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SPECIAL PERMIT Date ................................ 19...... <br /> File ................................ To Building Inspector; i <br /> You are hereby authorized to issue a <br /> APPLICATION for SPECIAL PERMIT "Special Permit" for thisapplication for <br /> signature of the Board of Appeals and are <br /> hereby advised that this apblication 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 M <br /> Conditions (if any) ...................................... <br /> a <br /> .................................................................................................. <br /> ....................................................................................... <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 /> .................................. <br /> To Build? .............................. <br /> ........................................................ <br /> (Yes or No) (date) <br /> 0 <br /> Use & occupancy? .................. ......... . <br /> (Yes or No) (date) Board of Appeals <br />