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SPECIAL PERAUT Date ................................'19....:. - <br /> Ar Flle ................................ To Building Inspector: <br /> You are hereby authorized to Issue a <br /> APPLICATION for SPECIAL PERwr "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 /> i <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 /> ...............................................:....:............ <br /> ToBuild? .............................. :............................. <br /> (Yes or No) (date) .................................................................... <br /> Use & occupancy? .................................................. <br /> .................................................................. . <br /> (Yes or No) (date) Board of Appeals , <br />