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SPECIAL PERMIT Date ................................ 19...... <br /> To Building Inspector: <br /> File ................................ <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 /> .......................................Name....................................... 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 /> ...............................................:...................1................... <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 /> To Build? ..................... <br /> ............................................... <br /> (Yes or No) (date) <br /> .................................................................. . <br /> Use & occupancy? ....................................... <br /> (Yes or No) (date) Board of Appeals <br /> i <br /> I ' - <br />