B-Y
DIST
DATE
WARD
No.
STREET
LOCATION
BUILDING
BAKERY
Front
Cellar
North
South
West
Side
E ase
Fear
East
Entire
Part
Occupies
Date of Erection
Non-Fireproof
Fireproof
or
Other Business
and Fat Boiling Height
OVEN
Hood over
Separate flue
Court
Inside
Street
Yard
Used as egress from yard
OPENINGS INTO BUILDING
Elevator shaft
Dumb-waiter shaft
Stairs
Windows
Transoms
Doors
DESIGNATE BY LETTERS ON DIAGRAM Number
CEILING
Concrete
FILLING
Brlck arches
Hollow tile
FIREPROOF
I Beams
Plaster on metal lath
Plaster board
Lath and plaster
Metal
NON-FIREPROOF
Sheathed
Open Jonts
EXPOSED GIRDERS
EXPOSED POSTS
Location
Number
Material
Locatlon
Number
Material
DESIGNATE BY LETTERS ON D1AGRAM
DESIGNATE BY LETTERS ON DIAGRAM
FLOOR
Concrete
Cement
Tile
Cobble
Flegging
Asphalt
Brick
MATERIAL
Earth
Wood
Wood over aoncrete
Dry
Wet
Water
WATER-TIGHT
Damp
LIGHTING AND VENTILATION
WINCOWS Number
Court
Shaft
Open on Street
Yard
Black
ADEQUATE
Light
Dim
Dark
ocaton
ERS ON DIAGRAM
DESIGNATE
REMARKS
WALLS AND PARTITIONS
Metal
Covered
Plastered
Sheathed
Brick
Stud
Diagram
Stone
Location
WATER CLOSETS
Number
Location
Separate room
Front
Partition to celing
Rear
VENTILATION
Yard
Court
Shaft
Open on street
Side
Kind
fixtures
Open
Waterproof floor
Kind
Base
Side
SINK
In bakery
Water supplied
Flushed
Open
(OVER)
137-28-14 (n 000
FORM 1019