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}c BUSINESS CERTIFICATE#� <br /> G THE COMMONWEALTH OF MASSACHUSETTS <br /> TO IVN OF MASIIPEE <br /> DATE 0 �22p�2910 <br /> • Expiration Date: rl S l <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 tinder the title l I <br /> Business Name/DBA: EO L,171 � LwA't"{yaC Corporation Name: <br /> ,� CCIk WCC 1 & CVet-k U SStlgeonducted at <br /> ,66 <br /> j <br /> Business Location: C5 I4o& S� fA< pee -y1�`'\A OZ& <br /> Business Mailing Address: OV\e. (:P'AVJQ+Bv` �V-�`-'�, ,t )V•'V e ,L-I <br /> Business Type: `re-- Ify Business Telephone: 1� (72 -/"T�t.�*7. <br /> } 9 3 57- <br /> Home Phone: _-o D •'�5• 3131 EmI <br /> Email Address: VA ANGIIp Q_"•"VIA- <br /> by the following named persons: <br /> Owner Name Owner Residence <br /> See a1fpc11ed I��} 01 Va�Le <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 /> � Z�-8o2Bg31 <br /> itgnature of au[ho 1 ed 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 /> i <br /> NAME: 7-4NQlnv 1lebp rJej �c TELEPHONENL11\1BER: BVV-j!43.2-q97 <br /> Alarm Curnpany: ��T <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 subject to license suspension or revocation. This request <br /> is made under the authority of Massachusetts General Law,Chapter 62C,Section 49A. <br /> Tire Commonwealth of iWassac/urserls <br /> BARt\'STABLE ss / DATE /O <br /> Personally appeared before me the above-named N1Z1.6 _ 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 thereafter so long as such business shall be conducted and shall lapse and be void unless so renewed. <br /> _ �,, Q� %0%l I l t 1111//'' <br /> Signed �v eBI,EAA ,, <br /> _ NOTARY ' - Notary Public <br /> • SEAL — * — = 7- 0 Z <br /> PUBOG Commission Expires: <br /> ///1jn ttlll` <br />