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BUSINESS CERTIFICATE # 30 <br /> THE COMMONWEALTH OF MASSACHUSETTS P <br /> TOWN OF MASHPEE <br /> DATE 0/2 <br /> Expiration Date: �O <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 Ibu_siness underthetittle of I^/ /) <br /> Business Nanmc/DBA: �LIC.k-IA t 1 C k.r+Cr 5 Corporation Name: /V /r7 <br /> is conducted at Business Location: nn.'')mo r 2o,I Er a BecC.L eXk7Cdls2 Commercial_Residential 74— <br /> Business Mailing Address: zzQr4S Alta,( 5u.;?- <br /> J <br /> c 11 CJ nn '' -- <br /> A <br /> Business Type: FiAt'hol r fcx— Business Telephone: <br /> J <br /> Business Phone 5-6tme. Home Phone: 95b8-5-39-ff7ya- Email Address: YSt4h C /Sa�� h <br /> 9 <br /> by the following named persons: <br /> Owner Name Owner Residence <br /> �RnrNOAJ (,k) ra n f Sa cOFi Ti%aller (�i//Q4 e <br /> Lj <br /> zzC.rds �'!4 Das eLa- <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 law. <br /> i <br /> nature of au0crized 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: TELEPHONE NUMBER: <br /> Alarm Company: <br /> "Your social security number will be furnished to the Massachusetts Deparnment 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 Commonwealth of Massachusetts <br /> BARNSTABLE ssnn DATE 0 Z <br /> Personally appeared before me the abovd-nanmcd Rrj r Y,[,A (.A2 S t n S 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 ps such business shall be conducted and shall lapse and be void unless so renewed. <br /> /.//. <br /> Signed <br /> tary Public <br /> r Notary Public <br /> • 'p,� Margtvet C.Sento: <br /> WRY <br /> ComttargOet of C.Santo sells Commission Expires: <br /> �V A1y Commission Expltes on Sept 72,2017 <br />