No.
Application for Permit to Build
(WOOD AND FRAME)
Brockton,
191
TO THE HONORABLE THE BOARD OF ALDERMEN:
INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a permit to bsild according to the following specifications:
1. Is the building in a block or separate?
Block of
2 Material?
the name of Owner?.
What
4. What is the name of Architeet?
5. What is the name of Builder?
What is the location
6.
Ward
District
7, What is the nearest street?
What is the purpose of building
8.
If a dwelling, for how many families
9.
Are there front and back stairs?..
s there to be a store in the lower story?
11
Size of lot;-No. of feet front
f feet deep
12
feet rear
No.
No.
The heigt the level of building lot above the grade of street isi
13.
feet
Size of building:
No, of feet front
: No
of feet rear
No. of feet deep
No. of stories
No. of feet in height from level
ground to highest part of roof
16.
17. Distance from surrounding building: front
18. Distance back frem line of street.....
feet; side
feet; side
feet: rear
eet
19. What
the height of the nearest building....
20, Will the building be erected on solid or filled land?
21, Will the foundation be laid on earth, rock, timber or piles
22
the material of foundation?
What
Will foundation conform with ordinanee
23.
Will the roof be flat, pitched or mansard?
24.
Will the building be heated by steam, furnaces, stoves or grates?
25.
Size of tlue
Will the beilding conformn to the requirements of the law?,....
Number of brick walls
27
and where placed?
Within eight feet of other buildings?
28
Within four feet of line of adjoining owners
29.
Size of posts
80
31
girts
floor timbers
32
3
rafters
Plans submitted?
Estimated cost
Show by diagram the location of proposed building, with relation to distances from adjoining lots.
I agree to notify Inspector when building is ready to lathe. I also hereby agree that all of the proposed work
shall be done in strict compliance with the description set forth in plans, statement and specifications.
NAME
Contractor.
Owner.
ADDRESS.
Du
Separate
pplication
required for e
Adar
