Laserfiche WebLink
/ BUSINESS CERTIFICATE# <br /> THE COMMONWEAL'T'H OF MASSACHUSETTS <br /> TO 111N OF MASHPEE <br /> DATE - - t9- o2ol <br /> Expiration Date: <br /> S' r <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 <br /> Business Name/DBA: Corporation Name:Cv.*.", C,,,,,Ajz40 5rrN«s tn,L;n;f¢c1 is conducted at <br /> Business Location: IIS DcerQA C'fde Meski2ee MA Q2C14a <br /> Business Mailing Address: ng peer-Q,,-t- G' tc rytaskjXe m4 OAC-11°1 <br /> Business Type: (' ns I Business Telephone: 73-0&- "1- 83% <br /> I-IomePhone: 774- 3ga.- IlGI Email Address: M-1,�t1y,,;pt to 1101ww.1.eom <br /> by the following named persons: <br /> Owner Name Owner Residence . <br /> ✓11 'rl ael A H..1+y.,;s+ 118' Deeegoo+ C'.2Ae Mask Pga MA 0°649 <br /> 1 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 der law. <br /> 114 039-Sq- 768'6 <br /> ature t rized 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 /> NAME: 014CK A !, Af7,AYr TELEPHONE NUMBER: 7e,3— a3.4- gaY2. <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 request <br /> is made under the authority of Massachusetts General Law,Chapter 62C,Section 49A. <br /> The Cruuutonweelth of Massachusetts f <br /> BARNSTABLE ss /, t DATE S <br /> Personally appeared before me the above-named Vl td4JA JJ4 L 1 Q IL 1 C7 and made oath that the f rcgoing statement is <br /> true. <br /> A certificate . ucd 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 Iheu cr so Ion ich business shall be conducted and shall lapse and be void unless so renewed. <br /> Signed <br /> • Notary Public <br /> SEAL <br /> =OF <br /> C <br />