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BUSINESS CERTIFICATE#1-Q <br /> LL_61L <br /> THE COMMONWEALTH OF MASSACHUSETTS <br /> TOWN OF MASHPEE <br /> • DATE 7-:) • '/ <br /> Expiration Date: `3 3 / ey4 <br /> In conformity with the provisions of'Chapter one hundred and ten, Section five of the General Laws, as amended, the <br /> undersigned hereby dcclare(s) that a business under the title of <br /> I �i 1 l^ <br /> Business Name/DBA: yrV*' l (()[Nyl� `Corporation Name::_ is conducted at`��{ <br /> Business Location: V �%V(IIVQI25Z-qfb „YJ>ti✓"t d't� Yt^ 11.Qle �t��QCQ t'"`�QJ� <br /> Business Mailing Address: <br /> Business Type: 1 `b Business Telephone: 11'' �MM�� <br /> Home Phone: Z Email Address:�J�9W4-->`�4l{o�ik L—�QtlItUIGItL .((/�,�. <br /> by th}e/e following named persons: Wow 11wn � <br /> W au <br /> C�ev�l�i�c� i(�.� • t,�a - �ZG,3Z <br /> I cc Mth- n ie f pc j ry that 1, to the best of my knowledge and belief, have filed all state tax returns and paid all state <br /> taxes as la <br /> 033 Ob 15�r <br /> •+Signature of an o 'zed agent "Social Security Number(Voluntary) <br /> or Federal Identification Number <br /> *Phis license will not be issued unless this certification is signed by applicant <br /> In case of emergency <br /> NAME: rV5-� d TELEPHONE NUMBER: � � <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 I O - 'I <br /> BARN'STABLE ss C ' 1 DATE <br /> Personally appeared before me the above-named EV �� U� and made oath that the foregoing statement <br /> is true. <br /> certifi atc issued in ante h this section shall be in force and effect for four years from the date of issue and shall be renewed <br /> each (our Acafter so ton as,uch si •s shall be conducted and shall lapse and be void unless so renewed. <br /> Signed r <br /> otnry Public <br /> EA) <br /> o COW <br /> . jj0VWPU" Commission Expires: <br /> w lo ~ ` <br />