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Business Certificate
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DATE FILED
Type: New
Expiration Date '�� z z ac o4
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Number 0 Renewal, no change
0 Renewal with chance
In conformity with the provisions of Chapter one hundred and ten, Section five of the Massachusetts General
Laws, asMended, the undersigned hereby declare(s) that a business is conducted under the title of:
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type of business G 1Lor SAJit /2�3
by the following named person(s): (Include corporate name and title if corporate officer)
� I 1 �LFull Name Residence Tel.#
J1AW SuJt2 I S'-RP,16yieul Ave Wq—To-i
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on 1•I the above named person(s) personally appeared before me and trade an
oath that the foregoing statement is true.
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-CITY CLERK - ----- ------------------ (Seal)---------
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Notary Public
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Date Commission Expires
identification Presented
State Tax I.D. # S.S. # u — SSI— 9Uol
(if available)
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In accordance with the provision of Chapter 337 of the Acts of 1985 and Chapter 110, Section 5, of Mass.
General Laws, business certificates shall be in effect for four(4) years from the date of issue and shall be
renewed each four vears thereafter. A statement under oath must be filed with the town clerk upon
discontinuing, retiring, or withdrawing from such business or partnership.
Copies of such certificates shall be available at the address at which such business is conducted and shall be
furnished on request during regular business hours to any person who has purchased goods or services from
such business.
Violations are subject to a fine of not more than three hundred dollars (5300.00) for each month during Which
such violation continues.