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SPECIAL PERMIT Date ............... ............... 19...... <br /> ` File ._ ........................ To Building Inspector: <br /> You are hereb��y authorized to issue a <br /> APPLICATION for SPECIAL PERMIT "Special Permit'; for'. this appl tion for <br /> signature of the'Board of Appe and are <br /> T <br /> .hereby advised that this appl cation has <br /> received the approval of theftoard of <br /> Appeals. tt <br /> Name + If any conditions are writtbelow, you <br /> n are requested to see that they a complied <br /> with, and included in permit. <br /> ...... ...... . ..... ................................:..........: <br /> Location <br /> i Conditions (if any) ......... ............................ <br /> ' .. � � - ' �' �h qty • �. <br /> z. <br /> ....................................................................................... <br /> ..................................................................:.................. <br /> ....................................................................................... <br /> Perplt granted (.................. ). <br /> Yes or No <br /> ....................................................................................... <br /> Date ....................:........... 19...... ............................................................................. <br /> If permit was granted what otherpermits <br /> were issued by the Building Dept?. `,;>::w. <br /> To Build? .............................. .............................. <br /> (Yes or No) (date) .......................................... <br /> -� . . _ . . <br /> fr'Use & occupancy? .................................................. ............. ...................... ...... ......... <br /> (Yes or No) (date) Board of Appeals <br />