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BUSINESS CERTIFICATE# �� <br /> • THE COMMONVVEALTfl OF MASSACHUSETTS <br /> TOVVAt OF MASfIPEE <br /> DATE 10h --? I ! 0 <br /> Expiration Date: <br /> In conformity with the provisions of Chapter one hundred and ten, Section rive of the General Laws, as amended, the <br /> undersigned hereby declare(s)that a business under the title of I <br /> v ` DBA R I C 60 h4 r 41A M 5 14021 I—I0 (i�cCa44 /0 <br /> q �cA u7 ►a��� r�c,_a� <br /> Business Location: I I o (�C e <br /> Business Mailing Address: 6Cs V-r\ <br /> Business Type: R 4 /-5 Business Telephone: 4 �' / C/ _fig L4 <br /> Home Phone: C) I - q <br /> by the following named persons: <br /> FU1LnLNg1ME RESIDENCE 1 ��, <br /> '( yT ' v \ S2 U(A %1 CS jt�(—�I �"r °a'x riry �k�Oc�-ry Ac <br /> tU �2 a <br /> I certify 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 /> taxes as required under law. <br /> *Signature of authorized agent *Signature of authorized agent <br /> 04%-f) ?-S- �? -7 <br /> "Social Security Number(Voluntary) <br /> or Federal Identification Number <br /> 11 In case of emergency <br /> NAME-.- -A (`a I- __ nA(lr" `—t, TELEPHONE NUMBER: 2/ 4 C 12 79 <br /> Alarm Company: U R y3s <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 riling 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 aurhority of Massachusetts General Law,Chapter 62C,Section 49A. <br /> The Coatmomveallh of Massachusetts <br /> BARNSTABLE ss QQ DATE Q <br /> Personally appeared before me the above-named )U0 W, Ln 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(our years thereafter so long as such business shall be conducted and shall lapse and be void unless so renewed. <br /> Signed <br /> • <br /> SEAL JOSEPH L. JR, <br /> * Notwry NLBC , <br /> OF MA99A�Enb <br /> mypamin-sink is W1 ires: <br /> pi9a0et1&2003 <br />