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BUSINESS CERTIFICATE N -2<) —60'-b <br /> ,J THE COMMONWEALTH OF MASSACHUSETTS P <br /> TOWN OF MASHPEE <br /> DATE Ades t-b 12013 <br /> Expiration Date: 7 (3C) <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: l Corporation Name: is conducted at <br /> Business Location: e-e (V\ <br /> Business Mailing Address: 1-�O P� )c o-? ILA ). a b C.(el <br /> BusinessType: 1 Gc�i� S CV-V [Z�e- Business Telephone: t,:;n25 uTl 7— <br /> akphone: rJt1d Sad- b6a'R Email Address: 11Hda�H� 4OVa�cm Gom <br /> by the following named persons: <br /> Owner NaI1m_e Owner Residence <br /> JrF�_QA ta?CSl AP_(—a <br /> tMXa��.�oe v1�V� oa bu�j <br /> {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 /> taxes as required under law. 77 <br /> �. V a /!w/1 Q �pll <br /> nature of authorized a 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 subiect to license suspension or revocation. This <br /> iEquest is made under the authority of Massachusetts General Law, Chapter,62C,Section 49A. <br /> i-.1 The Commonwealth of Massachusetts <br /> BARNSTABLE ss / DATE �� 3 <br /> Personally appeared before me the above-named I Q. .� ��tQ and made oath that the foregoing statement <br /> is'irue. <br /> A certificate issued in accordance with this section shall be in force and effect for four years from the dale of issue and shall be renewed <br /> each four years t ereafter so long as It business shall be conducted and shall lapse and be void unless so rene e <br /> Signed <br /> (� SEAL 111"UMAZZUCCHELU,JR <br /> • Notary Puh'c-. <br /> Comn��,�ne3 <br /> lkta0et 2013 <br />