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32 REAR BOSTON STREET - BUILDING JACKET i 1 32 R BOSTON STREET i tsustness t-enutcate Citp of *stem, ,RTassactusetts sgeC1��Nt• . o ` D ATE F ILE D m- ZZ, l995— Type: icY New Expiration Date,,-V-?2- yy 9 ❑ Renewal, no change Number 95-317 ❑ Renewal with chance In conformity with the provisions of Chapter one hundred and ten, Section five of the Massachusetts General Laws, as amended, the undersigned hereby declare(s) that a business is conducted under the title of: SAIQm iSion at 3a, a , OSTCn S1 type of business 4 UT O {3©C`) � by the following named person(s): (Include corporate name and tide if corporate officer) Full Name Residence /� SCIS-Q j2 ��� (3a�Tl�olc� trPv ST le0. Signatures �y --------------------------- _____________________________________________________ ______________________ _____________________________________________________ on 1 �— 19- the above named person(s) personally appeared before me and made an oath that the foregoing statement is true. -------------- ----------------------------------------------------- CITY CLERK Notary Public (seal) Date Commission Expires Identification Presented State Tax I.D. # S.S. # 0 3 3 - 4 g -3S 3 (if available) 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 years 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 subiect to a fine of not more than three hundred dollars ($300.00) for each month during which such violation continues. UP of 6aiem, Aaaarbuuttg 3 � �A 9ry�ryg:pP Withdrawal or Deceased from Business or Partnership In conformity with the provisions of Chapter 110, Section 5, of the Mass. General Laws, the undersigned hereby declare(s) that we (I) have this day: N1 ❑ Discontinued / ❑ Withdrawn from the business known as- conducted s conducted at- as set forth in the certificate filed on- Name Address -0v ror� X16 olerneu ST » 0ebl- PThe location of �( the business ❑ my residence as it appears on the business certificate of: filed o 2 Z/ has been changed to: �3 As executor or administrator for the estate of: who died on: I hereby request a: ❑ Discontinuance of the business certificate ❑ Withdrawal of his/her name from the business certificate so named: filed on: ----------------------------------------------------------------------------- si,--Pa re(s) M ------- --------------------------------------------- ----------------------------------------------------- 19 he above named person(s) personally appeared before me and made an oat t to foregoing statement t�true. ----------- ------------------------------- ---------------------- ------------------------------------------ CITY CLERK Notary Public (seal) Date Commission Expires r