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BUSINESS CERTIFICATE# /D— // 7 <br /> THE COMMONWEALTH OF MASSACHUSETTS <br /> TO PVN OF MASHPEE <br /> DATE <br /> Expiration Date: 3( <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 V <br /> Business Name/DBA:C1'Ieflt�P\SKA, Sc, yJi q�C\o1rporation Name: r�AkA+ �o`�r�tnnSisconducted at <br /> Business Location: '�'PO Nva Cx-v;_ ty\�.l�i R_���_MA�� M2a:► I <br /> Business Mailing Address: SE%Me. <br /> Business Type: vy) YP p i rBusiness Telephone: <br /> Home Phone: -LJ-LI1`1�)- .3Email Address: <br /> by the following named persons: <br /> Owner Name tO�w�ner Residence <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 /> 46" tgnamre of authorized agent **Social Security Number(Voluntary) <br /> or Federal Identification Number <br /> *This license will not be issued unless this certification is signed by applicant <br /> In case of emergency <br /> NAIME: TELEPHONE NUMBER: <br /> Alarm Company: <br /> "Your social security number will be fumished 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(6G.J /� <br /> BARI\'STABLE ss �y ' DATE Y 12. t ZoLo <br /> Personally appeared before me the above-named ` 0l!4_1Qi1 �� 1 WPI C 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 four years the after s long s such business shall be conducted and shall lapse and be void unles so renewed. <br /> Signed <br /> 1 <br /> Notary Public <br /> SEAL <br /> • o� DSbMh Daft Commission Expires: <br /> VYI CW���umeftmft <br /> PUBUC <br /> *woeE0n g <br />