Laserfiche WebLink
BUSINESS CERTIFICATE ft 3 � <br /> THE COMMONWEALTH OF MASSACHUSETTS <br /> TOWN OF MASHPEE i <br /> DATE 6f-I� ' IS <br /> Expiration Date: Qa <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: HfY�ScH10inf)Corporation Name: <br /> is conducted at Business Location: EMMA OAh1LO M1 /k L- A/ Commercial_ Residential_ <br /> v`tµ 5/,pey / MA OZ,V <br /> Business Mailing Address: Sf�Me <br /> Business Type: L AfICMA911 Business Telephone: 77V 30 -7 <br /> New/ J Renewal ] Home Phone: . Wy- 23�- 67501 <br /> Email Address: hnsrnCre'uco,% <br /> by the following named persons: <br /> Owner Name Owner Residence <br /> /45' FMm4 OAk b!., Mills <br /> k4h5h 9te / mpr 626(/9 <br /> Second Owner Name Second Owner Address <br /> Ortify under the 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 s required y er law. <br /> 1 47— 2;�2 01-795 <br /> * tgnature of&fiorized 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-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 /> BARNSTAQLE ss /� ` DATE�t-• t '�e�ls' <br /> Personally appeared before me the above-named C -&' Y L aUyl✓t,oh and made oath that the foregoing statement is true. <br /> A cenificate issued in accordance with this section shal I be in force and effect for four years from the date of issue and shall be renewed each <br /> four years thereafter so long as such business shall be conducted and shall lapse and be void unless so renewed. <br /> v `may <br /> Notary blit Ll AA /- <br /> �,Margar_et C::Santos taN Public <br /> SE§.yCtaZ;sio0n,Expir6isuon <br /> vealth of Massachusetts <br /> Sept.22,2017 g <br /> Commission Expires: . <br />