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SPECIAL PERMIT Date ................................ 19.- <br /> To Building Inspector: <br /> r 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 /> .......................................xame............ ......................... 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 /> Permit granted (....................) <br /> Yesor No .....................................................................'................. <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) v <br /> .................................................................. . <br /> Use & occupancy? ......................................... .. <br /> i (Yes or No) (date) Board of Appeals <br /> L ,, <br />