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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 /> 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 /> 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 /> (Yes or No) (date) <br /> Use & occupancy? .................................................. .................................................................. . <br /> (Yes or No) (date) Board of Appeals <br />