Laserfiche WebLink
4. <br /> BUSINESS CERTIFICATE# 522 <br /> 1 <br /> THE COMMONWEALTH OF MASSACHUSETTS <br /> TOWN OF MASHPEE <br /> • DATE�im�m �P�. � X i CL <br /> Expiration Date: �rrrm h r 3� r aGl 1, <br /> Inconformity with the provisions of Chapter 110,§5 of the Massachusetts General Laws,as amended,the undersigned hereby declare(s) <br /> that a business under the title of // <br /> Business Name/DBA: ��Z SS e j CQt�t P mCorporation Name: <br /> is conducted at Business Location: )OR I�ae.XA Commercial_ Residential V/ <br /> Business Mailing Address: /D$ f/ Oo IJ na� /✓/a5_{tTe-,✓✓1A C)p> � <br /> Business Type: �' n� i el f— Fn v,"n m e.,4 Sa�� Business Telephone: �T'7fo/SS <br /> New [Vf Renewal [ ] LL Home Phone: . <br /> Email Address: fbrS <br /> tSel%/la ai . om <br /> by the following named persons: <br /> /y Owner Name Owner Residence <br /> l -at� S e,! !08 Sanfw + Qaltrl iema,4 N�aApee MA n�G� <br /> Second Owner Name 'Second Owner Address <br /> �ify under the penalties of perjury that 1, 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 /> 1' ,� &Alaq7 -t`oB - 8537 <br /> *Signaturd,bf authorized agent **Social Security Number or <br /> or Federal Identification Number(Required) <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 subject to license suspension or revocation. This request <br /> is made under the authority of Chapter 62C, §49A of Massachusetts General Laws. <br /> Tire Commonwealth of Massachusetts <br /> BARNSTABLE ss DATE - i Ir-AGI t./" <br /> Personally appeared before me the above-named Or Cts G 3 I • S S "e J and made oath that the foregoing statement is true. <br /> A certificate issued in accordance with this section shall be in Jbrce and effect for four years from the date of issue and shall be renewed each <br /> four years t ereafter so long as such busine, shall be conducted and shall lapse and be void unless so renewed. <br /> �d <br /> Notary Public Notary Public <br /> Nfi�dret C.Santos <br /> %k Commomealth of Massachusetts <br /> Commission ExphesonSept 22,2017 Commission Expires: <br /> n <br />