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BUSINESS CERTIFICATE# ::�3 0 0 aa-- <br /> THE COMMONWEALTH OF/YIASSACHUSETTS <br /> TOWN OF iVLASHPEE <br /> DATE off 2 q . <br /> Expiration Date: k 3 / G <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: Nor n B lsi �� t6 -t Pr Corporation Name: SLY LA-C- <br /> /Vv A-C. <br /> P k " n 1� <br /> is conducted at Business Location: 72 Pal <br /> s A!0 MA o2G 4G Commercial ResidentiahC <br /> Business Mailing Address: 77 Pal P6ce 1-6.4 P01 MA 0-?/944 <br /> Business Type:L L Q W56t 1 w'� - "9 _JBusinesl's Telephone: SOS - (t I //q - InCIS- <br /> NewIvf Renewal I JHomeYhouc: 5DB-477- 7477 Email Address: L)J7P 686Dj �r�- (dVV-% <br /> g <br /> by the followinnamed persons: " UU <br /> > Owner Name Owner Residence <br /> Am 72- Pr�cPIGt[e I?fnA0#PIMA 62& Y7 <br /> I certify under the penaltiesofperjury that I, to the best of my knowledge and belief, have filed all state tax returns and paid all state <br /> taxe as r yuired andlaw. <br /> �6 -6gg0401 <br /> nature of authorized nt **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: Stil IL 1A) ft"4 wn TELEPHONE NUMBER:-'5DQj-4 -)- -71177 <br /> Alarm Company: D <br /> **Your social security number will be furnished to the Massachusetts Department or 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. n � I <br /> %Ire Commonwealth of lWassaclu sous <br />� BARNS"I-ABLE ss --}}�� � DATE� W� <br /> Personally appeared before me the above-named -troll I`In���lr vt��(�\ 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 tl ereafter so loi as su h business shall be conducted and shall lapse and be void unless so renewed. <br /> Signed <br /> t\'otm'y Public <br /> SEAL Debofsh OWI <br /> NOTARY PUBLIC <br /> COMMMWOM1� Commission Expires: <br /> My CommiuM El�Uea�2016 <br />