No.
Application for Permit for Alterations, Etc.
Brockton,
191
TO THE HONORABLE, THE BOARD OF ALDERMEN
Inspector of Buildings.
the following deseribed Building:
The undersigned applies for a permit to
Location,
Ward
Distriet
Name of owner,
Name of oecupant,
Name of architect
Name of mechanie
Material
No. of stories
feet rear,
feet deep,
Size
f building, No. feet front,
No. of stories,
: roof,
feet high:
feet wide;
Size of L
feet long:
feet in height from sidewalk
highest point
f roof,
No.
Material of roofing,
Style of roof,
Material of foundation,
Distance from line of street.
Thiekness of party walls,
inches.
Thickneas of external walls,
inches
For what purpose built?
How is the building occupied?
Number of stores in lower story?
If a dwelling, by how many families?
How protected?
Hoistways and elevators?
DETAIL OF PROPOSED ALTERATIONS, ETC.
F EXTENDED ON ANY SIDE.
No. of feet high above sidewalk,
Size of extension, No. of feet long .
No. of feet wide.
: Material of roofing,
( stories high.
Style of roof,
No.
Foundation,
of what material will the extension be built?
inches; and party walls?.
inches.
If of brick, what will be the thickness of external walls?.
Connection with main baila:
occupied?
How will the extension
Distance from surrounding buildings
feet; side,
feet: rear.
feet; side,
feet.
Front,
What distance from the lines of the adjoining lots will it be placed?
Eatimated Cost,
What distance from any other baildings?
IF MOVED, RAISED, OR BUILT UPON.
, Proposed foundation,
When moved, raised
r built upon
Present height of building
feet high from level of ground to highest part of roof..
No
Distance from surroanding buildings:-
feet; side,
feet: rear,
feet;
side
feet.
Front
Distance back from line of street,
Distance from nearest line of lot,
Will the roof be flat, piteh, hip or mansard?
What will
the material
roofing?
How many feet will the external walls
increased in height?
How many feet will the party walls be inereased in height?
How will the building
oceupied after alteration?
IF ANY PORTION OF THE EXTERNAL OR PARTY WALLS ARE REMOVED.
Will an opening be made in the party or external walls?
on
story.
What will be the tize of the opening?
feet wide:
feet high
How will the remaining portion
f the wall be supported?
by iron or stone lintels, give size,
t iron columns are used, give diameter,
inches: and thickness of shell
inches
brick piers are used, give aize,
(OVER)
