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BUSINESS CERTIFICATE# ��''��g <br /> 7. •1 <br /> 9 THE COMMONWEALTH OF MASSACHUSETTS <br /> TOWN OF MASHPEE <br /> DATE <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 dbclare(s) that business under the title of <br /> Business Name/DBA: D/J(i C ALw,&S f r?4.r3✓ Corporation Name: <br /> is conducted a[Business Location: /'1 a Commercial_Residential f/ <br /> Business Mailing Address: 1p— Ar7 &:gj�o r C /YJ_ /�A_() M )r <br /> BusinessType:h4;1'ir ,Cr it : Sti Business Telephone: 77�^ <br /> New ) Renewal Home Phone: Email Address: <br /> by the following named persons: _ <br /> Owner Name, Owner Residence <br /> yL� UT 41. r <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 /> Sze <br /> natur authori gent "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 Commonwealth of Massachusetts BARNSTABLE ss DATE 7`"Io—l7 <br /> Personally appeared before me the above-named rl J Q V t-�. Ll 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 year tereafter so long as such business shall be conducted and shall lapse and be void unless so renewed. <br /> Signed <br /> Notary Public <br /> SEAL <br /> Commission Expires: <br />