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BUSINESS CERTIFICATE a 3 <br /> TOWN OF MASHPEE <br /> Date: rYY\cc, r h `l J)(D 1 Q <br /> Expiration Date: Y-Zry> rr_4. 3 i r--;,o I Ir- <br /> in <br /> In conformity with the provisions of Chapter one hundred and ten, Section five of the General Laws, as <br /> amended, the undersigned hereby declare(s) that a business under the title of <br /> Business Name/DBA: Shelley's Garden Design &Consulting Corporation Name: <br /> is conducted at Business Location: 15 Cambridge Drive Certificate No. 2009-020 <br /> Business Type: Garden design <br /> New [ ] Renewal [ ] Commercial [ ] Residential [ ] Email Address: <br /> Business Mailing Address: 15 Cambridge Drive Mashpee, MA 02649 <br /> Business Telephone: 508-737-3605 Home [ ] Cell [ ] Phone: <br /> by the following named persons: <br /> Owner Name Owner Residence <br /> Shelley Bouthillette <br /> •I certify under the penalties of perjury that I, to the best of my knowledge and belief, have filed all state tax returns and paid <br /> all state taxes as required under law. <br /> 'Signature of authorized agent "Social Security Number (Voluntary) <br /> 'This license will not be issued unless this certification is signed by applicant or Federal Identification Number <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 <br /> filing or tax payment obligations. Licensees who fail to correct their non-filing or delinquency will be subject to license suspension or <br /> revocation. This request is made under the authority of Massachusetts General Law,Chapter 62C,Section 49A. <br /> The Commonwealth of Massachusetts <br /> BARNSTABLE, ss 11 DATE -\o, c-1,\ ao l ur <br /> Personally appeared before me the above-named up [-EP and made oath that the foregoing <br /> statement is true. <br /> 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 <br /> renewed cre our years thereafter so long as such business shall be conducted and shall lapse and be void unless so renewed. <br /> Signed Notary Public��^ _r I I I <br /> • -- `�,•, Commission Expires S- aa- Do 11 <br /> jt�7 Notdry Public <br /> Margaret C.Santos <br /> Cominimeallh of Massachusetts <br /> My Commission Expires on Sept 22,2017 <br />