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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 /> q with, and included in, permit. <br /> ....................................................................................... <br /> Location <br /> Conditions (if any) ...................................... <br /> .................:.............................................................:....... <br /> ...............................................................................I........ <br /> ......................................................................I................ <br /> ....................................................................................... <br /> ....................................................................................... <br /> ................................................:...................................... <br /> ..................................................................................... . <br /> ....................................................................................... <br /> Permit granted (:...................) <br /> Yes or No <br /> Date ................................ 19...... <br /> ....................................................................................... <br /> "1 <br /> If permit was granted what other permits <br /> were issued by the Building Dept? <br /> ' To Build? <br /> (Yes or No) (date) .................................................................... <br /> Use & occupancy? .................................................. .............................................................<... . <br /> Board of Appeals <br />