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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 /> ....................................... <br /> ...................................... If any conditions are written below, you <br /> Name <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 /> } -- ai <br /> Permit granted (...................J <br /> Yes or No ....... <br /> ............................. . <br /> OY ..................................................................................... . <br /> Date.........................:....... 19...... <br /> J <br /> 30. <br /> If permit was granted what other permits <br /> were issued by the Building Dept? ..................................... ........ . .. . . <br /> ToBuild? .............................. .............................. ................................................................... <br /> (Yes or No) (date) <br /> ............................................................ ..... . <br /> Use & occupancy? .....:............................................ <br /> (Yes or No) (date) Board of Appeals <br />