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P.E4:IVED 01/19/2016 14:51 2485883528 SITEONE LANDSCAPE <br /> Jan. 19. 2016 1 : 17PM No. 6533 P. 2/2 <br /> ro4 5q_I <br /> , 4 <br /> • � TOWN OF mnS13PEl; <br /> "Statement of Discontinuance,Change of Residence,Change of Location of Business, <br /> Withdrawal,or Deceased from Business or Partnership,Change of Business Name or Owner Name <br /> I /a i 6 <br /> DATE <br /> The Town is desirous <br /> ,o�f going <br /> �"G�reenn"as much as possible,Tu that end,please include your email address. <br /> Email Address: I'1"C.ly0Q-I�-V—eSI 1 UbNE ,COM <br /> Discontinuance <br /> In conformity with the provisions of Chapter one hundred and ten, section five, of the General <br /> Taws, as amended, the undersigned hereby declares)that IAVe has(have)this da_discontinued(retired <br /> from)(withdrawn from)the business of -10"1'-3 DL:' l-k <br /> conducted at I OCJ E Ho ROAn C)uT 2 <br /> STREET <br /> SIGNATURE <br /> Change of Location of Business <br /> 1 hereby state that the location of the business/my residence as it appears on the Business Certificate filed <br /> on i c)U -,cp 7 P-o&Oy N IT 2- has been changed to <br /> Name of Business <br /> SIGNATURE <br /> Change of Name of Business or Owner <br /> I hereby state that the name of the business or the owner as it appears on the Business Certificate has <br /> been changed firom 3000 D=—EaE LAr\I�ES /6Wt\.1t72 W,'WE-6AVIQ WE2l`11N(D. <br /> to Sl E Su l LLC_ /'OHNJEV nJ/1ME 1 -)L &4C- <br /> SIGNATURE h <br /> Notary Jan c' OZ <br /> Barnstable ss. J <br /> k Date <br /> Personally appeared before me the above named " '` and made oath <br /> that the foregoing statements are true" <br /> Deborah Dami Name-Notary Public <br /> ° NOTARY PUBLIC <br /> Commonwealth of Massachusetts Commission Expires <br /> My Commission Expires July 29,2016 <br /> Ongfomt/Discontinuance <br />