Laserfiche WebLink
' • BUSINESS CERTIFICATE# <br /> THE COMMOAWEALTH OF MASSACHUSETTS <br /> TOWN OF MASHPEE <br /> DATE <br /> • Expiration Date: r <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 /> 77 XVC4L "�ox may, <br /> Business Name/DBA: //VT121iL 1.{OLV0A1Pf )S Corporation Name: I RrJ1�C.fif/jSdZ)At L�--C is conducted at <br /> Business Location: _I_q sr G (4A tFTSWa! Gom wt WUs q <br /> Business Mailing Address: �. t7L1 k {,L� V4(y/ eelFi w 19, 02. 0 9 1 <br /> Business Type: f-� IBusiness Telephone: 5-.? 9 ' 3 /3�6 3 <br /> Home Phone: cib8 -a 9 ao Email Address: <br /> by the following named persons: <br /> Owner Name Owner Residence <br /> l Avvt e3 s u vu �� /6 <br /> S Amo 2v1�b�j �azs's� <br /> Coif.,\.L I l $'tJ L1,1 V&V\/ 1 % <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 /> taxes as required under law. <br /> (20 3 — 4 G -5-4 `76 <br /> /' -�gnantre of authorized 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: tJAwtel Svt-u uVw J TELEPHONE NUMBER: (FOO a 901-0 <br /> Alarm Company: /47V_"CVL <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 /> BARtNSTABLE ss DATE DkO <br /> Personally appeared before me the above-named QS `-Aj1�\\XIV\ 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 years thereafter so long as such business shall be conducted and shall lapse and be void unless so renewed. <br /> �� VI AN <br /> Signed \ 11C-aC�_ � e ,I, Notary Public <br /> COMMONWEALTH OF MASSACMU <br /> votary Pu 19.20rot <br /> • SEAL OF <br /> Commission Expires: <br /> I 1 <br />