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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 /> with, and included in permit. <br /> ....................................................................................... <br /> Location <br /> Conditions (if any) ...................................... <br /> ....................................................................................... <br /> ....................................................................................... <br /> ....................................................................................... <br /> ....................................................................................... <br /> ...........................................................................I........... <br /> Permit granted (....................) <br /> Yes or No <br /> ....................................................................................... <br /> Date ................................ 19...... <br /> Y Q <br /> Ifpermit was permits <br /> w were Issued y the Building Dept <br /> 1� , <br /> .................................................................... <br /> a4 To Build? .............................. ............. . <br /> (Yes or No) (date) <br /> ab <br /> se & occupancy? ............................. <br /> (Yes or No ) Board of Appeals <br />