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SPECIAL PERMIT Date ................................ 19...... <br /> To Building Inspector: <br /> File ................................ <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 /> .......................................................................... .......... . <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 /> To Build? .............................. <br /> .....................................................:...:.......... <br /> (Yes or No) (date) <br /> .:................................................................ . <br /> Use & occupancy? ..................................... . <br /> (Yes or No) (date) Board of Appeals• <br />