Laserfiche WebLink
BUSINESS CERTIFICATE# �� <br /> 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 declarre(s)that a business wider the title of J>✓!� <br /> 1 <br /> Business Name/DBA: SG t-kIm r"' Corporation-Name: W10�1I ✓t <br /> is conducted at Business Location: 3-7 AAAos L 9^01`IC 14o• Commerc�esidential_ <br /> Business Mailing <br /> Address: <br /> Business Type: W + U Business Telephone: // <br /> Business Phone)/ 4' 2 A 2 � Home Phone: ��'��7 I� Email Address: Cb #a*LS 't '4 <br /> by the following named persons: <br /> w n e r Name Owner Residence <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 /> to as required u er law. <br /> W_3 g3'79 <br /> r uthor' ent "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 SnSUCn$lnn or revocation. This request <br /> is made under the authority of Massachusetts General Law,Chapter 62C,Section 49A. <br /> The Commonwealth of Massachusetts 2 _QI /•7 <br /> BARNSTABLE ss DATE J I G— <br /> G�- / � /yam �,. <br /> Personally appeared before me the above-named c 1 n�� uc" J/Gt t�/ and made oath that the foregoing statement is <br /> true. <br /> cer ' tate 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 ears the after ng as such business shall be conducted and shall lapse and be void unless so renewed. <br /> i <br /> Signed <br /> 40t ry Public <br /> SEAL DebMh 08MI <br /> NOTARY PUBLIC <br /> ll Commission Expires: <br /> 0 Commonwealth of��oW�ss18 <br /> My Commission ExPi <br />