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~ BUSINESS CERTIFICATE# —Q f I' THE COMMONWEALTH OF MASSACHUSETTS P cs—A —i TOWN OF MASHPE'E t DATE �a.�t I ao ly Expiration Date:�Mc. 25t, oc)1 e In conformity with the provisions of Chapter 1 10, §5 of the Massachusetts General Laws,as amended,the undersigned hereby declare(s) that a business under the title of pp � Business Name/DBA: 11 �O Z �� Qnyl lryt� CO S Corporation Name: 611 is conducted at Business Location: )LI/ JP.Y16C O Ay-o, Commercial_ Residential Business Mailing Address: /'7/� Ma sl,.R-4a 1 02 6 y9 ! Business Type: ca/um44601 61'e4rt" Business Telephone: .3 —1L16 ' bSZ2 I New Renewal [ ] Home Phone: Email Address: 040Z 1e4fb LN41�yoQ 00. 00M by the following named persons: / Owner Name Owner Residence UcN�s/slav /��,vc�.e✓ Irl 5eNec,a �4ve Second Owner Name Second Owner Address ®rtify 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 taxes as required under law. �l 30] — Jy *Signature of authorized agent "*Social Security Number or or Federal Identification Number(Required) *This license will not be issued unless this certification is signed by applicant In case of emergency Name: Telephone Number: Alarm Company: **Your social security number will be furnished to the Massachusetts Department of Revenue to determine whether you have met tax filing or tax payment obligations. Licensees who fail to correct their non-filing or delinquency will be subject to license suspension or revocation. This request is made under the authority of Chapter 62C. §49A of Massachusetts General Laws. The Commonwealth of Massachusetts BARNSTABLE ss DATE 1 ?01 L4 Personally appeared before me the above-named 1/P11+s'S ✓ Lon Jit V and made oath that the foregoing statement is true. A certificate 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 four years thereafter so I as such siness shall be conducted and shall lapse and be void unless so renewed. E Notary Public otary Public SE-0daret C.Santos a :owwonweath of Massachusetts MyCamrd-;sion Exoreson Sept.22,2D17 Commission Expires: