WARD
To dersigned hereby applies for a permit to make additions or alterations according to the
following specifieadio ddress
INSPECTIONS
Date
Beverly, Mass..
191
Inspector's Name
Foundation
2. Architect's name
3. Mechanic's name and address
Chimneys
4. Location of building, No.
: 6. Material of building?
5. What is the purpose of building?
7. If a dwelling, for how many families?
8. is there to be a store in the lower astory?
Fire Stops
9. Size of addition,
10, No. of stories?
11. No. of feet from the level of the ground to the highest part of the roof?
12. How near line
f feet front.
No. of feet deep.
No.
No. of feet rear.
Light and Elevator Shafts
Egress
Means
the street?
14. What will be the means of access to the roof?
How near line of adjoining lot?
13.
1st 2d
15. Size of floor timber
3d
4th
5th
istance
center
16. Will the building be erected on solid or filled land?
17. Will the foundation be laid on earth, rock. timber or piles?
1 Will th roof he flstnitehed mansard or ambrel2
Last Inspection
20. Will the building be heated by steam, furnaces, stoves or grates?
21. Estimated cost?
REMARKS
Signature of Applicant
DETAIL OF THE WORK TO BE DONE
