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SPECIAL PERMIT Date ................................ 19...... <br /> File ................................ To Building Inspector: <br /> You are hereby authorized to. Issue a <br /> APPLICATION for SPECIAL PERNIIT "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 /> xame If any conditions are written below, you <br /> are requested to.see that they are complied <br /> with, and included in permit. <br /> k� <br /> Location <br /> Conditions (if any). .................... <br /> _:............ <br /> .................................................... <br /> ....................................................................................... jj w <br /> .....................................................:................................. <br /> Z <br /> ....................................................................................... t• <br /> ....................................................................................... <br /> Permit granted (...................J =� <br /> Yes or No <br /> Date ................................ 19...... ....................................................................................... <br /> If permit was granted what other permits <br /> were issued by the Building Dept? <br /> To Build? <br /> (Yes or No) (date) <br /> Use & occupancy? .................. <br /> (Yes or No) (date) Board of Appealz <br />