25C-231 (5) To the Inspector of Buildings:- ��
The undersigned hereby applies for a permit to build, move, alter, or repair, according to the
following specifications.-
1. Owner's name d,�.� .. ... .: ,rr. .................. . ............ ..............................................».......».......»........
2. Owner's address �l ..`....,,11. ;aC .r ! ...:..........»....».
3. Architect's name ...........`:::................................»..........................»....»............................................................................................................
4. Builder's name t......._
5. Builder's address ..»1 ......................................................,.........»..... ..........»..........................................................................................
.... .. :......:. ? :,t �t,,t�..: . ..................................................»................
6. Location of Building. Street No. »..
7. Is this a removal or new building.........a::. .;r.: 1 c..:: .:.....».....................................................................................
8. If removal, from where ..1. .»....' `.... . .....:J..1................_...................................... ».................
9. What-islhe purpose of building ..., ..... z . »/ ............................................
10. Material of building ......I �. »........................................................».............»............................».........................................
11. If a dwelling, for how many families ............. � .»................».....Number of rooms ..........�..._....._.
................................
12. Is there to be a store in the building .....»....»........................».....................................................:.......»............................................
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13. Size of building, No. of feet front ...........»... ..... ;No. of feet deep ............ .......; No. of stories ...........»....»..
14. Size of ell, No. of feet front , No. of feet deep :.....».....• No. of feet high l..
15. Size of Lot .......................»...........................................................Feet Wide ....5-.. '......r......».. Feet Deep .....i:.i�...s:............
16. How near the-line of street ..................................................................
17. How near the line adjoining lot. Right :.............». ....; Left ...............; Rear......:.........».
18. Nearest building is ................................. feet in a...................................................... direction ......................................................
19. Material of the floor...................................».............................»................................................................................................................
20. Size of timbers, 1st ...........»....».....; 2nd ........................ : 3rd ........................; 4th .............................; 5th ......................».....
21. No. of feet span ...........».............».......................................... ; Distance on centers ..............................
22. Will the building be erected on solid or filled land .............................»...............................................................................
23. What is the material of foundation .....».......»........................................»....»..................................; Footing ........................
24. Will the roof be flat or pitched ...........».»....»............................»..........; Covering....................»....»........................................
25. Heat; steam, hot water, furnace, stoves.........................................; Power oil burner ................................................
26. Fireplace .....»............._.............»...................................; Insulation ..............»...............................................................................................
27. How many sinks ............: Toilets .....».....; Lavato ries..».....; Bathtubs.....»..; Showers............; Settubs .........
28. City Service; Water ........................ Sewer ........................; Road Surface ...........................; Sidewalk ........................
29. Is lot on accepted street ..............»....».............».....................»...............................».....................................».............»...............................
30. Estimated cost (must be filled out) ........».................................».......»..............................................»....»........................................
Applicant agrees to give the Inspector of Buildings 24 hours' notice before lathing or
plastering this building. This building will conform to the requirements of the law.
Signatureof applicant .......».............».......................................................................
No........
:��r: ........
REMARKS
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