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BUSINESS CERTIFICATE# y� <br /> THE COMMONWEALTH OF MASSACHUSETTS <br /> TOWN OF MASHPEE <br /> DATE <br /> 5 3 1 <br /> Expiration Date: <br /> ,In conformity with the provisions of-Chapter one hundred and ten, Section five of the General Laws, amended, the <br /> undersigned hereby declaree(ss1 r t)that a business under the title of <br /> Business Name/DBA: 't- `sO ux� 11 'R40r'C Corporation Name: <br /> is conducted at Business Location: Root Le�wol 'in) <br /> y� p41 ommercial_Residential_ <br /> Business Mailing Address: �QC(/�` ���� "1 Mai <br /> - <br /> Business Type: Gerer-&L 5 �-r.L Business Telephone: 5'09 - <br /> New Jl,� Renewal I I Home Phone: ,SDFr' ?g0' m--59 Email Address: <br /> by the following named persons: <br /> Owner Name Owner Residence <br /> r 4a�n�ni S, <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 under law. <br /> nature of authorized 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 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 Cotntaonwealth of Massachusetts <br /> BARNSTABLE ss DATE�� .0-1t �)a <br /> Personally appeared before me the above-named 4L..�e n A titxx4ki h and made oath that the foregoing statement is <br /> r <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 s long as uch business shall be conducted and shall lapse and be void unless so renewed. <br /> Signed , ' C <br /> UNo�Public <br /> • try Public d a-DPS l <br /> & Margaret C.Santos Commission Expires: <br /> Commonwealth d Massechu 2017 <br /> MYCommission Expires on Sept• <br />