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2014_001
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Last modified
11/17/2016 3:11:02 PM
Creation date
11/13/2016 10:16:45 PM
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Box 038
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�> BUSINESS CERTIFICATE <br /> THE COMMONWEALTH OF MASSACHUSETTS <br /> TOWN OFMASHPEE I I t <br /> DATE <br /> 0 Expiration Date: tf 1 ,36 <br /> In conformity with the provisions of Chapter 110, §5 ofthe Massachusetts General Laws, as amended,the undersigned hereby declare(s) <br /> that a business under the title of le <br /> Business Name/DBA: l C,\�eC Corporation Name: <br /> is conducted at Business Location: 151 S010LOL*AnSGII(�(� t� C� Commercial_ Residential_ <br /> rV�v��Oe2 Vy\\A C. a co k_-IG <br /> Business Mailing Address: '� j, =' <br /> \ r,t QL , CAX-V 1 P <br /> Business Type: ' Pe-\ �_\1� Business Telephone: <br /> New IX Renewal I I Home Phone: <br /> Email Address: Qk� )Pss\, Q�OA • ;CCK <br /> by the following named persons: J <br /> Owner Name Owner Residence <br /> I5q kA(vVctAV) SCAvlaky\%0( <br /> VVV} crd�tl9 <br /> Second Owner Name Second Owner Address <br /> ify 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 /> Oes as c quku <br /> der law. <br /> "Si rize 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 mel tax filing or tax <br /> payment obligations. Licensees who fail to correct their non-tiling 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 and made oath that the foregoing statement is true. <br /> A tend ficate issued in accordance 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 thereafter so long as such business shall be conducted and shall lapse and be void unless so renewed. <br /> 0 Notary Public <br /> SEAL <br /> Commission Expires: <br />
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