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�r BUSINESS CERTIFICATE# SLS <br /> THE COMMONWEALTH OF MASSACHUSETTS <br /> TOWN OF MASHPEE -�}� <br /> • DATE A-v �)Y1 t0/l A_ 6 2 <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: C r0 STA / C C2.�-� C9 9 Corporation Name: ��/h iJ1 4 G'L�CG� 1/I� <br /> L ar d P mp $eiv cam <br /> is conducted at Business Location: 6Y 1 m Qr{f�7 �� Commerc all L-Residential_ <br /> Business Mailing Address: Y' -�r�� D ZSJ�Z ���h,i�-ems C2-6y <br /> Business Type: � lq I / 21 f)l',ar4 /1 R.t/Y�Business Telephone: 5� -.35a -DC6` 9l <br /> Dew I Renewal Home Phone: tU - 33Z-000 Email Address: YOSShT/ 01?-6��tl/ICIwJ . <br /> by the following named persons: <br /> Owner Name' Owner Residence <br /> Il�l<�ay /M 7 21 A4 a4 n Sf <br /> c ) CLt'0_4 L" ? 21 Mat / <br /> I certify under the penalties cif perjury that 1, to the best of my knowledge and belief, have filed all state tax returns and paid all state <br /> taxes as re uired under law. <br /> �A 0A_ �N - <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 t, <br /> NAME: /L/ 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 request <br /> is made under the authority of.Massachusetts General Law,Chapter 62C,Section 49A. <br /> Tha <br /> Tire Counoutvealth of Massachusetts n <br /> BARNSTABLE ss DATE'�..{ur.o I S tr?e11 <br /> Personally appeared before me the above-named —�t'c .S L_B 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 as such business shall be,conducted and shall lapse and be void unless so renewed. <br /> Signed <br /> ati� �Yha,tf,r�.l � <br /> Notary Public <br /> SEAL <br /> Margaret C.Santos Commission Expires: <br /> �� Commonwealth N Mttssachusetls <br /> My Commission Expires on Sept.22,2017 <br />