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BUSINESS CERTIFICATE tt <br /> THE COMMONWEALTH OF MASSACHUSETTS <br /> TOWN OF MASHPEE <br /> DATE Sb 1OT If 2.01¢ <br /> • ' <br /> Expiration Date: s;�Q'f 3Q o`'1 y <br /> In conformity 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: Gr Q PA I NT It\16r Corporation Name: <br /> is conducted at Business Location: 11 S 61WAT ltv6c -Az MAs10VT Commercial_ Residential ✓ <br /> Pa <br /> Business Mailing Address: 14"� —rrir ( Xx Zo7 �AS�I-�tP�0 MA r� <br /> Business Type: 40A/NT I PV Cr Business Telephone: <br /> New (� Renewal ( ] fJ Home Phone: . <br /> Email Address: e S �d q�f/v • Cd>7 <br /> by the following named persons: <br /> ownerName <br /> / Owner Residence 1 <br /> �aLai ICAC'S ne (( � C7 K Ext T 0'I lYG—S N/t IOASUPM <br /> / Second Owner Name 'Second Owner Address <br /> der the pens ties of perjury that 1, to the best of my knowledge and belief, have filed all state tax returns and paid all state <br /> 7* nLature <br /> uire n }ag <br /> Ul7 - 40 - -s7a9 <br /> of authonz d gent **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 famished 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 /> The Commonwealth of Massachusetts <br /> BARNSTABLE ss DATE S',.Fj IST I�l <br /> Personally appeared before me the above-named Gere- t Q o e S n a ( and made oath that the foregoing statement is true. <br /> A cerE is to issued in acco once with this section shall be in force and effect for four years from the date of issue and shall be renewed each <br /> four years th f/eer so long as s b -iness shall be conducted and shall lapse and be void unless so renewed. <br /> is __7t., <br /> tory Public J��-u <br /> Margaret C:Santos otary Public <br /> � Commonwealth t f Massachusetts " <br /> y Commission Expires on Sept•22,2017 07 ' d a ' <br /> Commission Expires: <br />