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BUSINESS CERTIFICATE <br /> • TOWN OF MASHPEE <br /> Date: may <br /> ry� <br /> ay <br /> Expiration Date: 3o' an <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 /> Corporation Name: Mashpee Senior Housing Lessee, LLC Business Name/DBA: Bridges by EPOCH at Mashpee <br /> is conducted at Business Location: 462 Old Barnstable Road,Mashpee, MA 02649 <br /> Business Type: Senior assisted living/Memory Care assisted living <br /> New[ )q Renewal [ ] --Commercial [ ] Residential[ ] Email Address: <br /> Business Mailing Address: 2310 Washington Street, Newton Lower Falls, MA 02462 <br /> Business Telephone:15oxt 477-oo43 Home [ )Cell [ ] Phone: <br /> by the following named persons: <br /> Owner Name Owner Residence <br /> Mashpee Senior Housing Lessee, LLC 2310 Washington St., Newton Lower Falls, MA 02462 <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 to as required under law. ,J <br /> ND EPO HPEE L <br /> *Signature of auth/ei'z96dgent Debom Pfaff **Federal Identification Number(Voluntary) <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 <br /> filing or tax payment obligations. Licensees who fail to correct their non-filing or delinquency will be sublect 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 /> Middlesex ss DATE <br /> Personally appeared before me the above-named Dehnrs Pfaff and made oath that the foregoing <br /> statement is true. <br /> A certificate issued in acc rdance with this section all be in force and effect for four years from the date of issue and shall be <br /> renewed eached each fo�after o long t�s suc Ines iall be conducted and shall lapse and be void unless so rend. ` <br /> • Signed o � / Notary Public <br /> ommission Expires / <br />