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BUILDING DEPARTMENT
TOWN OF SOUTHOLD, N. Y.
HOUSING CODE INSPECTION REPORT
Location 32260 Main Road - Rt. 25 Orient
number & street Municipality
Subdivision Map No. Lot(s)
Name of Owner(s) Stanley Korolseki
Occupancy R - 1 Owner
type owner-tenant
Admitted by: Mrs. Koroleski Accompanied by: Mrs. Koroleski
Key available Suffolk Co. Tax No. 019-001-011.2
Source of request George C. Stankevich, Esq. Date Sept. 11, 1979
DWELLING:
Type of construction Wood #stories One
Foundation Poured Concrete Cellar partialCrawl space rest
Total rooms, lst. Fl Five 2nd. F1 3rd. Fl
Bathroom(s) One Toilet room(s)
Porch, type Deck, type Patio, type
Breezeway Garage Utility room
Type Heat Gas `'r~r-ra A~rsp~i~~dter Hotwater
Fireplace(s) No. Exits Airconditioning
Domestic hotwater Yes Type heater Gas
Other
ACCESSORY STRUCTURES:
Garage, type const. 2 car Storage, type const.
Swimming pool Guest, type const.
Other
VIOLATIONS: Housing Code, Chapter 52
Location Descri tion Art. Sec.
Kitchen Gas stove has - -2
Garage had a Building Permit issued 6/76 - #86232
Remarks• C.O. issued / 2802'7
Inspected by: ~ _ ~ Date of Insp. Sept. 13. 1979
Curtis Horton Time start1:30 end 1:45
FORM NO. 6
TOWN OF SOUTHOLD
Building Department
Town Hall
Southold, N.Y. 11971
APPLICATION FOR CERTIFICATE OF OCCUPANCY
Instructions
A. This application must be filled in typewriter OR ink, and submitted in duplicate to the Building Inspec-
torwith the following; for new buildings or new use:
1. Final survey of property with accurate location of all buildings, property lines, streets, and unusual
natural or topographic features.
2. Final approval of Health Dept. of water supply and sewerage disposal-IS-9 form or equall.
3. Approval of electrical installation from Board of Fire Underwriters.
4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and installa-
tions, acertificate of Code compliance from the Architect or Engineer responsible for the building.
5. Submit Planning Board approval of completed site plan requirements where applicable.
B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing"
land uses:
1. Accurate surrey of peoperty showing all property lines, streets, buildings and unusual natural or
topographic features.
2. Sworn statement of owner or previous owner as to use, occupancy and condition of buildings.
3. Date of any housing code or safety inspection of buildings or premises, or other pertinent informa-
tion required to prepare a certificate.
C. Fees:
1. Certificate of occupancy $5.00
2. Certificate of occupancy on pre-existing dwelling or land use $5.00
3. Copy of certificate of occupancy $1.00
Date ..August 14, 1979
New Building .............Old or Pre-existing Building XR Vacant Land .
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Location of Property ,(No Num}~er) P4ain Ro«d Orient
House No. Street Hamlet
Owner or Owners of Property ,Stanley & Jean Koroleski
County Tax Map No. 1000 Section . , , 019 ,Block , , 001 Lot , , O11
Subdivision .................................Filed Map No. ..........Lot No. .
Permit No. Date of Permit ..........Applicant .
Health Dept. Approval ........................Labor Dept. Approval .
Underwriters Approval ........................Planning Board Approval .
Request for Temporary Certificate .....................Final Certificate .
Fee Submitted $ . 5.00
Construction on above described building and p eets all ap a e co s a regulations.
Applicant , ,
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Rev. 10-10-78 O`~~/~~%~
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