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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 PERMIT "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 conditions are written below, you <br /> are requested to see that they are compiled <br /> with, and included in permit. <br /> ........................................................................ <br /> Location <br /> Conditions (if any) ...................................... <br /> ................................................................................. <br /> ................................................................................... <br /> ..................................................:........................ . <br /> .................................................................................. <br /> ..................................................................................... . <br /> ..................I.................. ............................ ......... <br /> Permit granted (....................) <br /> Yes or No <br /> ....................................................................................... <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 /> ..................................................pp......... . <br /> Use & occupancy? ..... .............. . . . . . ... , <br /> (Ye.s or No. ........... . <br /> ) (da. . . ......te) Board of A eels .. <br />