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t <br /> BUSINESS CERTIFICATE# — I <br /> THE COMMONWEALTH OF MASSACHUSETTS <br /> TOWN OF MASHPEE <br /> DATE — ( , -00141 <br /> Oen <br /> Expiration Date:. � 301 0V I Q' <br /> nformity 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: W R(a6i op� <br /> E 1Corporation Name: / <br /> is conducted at Business Location: .SuNSe 5r— C &'L"' Commercial_ Residential Y <br /> Business Mailing Address: SU NS C t(LLl cC �/n � <br /> Business Type: �rOP/�6&�pT7 d� Business Telephone: ! !t"I -392--1 U0rl <br /> New [ vf"' Renewal [ ] Home Phone: . Sem 'S3`[ -2940 <br /> Email Address: A2 q/O @ <br /> by the following named persons: <br /> Owner Name Owner Residence <br /> z5 6 <br /> Second Owner Name Second Owner Address <br /> tfy u er 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 /> as of aired u der law. <br /> Dt,� -ioo - q�fSa <br /> 'Signatureauthori ed 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 fumished 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 <br /> Personally appeared before me the above-named ���eN G 64-uo t f and made oath that the foregoing statement is true. <br /> A certifc e issued in accordance with this section shall be in force and e c for four years from the date of issue and shall be renewed each <br /> four years thereafte so long as such business II be conducted and shall lapse and be void unless so renewed. <br /> Signed <br /> • Notary u Ic an, Public G v� <br /> SECI argarat C.Santos <br /> �"� CommolnveeBh of Massadtusetls �+} o",O(7 <br /> IdycommGssionEspltesonSept22 J17 Commission Expires: <br />