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BUSINESS CERTIFICATE# <br /> . T11E COMMONWEALTf/ OF MASSACffUSETTS <br /> TOWjV OF MASfiPEE <br /> DATE J. ! 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 a business under the title of <br /> Business Name/DBA:0,ninit �6 --4z zr- Corporation Name: =-- -fr is conducted at <br /> Business Location: il),-a T-i 4 55T <br /> Business Mailing Address: e/S h� 2<6 ir�i�.v.+ GT 1vsT )'t�—vc, rtf i''�e. 02.53 <br /> Business Type: z-a77TBusiness Telephone: -r0A-5.49-RS66 <br /> Home Phone: .549 - 392 - lff80 Email Address: <br /> by the following named persons: <br /> Owner Name Owner Residence <br /> rR1L� y7 �I7/J3�2✓��J 1.T. �. �i..-.c+TiY. �4_ <br /> I certify unde the penalties of pegury t t I, to the best of my knowledge and belief, have filed all state tax returns and paid all state <br /> taxes as re i ed under law. <br /> owl 3s zR�( �R <br /> *Signs y of authorized agent **Social Security Number(Voluntary) <br /> / // / or Federal Identification Number <br /> V *This license will not be issued unless this certification is signed by applicant <br /> In case of emergency <br /> NAMET" TELEPHONE NUMBER: -f426 <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 he sulllect to license snsnension or revocation. This <br /> request is made under the authority of Massachusetts General Law,Chapter 62C,Section 49A. <br /> The Commonwealth of Massachusetts 7 )& <br /> ` <br /> BARNSTABLE ss � DATE J ! <br /> Personally appeared before me the above-named :jAM I and made oath that the foregoing statement <br /> Is true. <br /> A cerli tate issued in actor .n with this section shall be in force and effect for four years from the date of issue and shall be renewed <br /> each four yearVfVereafter so long as a business shall be conducted and shall lapse and be void unless so renewed. <br /> Signed <br /> Notary Public <br /> • � SEAL <br /> L JOSEPH L. <br /> 7JR <br /> - be �gsErrs <br /> eii <br />