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BUSINESS CERTIFICATE#2&O^ <br /> • THE COMMONWEALTH OF MASSACHUSETTS <br /> TOVVN OF MASHPEE <br /> DATE� <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 C� ,, ,, I �. <br /> 4i�Q�(JFaLfC S1111I ,A—utkeu&0-m f�T(��,',r DBASIQ�q r �`„ {�O is conducted at <br /> Business Location: 1` knW 0-.$4.P "X�1�i "`Q 0-)�f <br /> Business Mailing Address: SA-mP- . <br /> Business Type: Qj -elL&e Ywaoz 4UBusiness Telephone: <br /> Home Phone: <br /> by the following named persons: <br /> FULL NAME RESIDENCE <br /> 1 ¢gym .1-. cli cx•, S� 1� VeRw dg Ndtgci Vitays <br /> I certify under the penal ' of perjury that I, to the best of my knowledge and belief, have filed all state tax returns and paid all state <br /> t es asrequired oder aw <br /> . <br /> *Signature of authorized agent *Signature of authorized agent <br /> **Social Security Number(Voluntary) <br /> or Federal Identification Number <br /> In case of emergency (� `'c <br /> NAME: -3VA� 57 TELEPHONE NUMBER; — • T 17 <br /> Alarm Company: �A`'t�c�I� Le mmm <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 st biecl 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 <br /> BARNSTABLE ss DATE <br /> Personally appeared before me the above-named and made oath that the foregoing statement is <br /> true. <br /> A certificate issued in acc rdance 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 thereafter so to as s ch buy ess shall be conducted and shall lapse and be void unless so renewed. <br /> Of <br /> Signed <br /> • Notary Public <br /> SEAL <br /> Commission Expires: <br />