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SPECIAL PERMIT Date ................................ 19...... <br /> File ................................ <br /> To Building Inspector; <br /> You are hereby authorized to Issue a <br /> APPLICATION for SPECIAL PERMT "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 conditlons 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 /> ....................................................................................... <br /> .................................... ............................................ <br /> ..................................................................................... . <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 /> ToBuild? .............................. .............................. <br /> (Yes or No) (date) .................................................................... <br /> Use & occupancy .................................................. <br /> .................................................................. . <br /> (Yes or No) (date) Board of Appeals <br />