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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 PERAIIT "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 /> .......................................Name <br /> ....................................... 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 /> 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 /> .................................................................... <br /> (Yes or No) (date) <br /> Use & occupancy? .................................................. <br /> .................................................................. . <br />_ (Yes or No) (date) Board of Appeals <br />