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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 complied <br /> with, and included in permit. <br /> ._......_............................................................ <br /> Location <br /> Conditions (if any) ...................................... <br /> ....................................................................................... ....................................................................................... <br /> ........... .................................................... ............ <br /> . ..................................................................................... <br /> ............................................................a-...................... . <br /> ....................................................I...................... <br /> .......................................:.............................. . <br /> ....................................................................................... <br /> Per;nit granted (....................) <br /> Yes or No <br /> ....................................................................................... <br /> Date ................................ 19...... .......................................................:............................... <br /> �3J �qr <br /> c If permit was granted what other.permits <br /> 4,) were issued by the Building Dept? <br /> . To Build? <br /> (Yes or No) (date) ..................................... <br /> ........................... <br /> .............. .....! <br /> Use & occupancy? .................................................. .................... ; <br /> (Yes or No) (date) Board of Appeals <br />