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� BUSINESS CERTIFICATE# 3 � <br /> THE COMMONWEALTH OF MASSACHUSETTS <br /> TOWN OF MASHPEE <br /> . DATE 'YYlar,cch a0, a0k4 <br /> Expiration Date: -yy-'C� 31 3*t S- <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: hG/ QPf(4ktAT]A_Y J� JCLS" Corporation Name: <br /> is conducted at Business Location: l(2> TI, IIAJ OA-tCC MI(AY' Commercial_ Residential <br /> Business Mailing Address: SAME_ <br /> Business Type: r_cP I.-InMi✓n. Business Telephone: �-b9-J-7. I —`( 1 (p <br /> New I,/� Renewal I I /- Home Phone: <br /> Email Address: � CtV 1 ( )Cn <br /> by the following named persons: <br /> OwnerName <br /> f Owner Residence <br /> G/�r2v /i�Tso�tJ In 17110 t�41 a�QUAz� <br /> Second Owner Name Second Owner Address <br /> Ortify under th penalties of perjury that 1, to the best of my knowledge and belief, have filed all state tax returns and paid all state <br /> taxes as re-quffed u der law. <br /> oy - -3!;r2-TW <br /> *Signature of authori ed 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 <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 filing or tax <br /> payment obligations. Licensees who fail to correct their non-fling 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 Lars. <br /> The Common iveafth of Massachusetts <br /> BARNSTABLE ss //�� DATE �Ylct.tz� 3e+tJGlS/ <br /> Personally ap eared before me the above-named Qa ''\-.t-t�ky`� and made oath that the foregoing statement is true. <br /> A certificate is- ed in accordance with this section shall be in folice and effect for four years from the date of issue and shall be renewed each <br /> four years thereafter soto g as such business shall be conducted and shall lapse and be void unless so renewed. <br /> �ed Not� ary Public <br /> -Margaret C.Santos Nota Public <br /> Commonwealth of Massechttsetls G/ - a - ao I <br /> My Commissioh Expires on Sept 22,2017 <br /> Commission Expires: <br />