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ii BUSINESS CERTIFICATE it Q , 9 <br /> I f <br /> �- THE COMMONWEALTH OF MASSACHUSETTS <br /> TOWN OF MASHPEE <br /> DATE j r]-6?01S <br /> Expiration Date: <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 /> Llc ) <br /> Business Name/DBA: C A('- 14— Corporation Name: / <br /> is conducted at Business Location: Commercial Residential_ <br /> rn 0'91^ dee, <br /> Business Mailing Address: tt ''ll.S ci AMq <br /> Business Type: MA �r�l"eYZaQJ �r0 l YlC l_ Business Telephone: Y63- 0)710 /-- 022 )3(L <br /> New � Renewal ] ] Home Phone: . 11 011/l -c;`Z `-t b <br /> Email Address: L ,(::� <br /> by the following named persons: <br /> Owner Name Owner Residence <br /> Second Owner Name Second Owner Address <br /> iun 'the penalts of perjury that 1, to tty�'est of my knowledge and belief, have filed all state tax returns and paid all state <br /> s r quire u er w. <br /> *Signature of autho ¢ed a e t "Social Security Number or <br /> or Federal Identification Number(Required) <br /> his 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 /> I <br /> The.Common wealth of Massachusetts <br /> BARNSTABLE ss DATE 9- GIS <br /> Personally appeared before me the above-named&o„ ✓ ,Q ' and made oath that the foregoing statement is true. <br /> A certific "'sued in ace "dance with this section sh 1 b1 in force an ect for four years from the date of issue and shall be renewed each <br /> fou years there o la-mg as s busines hall be conchae and shall lapse and be void unless so renewed. <br /> Signe - <br /> Notary Public <br /> SEL Deborah Dami <br /> e <br /> NOTARY PUBLIC Commission Expires: <br /> Commonwealth of Massachusetts <br /> My Commission Expires July 29,2016 <br />