: <br /> Alarm Company: <br /> i <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 lax 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 /> I <br /> Tire Commonwealth of Massachusetts <br /> BARNSTABLE ss DATE e�� <br /> I <br /> Personally appeared before me the above-namedo-zS A"/t�- 1 (Te!/zti/r2�1' -and made oath that the foregoing statement is <br /> INC. <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 hereafter so long as such business shall be conducted and shall lapse and be void unless so re4ewed. <br /> Signcd���¢e <br /> Notary Public <br /> SEAL &V JOSEPH L.MAZZUCCHL:'.'..9: <br /> C0MM0{It46t i-'fP�92WQSETTS <br /> My Conanissiatt Eslrites. <br /> 04*0 29,2015, <br />