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BUSINESS CERTIFICATE V-013^d / <br /> TOWN OF MASHPEE / ^ <br /> Date: l 0 5 <br /> • Expiration Date: <br /> In conformity with the provisions of Chapter one hundred and ten, Section five of the General Laws, as <br /> amended, the undersigned hereby declare(s)that a business under the title of <br /> -n+c A-e-wsa.t I is <br /> Corporation Name: COrvAPA-r-f 1CSI iNC__ Business Name/DBA: <br /> is conducted at Business Location: 3 LIST�EI�LE 51` rr AgW-DE' I M <br /> Business Type:"'9C7_A-( L_L CUDTW/r(�/5 NZTIP44 GovaS <br /> New [ ] Renewal [ ] --Commercial Wesidential [ ] Email Address: Y4Q✓l e YVLOC-e t✓I we 1!091- Ca»9 <br /> Business Mailing Address: ? U ] p)( 2 1 SQ mI H12k Y744— 0,�2&Y9 <br /> Business Telephone:503'I07- 1-77� Home [ J Cell [hone: <br /> by the following named persons: <br /> Owner Name Owner Residence <br /> I certify a penalties of perj ry that I, to the best of my knowledge and belief, have filed all state tax returns and paid <br /> all a taxes requir er as <br /> oy-3sa13'o7loo <br /> *Signature o authorized agent **Social Security Number (Voluntary) <br /> 'This license will not be issued unless this ce1f, tion is signed by applicant or Federal Identification Number <br /> In case ofemergency <br /> p /- <br /> NAME: -fit1&i Q• - wSod TELEPHONE NUMBER: SeoG' o � G/Ceg j <br /> Alarm Company: <br /> "Your social security number will be furnished to the Massachusetts Department of Revenue to determine whether you have met tax <br /> filing or tax payment obligations. Licensees who fail to correct their non-filing or delinquency will be subject to license suspension or <br /> revocation. This request is made under the authority of Massachusetts General Law,Chapter 62C,Section 49A. <br /> —� The Commonwealth of Massachusetts <br /> BARNSTABLE, ss DATE <br /> Personally appeared before me the above-named and made oath that the foregoing <br /> statement is true. <br /> rtificate issue in accordance with this section shall be in force and effect for four years from the date of issue and shall be <br /> renew each our years the a er so long as sucheach our years the a er so long as such busin�e conducted and shall lapse and be void unless so renewed. <br /> �i ed�. Notary Public <br /> Commission Expires <br />