The inebriate asylum was originally T-shaped in plan, with a main wing, called the "west building", facing the City of Binghamton and a secondary brick service wing, or "east building", extending eastward from its center.

View of Binghamton from the Asylum

The plan of the west building or wing, the portion of the asylum that survives today, was centered on a four-story central administration core, or transept, containing a staff dining room, apothocary, and sleeping quarters for the medical staff in the basement; the superintendent's office and living quarters, trustee's room, and reception room on the first floor; three parlors and a library on the second floor; and a two-story chapel with additional staff sleeping quarters on the third floor.