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SPECIAL PERMIT Date ................................ 19...... <br /> File ......'......................... To Building Inspector: <br /> You are hereby authorized to issue a <br /> APPLICATION for SPECIAL PERMIT "Special Permit" for this application for <br /> signature of the Board of Appeals and are <br /> hereby advised that this application has <br /> received the approval of the Board of <br /> Appeals. <br /> .............................................................................:......... <br /> Name If any conditions are written below, you <br /> .are requested to see that they are complied <br /> with, and included in permit. <br /> ....................................................................................... <br /> Location .. <br /> Conditions (if any) .......:.............................. <br /> .................................. .........::.......................... ............ <br /> .....................................................................:................... <br /> ..:.................................................................................... <br /> ....................................................................'............... . <br /> ....................................................................................... <br /> ..................................................................................... . <br /> ............................................................. ........................ <br /> Permit granted (....................) <br /> Yes or No <br /> ....................................................................................... <br /> Date ................................ 19...... ....................................................................................... <br /> If permit was granted what other permits <br /> were issued by the Building Dept? ...........................................:........................ <br /> ToBuild? .............................. ....:......................... <br /> .................................................................... <br /> (Yes or No) (date) <br />� Use & occupancy? .................................................. <br /> .................................................................. . <br /> (Yes or No) (date) Board of Appeals <br />