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SPECIAL PERMIT Date . . . . . .... . ..19.. . . <br /> File .. . .. .. . . To Building Inspector <br /> Application for Special Permit You are hereby authorized to issue <br /> a Special Permit for this applica- <br /> tion for signature of the Board of <br /> Appeals and are hereby advised that <br /> this application has received the <br /> .. . . . . . .. . .. .. . .. . ... . . .. . . . . . approval of the Board of Appeals. <br /> Name <br /> If any conditionssaHe_'ritten below, <br /> permit. �: d$« uded in <br /> you are requested `to see th <br /> Location p uded. in <br /> P <br /> are complied wi-th an nc <br /> t <br /> Conditions (if an'-T1 .. . .. . <br /> .. ....... . . .. . ... . .. .. . . ... . . <br /> Permit granted ( . . .. ) <br /> Yes or No <br /> Date .. . . . .. . .. . .. .. .19. .. . <br /> . . . .. . . .. . . . .. . . .. . . . . . . . . . . . . . . . . . . <br /> If permit was granted what other . . . . . . • •• • . .. . . . .. . . . . . . . .. . • . <br /> permits were issued by the Building <br /> Department? <br /> . . ... . .. . . .. . . . . . .... . . . . . . . . . . . . .. <br /> To Build? . . . . . . . .. . . .. .. .. .. . ... <br /> (Yes or No) (date) . . .. .. . .. . . .. . .. . . ... .. . . . . . . .. .. . . <br /> Use & Occupancy? .. . .. . . . .. . .. .. . . . . . . . . . . <br /> (Yes or No) (date) Board of Appeals <br />