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• BUSINESS CERTIFICATE# Z I SCP <br /> THE COMMONWEALTH OF MASSACHUSETTS <br /> A ' TOWN OF MASHPEE <br /> DATE 3 <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 declare(s) that a business under the title of <br /> Business Name/DBA: en ar L(1-hr1 Corporation Name: <br /> is conducted at Business Location: <br /> r Commercial_Residential� <br /> Business Mailing Address: `T f r-t--\ Ck '✓v t A iAG A0 pee <br /> 11 ` ! <br /> Business Type:�p:.i hT j tln Business Telephone: Sbcg QlLo V — 1 01 <br /> Business Phone TD y� 77 gS ome Phone: �� <br /> `6 1 _Email Address: ctr <br /> by the following named persons: v e <br /> ( <br /> �{t ,a,ber(idimper� fG� Oyner Res�Benrce 6n <br /> cio�n�Q <br /> � nn <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 required under law. <br /> va i �a i --X 8� <br /> ignature of authorized agent ^o� "Social Security Number(Voluntary) <br /> or Federal Identification Number <br /> i <br /> *This license will not be issued unless this certification is signed by applicant <br /> In case of emergency ,Q` <br /> NAME: 3 L ZI=' � `�J p^�. TELEPHONE NUMBER: S -4 <br /> D11 $� ?V <br /> Alarm Company: <br /> "Your social security number will be furnished to the Massachusetts Department of Revenue to determine whether you have met tax filing or tax <br /> payment obligations. Licensees who fail to correct.their non-filing or delinquency will be subject to license suspension or revocation. This request <br /> is made under the authority of Massachusetts General Law,Chapter 62C,Section 49A. <br /> The Commonwealth of Massachusetts <br /> BARNSTABLE ss 1r, Gni ` DATE <br /> Personally appeared before me the above-named I��t 2-Q/j Ott /-/F'��f� and made oath that the foregoing statement is <br /> true. <br /> A certificate issued in accordance with this section shall be in force and effect for four years from the date of issue and shall be renewed <br /> each four year eafter so/long asesuch business shall be conducted and shall lapse and be void unless so renewed. <br /> Signed � � <br /> otary Pu tc <br /> SEAL <br /> W1 JOSEPH L.MAZZUCCIIE <br /> ftlem$a460n Expires: <br /> COMMONWEALTH OF MASSAO%M" <br /> My Commission Eiphw <br /> tktaber 26.20171' <br />