Created by gemini-2.0-flash on 2025-05-01

Here's a description of the image:

The image is a yellow inspection form, possibly from a building or housing inspection. It's labeled "CI" at the top right. The form is organized into various sections with headings and blank spaces to be filled in, likely by an inspector.

Here are the key sections:

• Address Information: Sections for "STREET," "NO.," "WARD," and "DIST."

• Property Owner and Agent: Spaces for "OWNER" and "AGENT," along with their respective addresses.

• Occupancy: Radio buttons for "Families" or "Business" to denote the type of occupancy.

• Arrangement: Also with "Families" and "Business" options, with a specific "Bakery Bakery" field.

• Observations: Sections for various aspects of the property, including "RUBBISH," "WATER SUPPLY," "W.C. FLUSH," "FIRE PASSAGE OBSTRUCTED," "F. E. EGRESS," "PLUMBING SYSTEM," "PLUMBING DEFECTS," "GARBAGE CANS," "ASH CANS," and "DEFECTS (REPAIRS)." These sections include spaces for details and observations regarding each area.

• Conditions: "DANGEROUS CONDITIONS" and "UNLAWFUL USE" sections.

• Halls and Stairs: A table-like grid to mark conditions of "HALLS AND STAIRS" using parameters ranging from C to 11.

• Floors, Walls, Ceilings: Categories of inspection ("FLOORS AND STAIRS," "WALLS AND CEILINGS") with tick-box options such as "RUBBISH," "CLEAN," "COVERING," "NEED P. OR W." and "OLD PAPER."

• Remarks: A "REMARKS" section for additional notes.

• Administrative Information: Sections for "BOROUGH OF," the form number ("FORM 1051. 3157-09 (B) 100,000"), "OVER" (indicating there may be information on the other side), and a space for the "INSPECTOR" signature.

The form uses a simple, functional layout, designed for quick assessment and recording of information. The yellow background suggests the form may be old or standard for certain types of inspections.

Created by gemini-2.0-flash-lite on 2025-05-01

This is a vintage inspection form, likely from a building or property inspection. The form is divided into several sections, each focusing on a different aspect of the building's condition.

Here are the sections and what they cover:

• Identification: Includes spaces for the street, owner, agent, number, ward, district, and date of the inspection.
• Occupancy and Arrangement: Spaces to indicate the type of occupancy (families or business) and arrangement of the building.
• Rubbish: Questions about the kind of rubbish and its location, like public parts of the building, areas, yards, courts, and roofs.
• Water Supply: Section to assess the water supply and suggest remedies.
• W.C. Flush: Checks if the water closet flush is adequate or inadequate and notes the type of apartment.
• Fire Passage Obstructed & F. E. Egress: Focuses on the passage for fires and its egress, with spaces to fill in details.
• Plumbing System & Plumbing Defects: Assessing the plumbing system as obstructed or not, along with the types of defects.
• Garbage Cans & Ash Cans: Looks at the material and adequate number of garbage and ash cans.
• Defects (Repairs): A section to document defects, including stairs, rails, roofs, gutter leaders, etc., along with their locations.
• Dangerous Conditions & Unlawful Use: Checks for dangerous conditions such as stability or the presence of rags and unlawful uses like moving pictures.
• Halls and Stairs: Rows to inspect the halls and stairs, detailing any rubbish, cleanliness, covering, or any need for painting or wallpaper.
• Remarks: A space to add any remarks or notes about the inspection.
• Footer: Contains the borough, form number, and an inspector's signature line.