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SPECIAL PEkIII Date . . .. . . . . . . . . .19. . . . <br /> File .. .. . . . . . To Building Inspector <br /> You are hereby authorizeAo issue <br /> Application for Special Permita "Special Permit' for this applica- <br /> tion for signature of .the.Board. of , <br /> Appeals and are hereby: adv�ised that` <br /> this application has received the <br /> ... . . approval of the Board of Appeals. . <br /> Name <br /> If any conditions are written below <br /> ... . . you are requested to see'that-they <br /> Location are complied with, and included in <br /> permit. <br /> . .. . . . .. . .. . . .... ... .... . . . . . <br /> Conditions (if any) . . .. .. . .. . . . . . . <br /> Permit granted ( .. . . . .. .. . <br /> ) <br /> Yes or No <br /> Date .. . .. .. . . ... . .. .19. ... .. . . . . .. . <br /> If permit was granted what other . . .. . . . . . . .. . . . . . . . . . . .. .. . . . . • • • • • <br /> permits were issued by the Building <br /> Department? <br /> .. ... . .. .. .. .. .. . . .. . . . . . . . .. . .. . . . <br /> To Build? . . .. .. . ... . ... . . . .. .... <br /> (Yes or No) (date) . . . . . . . .. . ... . . .. . ... . ... . ... . . . . . . <br /> Use & Occupancy? . . .. .. .. . .. . . . . . . . . .. .. . . . . . .goard of Apj.?ejls <br /> (Yes or No) (date) <br /> r <br />