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BUSINESS CERTIFICATE # 3 <br /> THE COMMONWEALTH OFMASSACHUSETTS <br /> TOWN OF MASHPEE <br /> • DATE 'lrYl . 20, I�/ <br /> Expiration Date7y lo".�h 31 Sol t- <br /> in conformity with the provisions of Chapter 1 10, §5 ofthe Massachusetts General Laws, as amended,the undersigned hereby declares) <br /> that a business under the title of <br /> tttv-C. C-� s�kh <br /> -Coration StioName: <br /> sG <br /> Business Name/DBA: ��� ' 1 Corporation Name: <br /> is conducted at Business Location: �� �UJ1vr\ oCL�-5 Of- Commercial_ Residential <br /> Business Mailing Address: <br /> GYl t�li o <br /> Business Type: � 5 �I �InSt 1T�� Business Telephone: � Y U2-p <br /> New V 1 Renewal pp� ] Home Phone: <br /> 2 / �� 3 <br /> Email Address: SLI) Y t n ""-' 1 �`� U� ' ` " � <br /> by the following named persons: <br /> Owner Name _ Owner Residence <br /> l-gylne\&( n51 ./4 Cir <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 aIreired under law. <br /> /�� d -3 55 63 3 <br /> "Signature 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 C� /_ �7 /tLY/ <br /> Name: C ov- Telephone Number: W 5lU 1 ^7 O <br /> Alarm Company: <br /> **Your social security number will be furnished to the Massachusetts Department of Revenue to determine whether you have mel 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 Commonwealth of Massachusetts <br /> BARNSTABLE ss 11 � 1�pp-�t� . ` ' DATE�.I-t aOt20tf-/ <br /> Personally appeared before me the above-named"111) cl/ojn30 h -t..ctA-.Bead made oath that the foregoing statement is true. <br /> Ace 'ficate issued in accordance with this section sh II be in force and effect for four years from the date of issue and shall be renewed each <br /> four years the a ter so long as such usiness shall be conducted and shall lapse and be void unless so renewed. <br /> Od _ <br /> N ary Public <br /> AL tary Public 9 _as -DOH <br /> Margaret;C. Santos <br /> Commonweafth0lMassaehluetts Commission Expires: <br /> MY Commission Expires onSepl 221017 <br />