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'• BUSINESS CER'T'IFICATE# 16 <br /> TIM COMMONWEAL THOFMASSA CTIUSETTS .0 to,— <br /> JjS <br /> S TOIVN OF AfASHPEE �— <br /> DATE 5 <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: 64rnna ' -jjiof Corporation Name: is conducted at <br /> Business Location: �� r2ttn�Atn ✓Y1/n5 p /l�� <br /> Business Mailing <br /> Address: Fl-,. <br /> Business Typc: fnonra&rv 1�J1n�n✓ �Boul siness�T�e�lephone�:� — _ �m9�C7��$ <br /> Home Phone: EO _ � qy <br /> Email Address: daaru�ron� Inn�oar ,w VA <br /> by the following named persons: <br /> Owner Name Owner Residence <br /> ^�rtn Frona rr ��U Frr[ 1 On�7 1f/l <br /> I certify under the penalties qury I, to the best of my latowledge and belief, have filed all state tax returns and paid all state <br /> taxes as required under la <br /> ign n au a ent "Social Security Number(Voluntary) <br /> or Federal Identification Number <br /> *This license will not be issued unless this certification is signed by applicant <br /> y� ��^^ In case of emergency C <br /> NAME: fPgg,t Frej�j5 TELEPHONE NUMBER: SB$-��y-ia�ffC <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 subiect to license suspension or revocation. This request <br /> is made under the authority of Massachusetts General Law,Chapter 62C,Section 49A. <br /> The Commonwealth ofA7assachuscas <br /> BARtNSTtIBLE ss DATE /d <br /> Personally appeared before me the above-named D 1+01 tri I- F e-V't�i (Iti4­and made oath that the foregoing statement is <br /> true. <br /> A certificate issued in accor eneezvi} 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 1 g s s ch business,hall be conducted and shall lapse and be void unless so renewed. <br /> Signed <br /> I <br /> da <br /> i <br /> . JOSEPH UMMOUMM.JR <br /> U'EALNotary Public <br /> COMYONWFALTH OF W881ICtQJpETi� <br /> Pt res: <br /> I <br />