8rd Class
No.
APPLICATION FOR PERMIT TO BUILD.
[Separate applieation required for each building.
Waltham,
191
TO THE INSPECTOR OF BUILDINGS:
as specified below:-
The undersigned hereby applies for a permit to build a
RESPONSIBLE PARTIES: Owner?
Address?
Architect?
Address?
Builder?
Address?
Are you authorized by the owner
do this work?
LOCATION: Street?
Which side?
Which lot?
Size of lot?
upon lot: give distance from two adjoining sides?
If buildin
roof water be conducted away?
...
Distance from surrounding buildings
Front,
Side,
Side,
Rear,
Use of surrounding buildings: On front?
On rear
On side?
On side 7
NATURE OF LAND: Solid, filled, earth, rock, marsh?
WILL any building be demolished, moved or altered
make way for this one?
ANY SECOND HAND materials to be used?
NATURE OF BUILDING: Material?
Use?
Number of units applied to this use ? (tenements, stores, offices, etc.)
Dimensions: Length?
Height?
Width?
Number of stories?
Is building block or separate?
Cost?
FOUNDATIONS: Will footings
rest on clay, sand, gravel, rock, timber, or piles?
Give diagram section of foundation and underpinning, footings and drains, with dimensions?
Material?
Dry or mortar wall?
Material?
CHIMNEYS: Number?
Mortar?
Thickness of walls?
Size of flues?
How far does chimney rise above roof?
How finished
top?
Use of flues?
Any hollow brick, terra cotta or tile in use?
Are chimneys inclined
corbelled?
Any brick veneering?
Dimensions of hearth?
Support?
COLUMNS, POSTS AND PIERS:
Cast iron, wood, or iron and concrete, brick, stone?
Number of each?
Diameter?
Shape?
Spacing?
WOOD CONSTRUCTION: Style of frame?
Thickness of shell?
Bases?
Mortise and tenons, where?
Caps?
Any headers or trimmers more than 4' o" long?
Bridging: where placed in floors?
In roofs?
Wall Bracing?
Any fire-proof shutters or doors?
Number?
Fire escapes?
Elevator enclosures?
Pitch?
Style of o
Proposed plan of fire stopping?
Material?
If wood, where?
Lathing?
If metal, where?
Outside studs and spacing?
Dimension of sills?
Inside studs and spacing?
Partition caps?
Girts?
Girders?
Rafters and spacing?
Ceiling joists and spacing?
2nd,
Floor joists: 1st,
rd
4th,
Spacing of floor joists?
Trussing
Plates?
Partition braces?
How are partitions carried?
the building?
ANY depositories for ashes
DOCUMENTS AND PLANS FILED:
Number of floor plans?
Number of elevations?
Other drawings?
Specifications?
Sworn Statements?
WILL THE BUILDING CONFORM TO THE REQUIREMENTS OF THE LAW?
Owner's name
Agent's name?
