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BUSINESS CERTIFICATE# oZ <br /> T1-1E COMMONWEALTF/OF MASSA CTIUSETTS P <br /> JQ- <br /> TO N/A'OF MASTIPEE <br /> DATE � � <br /> 2— <br /> Expiration Dare: 3 � <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 y <br /> Business Name/DBA: J & (-clr r 4-- t-ot_r9j oration Name: <br /> is conducted at Business Location: I 1 II^r�,, n 4 O �Conunercial_Residential_ <br /> Business Mailing <br /> ''Address: 12,0 ..4.4 111/I.pi/wC 1`r� !r✓l4rS�anc �IIIt. OA 026yB <br /> Business Type:(^ AJr— / Business lTelelflione: S'087-S3 !—y 90© <br /> Business Phone 5 $-539^y90O Home Phone: 617- 2,06- TI .Q Email Address: d4✓1J(-) ('[qf P( r-,.COL., <br /> by the following named persons: <br /> OwnName Owner Resid <br /> �,t.. ' Zer IzO �u fMet IAA-iz sills MA oz6y8 <br /> I/6-rtify a der d alties of perjury that I, to the best of my knowledge and belief, have filed all state tax returns and paid all state <br /> �t es as quit u er law. <br /> 1 <br /> .'nature of thorized agent .. **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 /> **)'our social security number will be furnished to the Massachusetts Departnment.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 nmade under the authority of Massachusetts General Law,Chapter 62C, Section 49A. <br /> The Conuuomvealth of Massachusetts <br /> BARNSTABLE ss nn-- DATE - &h 30 901a <br /> P sonall appeared of •me the above-named rJ. Ye[.r ryLi 2� and made oath that the foregoing statement is <br /> true. <br /> certifi ate issue m cordance with this section shall be in force and effect for four years from the date of issue and shall be renewed <br /> each fol f ears t reafter so n as such business shall be conducted and shall lapse and be void unless so renewed. <br /> Signed <br /> Votary Public <br /> SEAL <br /> • .. • Notary Public Cc- o a -aot 7 <br /> Margaret C. Santos . . Convnission Expires: <br /> ji Commonwealth of Massachusetts <br /> `�My Comm scion Expires on Sept.22,2017 <br />