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BUSINESS CERTIFICATE# <br /> THE COMMONWEALTH OF MASSACHUSETTS ! �� <br /> TOWN OF MASHPEE —yam <br /> DATE <br /> ExpirationDat 3 t ({ <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 <br /> Business Name/DBA: J-M6 PRoSCCGr tAPWaC+E?0C'CorporationName: <br /> isconductedat Business Location: �{3C7tI�e6Lat�`/ tJQ�JC— MI{gNPCE Commercial_ Residential_ <br /> Business Mailing Address: OZt> Y �fLt�C— - MA-9,142 € <br /> Business Type: f9-C7S-&C-r Business Telephone: 7.40 <br /> New ] ] Renewal ] ] Home Phone: <br /> Email Address: LS6tani . EDG—RR 4$ C;,MAIt— C_oY\t,% <br /> I <br /> by the following named persons: <br /> Owner Name Owner Residence <br /> es—cyt-et�:'CcPrQ (.C9 Ot-D Catary-f AA AS.R <br /> Second Owner Name Second Owner Address <br /> Otify 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 /> taxes as required under law <br /> oat . tea , 422 <br /> *Signature of authori ed "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 met lax 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 Massachasefrs , <br /> BARNSTABLE ss \ DATE l 9 t ltt-tf S, aO�l( <br /> Personally appeared before me the above-named `1� \r\ LA and made oath that the foregoing statement is true. <br /> A certificate issued in accordance with this section shall be in force and dFrect for four years from the dale of issue and shall be renewed each <br /> four years thereafter so to as such business shall be conducted and shall lapse and be void unless so renewed. <br /> d ppt <br /> ^M ui✓' J <br /> Notary Public H ' N tory Public <br /> SEAL PAY TOTH PnNYMargaret C. Santos <br /> HOCKLAND TR �,GommomveaM of Massachusetts <br /> FOA DEP �lCitmmissionExgresonSept 22,2017 Commission Expires: <br /> DEPT <br /> TOWN48 FMA HPEE `' <br />