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SPECIAL PERMIT Date . . .. . . . . . . . . .19.. . .
<br /> File .. . . . . . . . io Building Inspector
<br /> Application for Special Permit You are hereby authorized to issue
<br /> a Special Permit for_lhis applica-
<br /> tion for signature .of, he Board of
<br /> Appeals and are hereby advised that
<br /> this application has Feceived the
<br /> , , ,, ,, , , , , , ,,, • , , , , ,, ,, ,, ,, , , ,, approval of the Board Zof Appeals.
<br /> Name
<br /> If any conditions are written Delow
<br /> ,,, ,, , , ,,, , ,, , , •• , • , , , , , ,• , ,, • , you are requested to see that they
<br /> Location are complied with, and included in
<br /> permit.
<br /> Conditions (if any) . . .. .. . . .. . . . . .
<br /> .. .. . . . . . . . . .. . . . . . . . . . . .. .. .. . . . . . .
<br /> . . .... ...... . . ... . . . . . . . .. .. . . .. . . .
<br /> ... . . . . . .. . . . . . . . . . .. . .. . . . . . . . . . . .
<br /> Permit granted ( . . . . . ... . .
<br /> )
<br /> Yes or No
<br /> . . .. . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . .
<br /> Date . .. . .. . . . . . .... .19.. . .
<br /> . . .. . . . .. . ... . ... . . . .. ..... . . . . . .. .
<br /> If permit was granted what other • •-•• • •• ••• • • • • ••• ••• • ••• • • •• • • •.
<br /> permits were issued by the Building
<br /> Department?.
<br /> To Build? .. . . . . .. . .
<br /> (Yes or No) (date) . . .. . . . .. . . .. . . . . . . . . . . . . . . . . . . . . . .
<br /> Use & Occupancy? . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . .
<br /> (Yes or Na) (date) Board of Appeals
<br /> ,r
<br />
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