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BUSINESS CERTIFICATE# '— �-0 <br /> THE COMMONWEALTH OF MASSACHUSETTS P r- <br /> TOWN OF MASHPEE J Z �t Z 6 Z <br /> DATE <br /> Expiration Date: 7 3 1 <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: Y r 1 a Go I e v, Ayc� Sb n S <br /> Corporation Name: lo kP V\ soy) <br /> s S r1 C <br /> p <br /> Cl <br /> U �is conducted at Business Location: 2 Amercial_kResidential <br /> Business Mailing Address: '✓ occil^eto mvt � <br /> So n S . 70/Toti S+ SMAS 141EE /0/16 z 6 yy <br /> — 7IO O <br /> VN l—I✓ "� one:Bus mess Tele hO O — S LJ <br /> Business Type: LO-S1,21_ p <br /> CellQQj� <br /> New [% Renewal I IHomePhone: � IO — 636 - 0 0 Email Address: rC0tf-V1eY'(aMCO6NQnAScv)SS <br /> I <br /> by the following named persons: <br />! Owner ameOwner Residence 02536 <br /> �slM - fZiG� �otr,e / 3S �awsa. PA <br /> A I(Q.L"N CO3 kp_v, q66 koo 8iroo�o. I PA r 166 a <br /> 1 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 /> Itaxes as required under law <br /> I ��� �/� re ��`l 3�• iG. Z3 � 6G 02 -1 <br /> of authorized age "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 DATE 2'p17�t/L <br /> BARNSTABLE ss — 17— <br /> Personally <br /> ZPersonally appeared before me the above-named R 1,6-\ 66✓i ey- 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 /> Notary Public <br /> • SEAL 10awpum <br /> N/ �w��{• Commission Expires: <br />