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SPECIAL PERMIT Date . . . ... . . . . . . . . <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 /> ... . . ... .. .. . .. . .. .. . . . . . . . . . .. .. .. . <br /> Conditions (if any) . . .. . . .. .. . . . . . <br /> . . .. .. . .. .. . .. .. . . . . .. .. .. .. .. .. .. .. . . <br /> Permit granted ( . ... ) <br /> Yes or No <br /> Date . . . .. . . . . . . . . . ..19.. .. <br /> . . .. .. . . . . . ... . . . . . ... .. .. . . . . .. . . . <br /> Ifpermit was granted what other . . .. .. • • • • ••. . . . ... . . . . ... . . . . . • • • • • <br /> permits were issued by the Building <br /> Department? <br /> . . ... . .. .. . .. . ... . .. . . . . . . . . . . . . . . . <br /> To Build? . . .. .. ... . . .. . . . . .. .... <br /> ac (Yes or No) (date) <br /> CA Q <br /> Use & Occupancy? .. .... .... .. .. .. .. ' " <br /> Board of Appeals <br /> , (Yes or No) (date) <br />