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SPECIAL PERMIT Date ..........'..................... 19...... <br /> File ................................ <br /> 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 /> .. <br /> Location <br /> Conditions (if any) <br /> ................................................................................... <br /> ............................................... ........................................ <br /> ...........................:............................................................ <br /> ..................................................................................... . <br /> Permit granted (....................) <br /> .' Yes or No <br /> Date ................................ 19...... , ....................................................................................... <br /> If permit was granted what other permits <br /> were issued by the Building Dept? ................................................................... <br /> - To Build? <br /> :_(Yes or No) (date) <br /> Use & occupancy? .................................................. <br /> (Yes or No) (date) Board of Appear <br />