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- BUSINESS CERTIFICATEao,S_p06 <br /> TOWN OF MASHPEE <br /> • Date: )Q,(\I1 C1C\/ A00 aRQ 15 <br /> Expiration Date: �]q <br /> In conformity with the provisions of Chapter 110, §5 of the Massachusetts General Laws, as amended, the <br /> undersigned hereby declare(s) that a business under the title of <br /> Business Name/DBA: The Marcus Group Corporation Name: <br /> is conducted at Business Location: 5 Miller Circle Certificate No. 2011-008 <br /> Business Type: Consulting <br /> New [ ] Renewal [ ] Commercial [ ] Residential [ ] Email Address: marcusgroup@verizon.net <br /> Business Mailing Address: 5 Miller Circle Mashpee, MA 02649 <br /> Business Telephone: 617-947-3692 Home [ ] Cell [ ] Phone: 508-477-1834 <br /> by the following named persons: <br /> Owner Name Owner Residence <br /> Joseph Marcus 5 Miller Circle Mashpee MA 02649 <br /> 01 certify under the penalties of perjury that 1, to the best of my knowledge and belief, have filed all state tax returns and paid <br /> all state axe s require der law. <br /> 'Sign f authorized agent "Social Security Number <br /> 'This%icense will not be issued unless this certification is signed by applicant or Federal Identification <br /> v Number(Required) <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 subject to license suspension or <br /> revocation. This request is made under the authority of Chapter 62C,§49A Massachusetts General Laws <br /> The Commonwealth of Massachusetts <br /> BARNSTABLE: ss DATE t p �0 aU <br /> Personally appeared before me the above-named�ph and made oath that the foregoing <br /> statement is true. <br /> A-cerlific a issued in accordance with this section shall be in force and effect for four years from the date of issue and shall be <br /> •rene��ach four y rs ther�r so long as such business shall be conducted and shall lapse and be void unless so renewed. <br /> Signed Notary Pub ic ! <br /> r ary ubllc <br /> (("/////// Margaret C. Santos Commission Expires <br /> Commorrvrealth M Massachusetts <br /> My Comrlilssbn Expires on Sept.22,2017 <br />