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SPECIAL PERMIT a e . . . . . ... . <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 conditions are written below, <br /> . .. .. .„ • . . . . . you are requested to see that they <br /> Location are complied with, and included in <br /> permit. <br /> .... . . .. . . 1 . . .. . ... . . .. . ... . . .. . ... . <br /> . .. . . .. .. . . . . . .. . . . . . . .. . . .. . . .. .. .. <br /> Conditions (if any) . .... . .. . . . . . . . <br /> Permit granted ( . . . . . . .. . . <br /> ) <br /> Yesor No . . . . . .. . .. . .. . . . . . . . .. . .. . . . . . . . . . . . <br /> Date . . . . . . . . . .19. . . . .. . . . . .. . . . . . . . . .. . . .. . . . . . . . . . . . <br /> If permit was granted what other • •• • • • .. .. . . . . .. . . •• • • . . . . . . .. . . . . • <br /> permits were issued by the Building <br /> Department? <br /> r . . .. . . .. . . .. . . .. . . . . . . . . . . . . . . . . . . . <br /> ToBuild? . . . .. . ... . . .. .. . . .. . ... <br /> (Yes or No) (date) ,. . . :. <br /> x <br /> b� Use & Occupancy? . . .. . . .. . . . . <br /> "' . (Yes or No) (date) Board of Appeals <br />