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r BUSINESS CERTIFICATE# (.�(� <br /> `��/• THE COMMONWEALTH OF MASSACHUSETTS S <br /> TOWN OF MASHPEE Z <br /> • DATE <br /> 0,1 <br /> Expiration Date: S 5 <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: [3F—AA.fCO �.S CZCA v1616. 5_&A' 0rfp'6r•aiion Name: <br /> G � <br /> is conducted at Business Location: 6 ��lMF nnlc IDRtVeC Commercial Residential <br /> Business Mailing Address: / ,nAigt:iL�A,, 1��I /C. G —7 r/�/ [^ <br /> Business Type: ` t A ^I /^1 Business Telephone: SDO 5 / Z d / 6 J <br /> I <br /> New [ ] Renewal [� Home Phone: <br /> Email Address: by ANCoS C-LeAfq( g (®VSA •COA- <br /> by the following named persons: <br /> Owner Name Owner Residence <br /> I k/ to A/L-T(/I/f %• C`��.g �•C r D�/ r/�� <br /> Second Owner Name Second Owner Address <br /> Otify under th penalties of rjury that I, to th best of my knowledge and belief, have filed all state tax returns and paid all state <br /> taxes equir under law. <br /> ozy-7 �- � y2l <br /> Signatur of authorized 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 _ 6 p. e G <br /> Name: I AA(G_r De M�Der 2oS Telephone Number: 5-J? 0 z 7 J 6 Z <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 Conmronweafth ofMassacdusetrs DATE <br /> BARNSTABLE ss /�Q � <br /> Personally appeared before me the above-named(Ls OAS � ' o //`�/� '-/1k �('made oath that the foregoing statement is true. <br /> A certificat 'sued in accordance w' It this section s all be in force and effect for four years from the date of issue and shall be renewed each <br /> four years thereaft long .uch busine shall b on ted and shall lapse and be void unless so renewed. <br /> i <br /> SEAL JOSEPH CCHEW,J6. <br /> -Pua�LtG— <br /> NIWBA PI BPINIASSACtNSE718 <br /> / <br /> t y Cantu.Explr a Oct 16,2020 <br />