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BUSINESS CERTIFICATE# 20t-11 <br /> THE COMMONWEALTH OF MASSACHUSETTS <br /> TOWN OF MASHPEE DATE Z� Z <br /> • Expiration Date: (_.t 3J <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 Nanle/DBA: �^ Corporation Name:. / <br /> is conducted at Business Location: Q2I ,��1(7\1 � ca P ��V�I] J Commercial \, Residential_ <br /> Business Mailing Address: q� �p Y 1� QU�� tMt DV tit V6+ �0Q -+L411 JJ L / — <br /> Business Type: On-L�- V ,Ojcam OU.�A\gAlj4sinne1ss1Telephone: SCIC� -1 — 66G Pt�Wt <br /> New VI Renewal Home Phone: �)L)R - 3?Jd.— 91:)�1EmailAddress: ome_ (Y �� W.Coro <br /> bytthe <br /> , f�ollopwing named persons: I A <br /> �1C7.� LQ tv ne Owner esld�nce pQ P I l L IIVQ.Ui <br /> I certify under the pena o peri ry t t I, o he best of my knowledge and belief, have filed all state tax retums and paid all state <br /> taxes as required under <br /> nature of author' gent **Social Security Number(Voluntary) <br /> or Federal Identification Number <br /> *This license wil 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 Conmronweahh of Massachusetts BARNSTABLE ss DATE r � <br /> Personally appeared before me the above-named '� gPA�I S�e and made oath that the foregoing statement is <br /> true. <br /> A beac <br /> kardance with this section shall be in force and effect for four years from the date of issue and shall be renewed <br /> each four yeh business shall be conducted and shall lapse and be void unless so renewed. <br /> Signed <br /> • SEAL JOSEPH L.MAZZUC <br /> Nota Put <br /> b,. .Pkw <br /> October 25.T('t3` <br />