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BUSINESS CERTIFICATE ft <br /> THE COMMONWEALTH OF MASSACHUSETTS <br /> TOWN OF MASHPEE Lf/VC� / <br /> DATE Z `-0 <br /> • 11 1 <br /> Expiration Date: 0 <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: s:! el Corporation Name: <br /> is conducted at Business Location: j3p La�� GC 1F1Je Commercials Residential_ <br /> Business Mailing Address: y" \xj Y AQ� <br /> Business Type: Business Telephone: <br /> New Renewal ( ] I Home Phone: <br /> Email Address: �Wr!t_ <br /> by the following named persons: <br /> Owner Name Owner Residence <br /> Second Owner Name Second Owner Address <br /> ®rtify under the penalties of 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 /> c(o Zo <br /> *Signature of authorized agent "Social Security Number or' <br /> or Federal Identification Number(Required) <br /> e "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 /> The Conunomven!!lt of Massacltuseirs <br /> BARNSTABLE ss /� / — DATE � 2oJt1 <br /> P /`tersonally appeared before me the above-named ur4 - �ci rXt/7-7 and made oath that the foregoing statement is true. <br /> A certificate issued i 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 ther o as such bus' ess shall be conducted and shall lapse and be void unless so renewed. <br /> _ 4 0< 4 <br /> j S44 <br /> Njyy Public <br /> Notary Public <br /> Margaret C.Santos <br /> CtxntnonweellholMassachusetts Commission Expires: <br /> I&My Commission Expires on sept.22,2017 <br />