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BUSINESS CERTIFICATE# <br /> THE COMMONWEALTH OF MASSACHUSETTS <br /> TOWN OF MASHPEE / <br /> DATE 7 - l.-O •�o <br /> ' — IS <br /> • Expiration Date: A - 3O- 19 <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: 1�1� �lnoroatafFPN y Corporation Name: <br /> is conducted at Business Location: -7 12oe,,nl L NNE Commercial_ Residential X <br /> Business Mailing Address: 7 (hoar ra L-nnt E <br /> I <br /> Business Type: *-1AR6!w-'AL1 Business Telephone: 11 $s3-yoN,/y <br /> New ] Renewal ] ] Home Phone: . 4th rsC Lit 0`/7 <br /> Email Address: "'teff 4v - <br /> by the following named persons: <br /> Ownera <br /> -,Ngme Owner Residence <br /> \. J 0%V t b w - 'r �l ve 1-�-- 7 _�o eo-J -N N E <br /> Second Owner Name Second Owner Address <br /> ify un enalties of perjury that 1, to the best of my knowledge and belief, have filed all state tax returns and paid all state <br /> es as r quired under w. <br /> t 3b6 74 C,-78,S- <br /> are <br /> 78Sare o aut ized 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: D A%J to Telephone Number: '{ t'3 6$3 -y oil y <br /> Alarm Company: a'^ <br /> **Your social security number will be furnished to the Massachusetts Department of Revenue to determine whether you have met tax tiling 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 Commontverrlth of Massachusetts <br /> BARNSTABLE ss DATE /3 /S <br /> Personally appeared before me the above-named AV t 1 V4 . and made oath that the foregoing statement is true. <br /> A ccrtificitussiuct accordance with this section shall be in force and effect for four years from the date of issue and shall be renewed each <br /> four years thereallif so long as sue usiness shall be conducted and shall lapse and be void unless so renewed. <br /> Signed <br /> • �4.� ��� <br /> Notary Public <br /> SEAL Deborah Dami <br /> ° NOTARY PUBLIC <br /> Commonwealth of Massachusetts Commission Expires: <br /> My Commission Expires July 29,2016 <br />