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SPECIAL PERMIT Date ................................ 19...... <br /> e ` <br /> To Building Inspector; <br /> ' You are hereby authorized to Issue a <br /> APPLICATION for SPECIAL PERMIT. .ti "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 /> «, ' Y •t are requested to see that they are compiled <br /> with, and included in permit. <br /> ..................................... ....... •`' <br /> Location <br /> h <br /> 'v Conditions (if any) .... ................. ............... <br /> r <br /> .# - - <br /> .......................................................................... ... ........ <br /> s: <br /> • y , <br /> ....................................................................................... <br /> PerWIt granted (....................). <br /> Yes or No - <br /> ....................................................................................... <br /> Date ................................ 19...... <br /> It permit was granted what otherpermits <br /> were issued by the Building Dept?.»., ',' " ................................. .................................. <br /> To Build? ............................. ` <br /> (Yes or No) (date) .................................................. <br /> Use & occupancy? ..........................'.........:.............. <br /> .........................._.......I.......................... ... . <br /> (Yes or No) (date) Board of Appeals <br />