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SPECIAL PERMIT Date . . 1.a.. . .y19. . . . <br /> File . . . .. . . . . To Building Inspe�to'r' <br /> You are hereby ut rid to issue <br /> Application for Special Permit a "Special ;Pe.rmit' ipr 1,hhis� tppli6- <br /> tion for signaturePf the hoard of <br /> Appeais and are hereby,adv1sed that <br /> this application has received the,J <br /> approval of the Board .of Appeal'sf <br /> Name If any conditions are writte belol,•; <br /> . .. . , you are requested to see that they <br /> Location are complied with, and included in. <br /> permit. <br /> . ... . . . . .. . . . . .. .. . . .... . .. . . . . . .. .. <br /> ... . .. . . . . . . .. .. . .. . . . . ... .. . . .. . .. . <br /> Conditions (if any) . . .... . . . . .. . . . <br /> . . .. . . . . ... . . .. . .. . .. . .. ... . ... . .. . . <br /> ...... . ... . . . . . . . . . . . . ... . .. . . .. . . . <br /> . . .. .. . .. . .. . . . . . . . . . . .. . . . . . . .. .. . <br /> . . ... . .. . . . . . . .. . . . . . . . .. . .. . . . . . . . <br /> Permit granted ( . .... . . .. . <br /> ) <br /> Yes or No <br /> Date . . . . .. . . . . ... .. .19.... . . . . . <br /> Ifpermit was granted what other . . .. .. . .. . .. . . . . . . . .. . ... . . . . . • • • • • <br /> permits were issued by the Building <br /> Department?. <br /> . . ... . .. . . .. . . . . . . . . . . .. . .. . .. . . . . . <br /> To Build? <br /> . . . . . . .. . . . . .. . . .. <br /> (Yes or No) (date) . . .. .. . .. . . .. . . .. . . . . . . . . . . .. . . . . . . <br /> Use & Occupancy? . . . . . . . .. . . . . . ..... . . . . . .. . . .. . .Board of ftpeai_ <br /> (Yes or No) (date) <br /> 4 <br />