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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 PER= "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 /> C <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 /> ToBuild? .............................. .............................. <br /> (Yes or No) (date) ................................................................. <br /> Use occupancy? .................. . . ................................... . <br /> l .. . ..:...........a............ <br /> (Yes or No) (date) L Board of Appeals <br />