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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 PERNIIT "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 /> .......I.............................. . ............................................ <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 /> 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 /> Use & occupancy? ....................................... ....... .. <br /> . .................................................................. . <br /> . . <br /> (Yes or No) (date) Board of Appeals <br />