Laserfiche WebLink
BUSINESS CERTIFICATE# <br /> • THE COMMONWEALTH OF MASSACHUSETTS <br /> TOWN OF MASHPEE <br /> DATE - z CD 1 <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 business under the title of <br /> Business Name/DBA:)i 0fv& (:gook 4001 Corporation Name: is conducted at <br /> Business Location: 3 MONK/♦)(! AVE <br /> Business Mailing <br /> ,,tAddress: � MomteA , Ove ^ c <br /> Business Type: It!1'i (tJ4EQ 7(- I Business Telephone: 3')2- ZT! Z <br /> Home Phone: Email Address: Amort (%o,4,- @ C res. zd'+ <br /> I ' <br /> by the following named persons: <br /> OwnerNname �7 OwnerrwResirilence �f <br /> G Iy16�n C lbD�t 1 .tel es/if i CAS /fl/Prur.0 <br /> I certify under the penalties of perjury that 1, to the best of my knowledge and belief, have filed all state tax returns and paid all state <br /> taxes nred unde aw. <br /> Ah �nL It-5 - 2v6 ����- <br /> 'Sign a of authiiied 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 /> /1 n In case of emergency -1 (c. <br /> NAME: ( -Ar�•�Q �/Do4 TELEPHONE NUMBER: 77 T L «Iq- <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 subject to license suspension or revocation. This <br /> request is made under the authority of Massachusetts General Law,Chapter 62C,Section 49A. <br /> The Commonwealth of Massachusetts <br /> BARNSTABLE ss DATE , 'r <br /> Personally appeared before me the above-named 0�2/yL r a��4--and made oath that the foregoing statement <br /> is 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 /> Signed <br /> 8 Notary Public <br /> • SEAL <br /> 0-0 <br /> JOSEPH��JR <br /> a,}t Notary PubrIIhW�Yj <br /> COMMONWEALTH OFF <br /> COMMONWEALTHtMA MSSACNyiEiTB I <br /> MyCommw s'otEVues <br /> lktobti.25.21119• <br />