HomeMy WebLinkAbout1000-59.-3-16.2 Of sout TOWN OF SOUTHOL
Rental Permit
T"I 0233
Owner: DRU PROPERTIES LLC
Occupied as: Single Family Dwelling
Located at: 1820 Kenneys Rd Southold 59.-3-16.2
Maximum Permitted Occupancy: 12
Is in compliance with all of the provisions of the code of the Town of Southold, the laws and sanitary and housing regulations of the
County of Suffolk and by the laws adopted by the New York State Fire Prevention and Building Code Council. Expiration is two (2)
years from date of issue. The operator is responsible for arranging for the bi-annual inspection.
Issued: 03/06/2025
Expiration: 03/06/2027 Co nforcem�tofffifi�cial
This Notice must be posted by the main entrance at all times
SO
TOWN OF SOUTHOLD BUILDING DEFT.
631-765-1802 5q-3 a
INSPECTION
[ ] FOUNDATION 1 ST/ REBAR [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION/CAULKING
[ ] FRAMING /STRAPPING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FIN L)
[ ] CODE VIOLATION [ ] PRE C/O [ RENTAL
REMARKS:
1-
�- Son OCGv
DATE INSPECTOR
TOWN OF SOUTHOLD-BUILDING DEPARTMENT
Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 11971 0959
Telephone (631) 765-1802 Fax (631) 765-9502httP :��� ww,soqth�aldto�wM, . i
F E B 2 8 2025
RENTAL PERMIT APPLICATION n ;
Rental Permit Fee $300 (Application must be renewed every two years)
Section A.
Property Information:
Rental Property Address:
Tax Map Number: 1000 SECTION 5 `J -BLOCK ,?�' -LOT -
SECTION B.
OWNER INFORMATION:
Property Owner Name: ®RU G`'G�al�c-aaTiCsS l---LI--
Property Owner Legal Address: Property Owner Mailing Address:
(Cannot be the same as Rental Property Address)
Loss _L/Z
M� A/ P
Telephone Number (s): Daytime ,Evening .Emergency
Property Owner Email Address:
ov r5, /-�Z A 4Z�o H/ , G z5 Al
* 2co
'PS a - I _�Pkf
rzuC 100) L[y--I
Page 1 of 4
SECTION F.
PROPERTY DESCRIPTION:
Number of Rental Dwelling Units on property: 6701JL.
For each Rental Dwelling Unit set forth the Rental Dwelling Unit identifier(for example,
Unit 1, Unit 2, Unit 3 or Apt A, B, C); the use of each room in the Rental Dwelling Unit
(for example, Kitchen, Bedroom 1, Bedroom 2, Living Room) and the dimensions of each
room.
For properties with multiple Rental Dwelling Units use "Rental Permit Application
Addendum."
Rental Dwelling Unit Identifier: L, tj / T
Requested Maximum number of persons allowed to occupy Dwelling Unit:
Number of rooms in Rental Dwelling Unit:
Use and Dimensions of each room in Rental Dwelling Unit: m/'4- A
03 RK i=5% R M SST, �°'.� t�� ��' " b Sf- � �VI AJe,� /,'M ,l L s
NNNI/J& ;"' A F a -lam , 63etikM A°""roko 6 _ 2 ,W D
SECTION G.
INSPECTION:
Pursuant to the Town Code of the Town of Southold Chapter 207 (Rental Properties), a safety
inspection by Code Enforcement Official is required. If the owner chooses not to have said
inspection performed by the Town, a certification from a licensed architect, a licensed
professional engineer or a home inspector who has a valid New York State Uniform Fire
Prevention Building Code Certification is required stating that the property which is the subject
of the rental permit application is in compliance with all of the provisions of the code of the
Town of Southold, the laws and sanitary and housing regulations of the County of Suffolk and
by the laws adopted by the New York State Fire Prevention and Building Code Council.
❑ 1 am requesting a fire safety inspection to be performed by a Code Enforcement Official
from the Town of Southold
❑ I am submitting a completed Town of Southold certification form from a licensed
architect or a licensed professional engineer.
Page 3 of 4
SECTION H.
DECLARATION: Signature must be notarized and MUST be the owner of the dwelling unit.
STATE OF NEW YORK)
)
COUNTY OF SUFFOLK)
i ��✓/s / w certify under penalty of perjury, the following:
1. 1 am the owner of the property identified in "Section A" of this application.
2. The property owner's legal address set forth in "Section B" of this application is my legal
address and I understand the Town will use the address for service pursuant to all
applicable laws and rules. I further acknowledge that I will notify the Town of Southold
Building Department of any changes of address within five (5) days of any changes
thereto.
3. 1 have read and received a copy of Chapter 207 of the Code of the Town of Southold and
agreed to abide by the same.
4. 1 will notify the Town within five (5) business days s to any change to the information
regarding Authorized Agent, Managing Agent, or Site Manager.
Property Owner's Name: < _ �- A "
Property Owners Signature: , .. „° """
C,
Sworn to before me thisZL` dy of ` 0 20
aa
Official Notary Public Signature and Original Notary Stamp
C: 'NNIE D.BUNCH
Notary Public,State of New York
No,01 BU6185050
C?uallfled In Suffolk County
Commission Expires April 14, -�-`
Page 4 of 4
re
Town Hall Annex � �T, Telephone (631)765-1802
54375 Main Road {°,, Fax(631)765-9502
P. O. Box 1179 a`
Southold, NY 11971-0959
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
RENTAL PROPERTY CERTIFICATION
Form is to be completed by a licensed architect, licensed engineer or licensed home inspector
Separate form is required for each individual Rental Dwelling Unit
Professional seal re aired for Architect or Engineer, Licensed Home Inspector mnust
provide copy of valid current certification
Rental Property SCTM Number:
Rental Property Address: ;)-0 1��VA1 '!2)0 7 t
Owner/Name: &W PR0P,9-RT1&S
Rental Dwelling Unit Identifier:
Number& Square footage of each bedroom as depicted in the attached floor plan;
(i.e. Bedroom#1 — 100 sgft., Bedroom#2—90 sgft., etc.)
Property Description (Include all improvements indicated on survey)
I certify that I have done a physical inspection of the subject rental dwelling unit and find that it fully
complies with all the provisions of the Code of the Town of Southold, the Residential Code of New York
State, the Building Code of New York State, the Plumbing Code of New York State, the Fuel Gas Code of
New York State,the Fire Code of New York State, the Property Maintenance Code of New York State
and the Energy Conservation Construction Code of New York State.
Print Name and Title Original Signature
Please place Professional Seal:
I
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�� � TOWN OF SOUTHOLD
e
Rental Permit
0233
Owner Louis Vircillo & Ors.
Occupied as Single Family Dwelling
Located at 1820 Kenneys Road Southold 59.-3-16.2
Maximum Permitted Occupancy 12
Is in compliance with all of the provisions of the code of the Town of Southold, the laws and sanitary and housing regulations of
the County of Suffolk and by the laws adopted by the New York State Fire Prevention and Building Code Council. Expiration is
two (2) years from date of issue. The operator is responsible for arranging for the bi-annual inspection.
12/28/2023
Code E€M rce nt Official
This Notice must be posted by the main entrance at all times
q
OLD BUILDINGDEPT.
.1802 3--/�.�-
T 10
[ ] ROUGH PLBG.
[ ] INSULATIOWCAULKING
[ ] FINAL
[ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
] CODE VIOLATION [ PRE C/O [ 14° RENTAL
REMARKS: _4�t�
ly
DATE ff 3 - INSPECTOR
��
Town Hall Annex
Town of Southold 54375 Main Road
PO Box 1179
Rental Inspection Report
Southold, NY 11971-1179
4li5> +1 ► 14�' Tel: 631-765-1802
SCTM# W G . Date
Owner / a Phone
Address « O Visible
Inspector
Hamlet .m �
Floor Level Quantities �� Y1Te1 Sub 1 2 3 i
_.._
Smoke Detectors (no ,.. i
t located n bedrooms)
Carbon Monoxide Detectors
Fire Extinguishers
Exits
s
Bedrooms,
Smoke Detector,; � 3 4 '._ 3
_ _ _
V
Egress
Occupant Count �- -
Building Systems Maintained & Operational Condition of Property
Heating Building interior
Hot water Building exterior
Electrical Property clean, maintained &safe
Mechanical Handrails &guards installed & secure
Pool Safety o
Date on Site
Surface water alarm ce doh
f CO issuana,w. .._. �•. _m w
Door alarms completely d
._.... _. Pool comletel enclosed
Self closing/ _e
latching gates Pool fence to code requirements
CO's for all items present Prior Rental
Comments: _
TOWN OF SOUTHOLD
ki
Rental Permit
>_
0233
Owner Louis Vircillo & Ors.
Occupied as Single Family Dwelling
Located at 1820 Kenney's Road Southold 59-3-16.2
Maximum Permitted Occupancy 12
Is in compliance with all of the provisions of the code of the Town of Southold, the laws and sanitary and housing regulations of
the County of Suffolk and by the laws adopted by the New York State Fire Prevention and Building Code Council. Expiration is
two (2) years from date of issue. The operator is responsible for arranging for the bi-annual inspection.
12/28/2021
Code Enforce t Official
This Notice must be posted by the main entrance at all times
Town Hall Annex
54375 Main Road
z of PO Box 1179 Southold,
Rental( 1 5 gi n1 NY 11971-1179
Tel: 631-765-1802
Fax 631-765-9502
o
�SCTM # Date
Owner Z-OW '_ G`S Phone / `5-69 a
(Address ..o N .,. Zip
Hamletw( _o Inspector
Address visible from street?
........LEVELS SUB 1 2
Smoke Detectors (#-bedroom detectors excluded)
Carbon Monoxide Detectors
Fire Extinguishers(#)
Exits (#)
Smoke Detector Alarms (#)
Carbon Monoxide Alarms (#)
Egress (windows)...( "/d ')
BUILDING TCONDITION F
Heating system maintained/operational Building Interior is clean/maintained
Hot water system maintained/operational Building Exterior is clean/maintained
Electrical system maintained/operational Property is clean/safe/maintained
Mechanical system maintained/operational Handrails &guards present
POOLS
POOL BARRIERSYIN
Pool present Pool is completely enclosed
Pool surface alarm and/or door alarm Barrier is a min.48" high
resent
POOL GATES Y N All openings in barrier less than 4"
Self-closing, self-latching Max. 2"clearance @ bottom of barrier
Latch on pool side of gate, meets height Barrier capable of being locked &child-
requirements proof when unattended
COMMENTS:
Isidore Miller and Luis Vircillo
1820 Kenney road MOM �
�,.�:��4 114�"VII::SOUTH .,.N�:uU...D
Southold NY 11971
November 15, 2021
To The building department,town of southold.
This is Isidore Miller, I am the owner of the property located at 1820 kenneys road southold NY
11971. 1 have attached our current rental permit and am writing to request a renewal of the permit. I
have also included a$200 check for the permit fee. Please contact me, Isidore Miller at(917) 509-8866
in order to schedule the inspection if needed.
Additionally there have been no changes to the home or certificate of occupation since the last rental
permit was issued.
Thank you in advance for the help.
Isidore Miller
TOWN OF SO T OL
-We3Rental Permit
�s
e
Permit No. 0233
Owner Louis Vircillo & Ors.
Occupied as Single Family Dwelling
Located at 1820 Kenney's Road Southold 59-3-16.2
Address Village S/13/1-
Maximum
/B/LMaximum Permitted Occupancy 12
Is in compliance with all of the provisions of the code of the Town of Southold, the laws and sanitary and housing regulations of
the County of Suffolk and by the laws adopted by the New York State Fire Prevention and Building Code Council. Expiration is
two (2) years from date of issue. The operator is responsible for arranging for the bi-annual inspection.
11/20/2019 John Jarski
Date of Issue Code Enforcement Officer
This Notice must be posted by the main entrance at all times
Town Hall Annex T (631)765-1802
54375 Main Road
P.O.Box 1179 Fax(631)765-9502
5
Southold,NY 11971-0959 `
BUILDING DEPARTMENT
RENTALTOWN OF SOUTHOLD
PERMIT APPLICATION
Rental Permit Fee$200(Application must be renewed every two years)
Section A.
Property Information:
Rental Property Address:
Tax Map Number: 1000 SECTION
-BLOCK 3 -LOT
SECTION B.
OWNER INFORMATION:
Property Owner Name: °°,.,e fie r
Property Owner Legal Address: Property Owner Mailing Address:
q� 11 LAV
u
Telephone Numbers : Daytime � el ing rv�"y Ernergen y
Property Owner Email Address: Id
,J IJ L 2 3 201
Page 1 of 5
;1 'W"STT TRAT(; 1)F
Town Hall Amex
18W.
54375 Mam Road x(�( 1)765 9502
P.O.Box 1179
Soudiold,NY 11971-0959 4111 0 a�
BUELDING ENS
TOWN OF SOUTHOLD
Section C.
Authorized Agent Information:
Name riz ® @ if any.
Address ° P.O. Boxes):
Mailing Authorized
Telephone Number ® Daytime Evening_
Email Address:
Section 0.
Managing Agent Information:
Name of Authorized i ,if
Address ized Agent(no P.O. Boxes):_,.__..._.....
Mailing riz
Telephone Number(s):Daytime Evening_Emergency_—
i s®
SECTION E.
SITE MANAGER INFORMATION:(required for rental properties containingr more rentalunits)
Name of Managing Agent of dwelling unit, ..._.._...... ..................
Address of Managing AgentP.O. Boxes)-_--.-....
Page 2 of 5
Town Hall Amex Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
r
P.O.Box 1179 mm
Southold,NY 11971-0959 "
eo �v
BUILDING DEPARTMENT
TOWN OF SOUMOLD
Mailing Address of Managing Agent:
Telephone Number(s):Daytime Evenine Emergency
Email Address:
SECTION .
PROPERTY DESCRIPTION:
Number of Rental Dwelling Units on property:
DA 4 '1
For each Rental Dwelling Unit set forth the Rental Dwelling Unit identifier(for example,
Unit 1, Unit 2, Unit 3 or Apt A, B,C);the use of each room in the Rental Dwelling Unit
(for example,Kitchen, Bedroom 1, Bedroom 2,Living Room)and the dimensions of each
room.
For properties with multiple Rental Dwelling Units use"Rental Permit Application
Addendum."
Rental Dwelling Unit Identifier:
Requested Maximum number of persons allowed to occupy Dwelling Unit
m
Number of rooms in Rental Dwelling Unit:
Use and Dimensions of each room in Rental Dwelling Unit.-40 '4 "I,
(61
Page 3 of 5 .,
gg-
t
Town Hall Annex �p1 'f (631)765-1802
54375 Main Road Fax(6-31)765-9502
Pe0_Box 1179
Soudtold,NY 11971-0959
,S
EUn,DJNG DEPARTMENT
i°
TOWN OF SOUTHOLD
SECTION G.
INSPECTION:
Pursuant Properties),a safety
inspection i ss not to have said
inspection " a certificationlicensed rclicensed
professional engineer or a home inspector who has a valid New York State UniformFire
Prevention ing Code Certification is requiredi that the property whichis the subject
of the rental i i is in compliance with all of the provisions
Town of ®the laws and sanitary and housingregulations County of Suffolk and
by the s adopted by the New York State Fire PreventionBuilding i .
safety inspectionOfficial
from the Town of Southold
submitting i t i
architect or a licenseds ® i
DECLARATION:SECTION H.
zdwelling unit.
STATE
COUNTY OF SUFFOLK)
1 certify under penalty of perjury,the following:
1, 1 am the owner of the property identified in "Section A"of this application,
® s legal address set forth i is application is my legal
addressill use the address for service r t to all
4
Town xTdcphow oiuC ( 1)7
65-1802
375 Main Road Fax( 1)765-9502
P.O.Box 1179
Southold,NY 11971-09.5
BUILDING DEPARTMENT
TOWN OF SOUTMOLD
applicable laws and s® I further acknowledge
Building changes of address changes
p 1 have read and received a copy of Chapter 207 of the Code of the Town of Southold and
abideagreed to same.
® 1 Will notifybusiness days as to any change
regarding Authorized , Managing Agent,or Site Manager.,
� r
t�✓
Pe
Property Owner's Name:
Property sSignature:
Sworn to boa e this d of 4' 20
�W
Official ` Public Si tu re ar ori inial Notary Stamp
�r� r01t:.;.Ri� iJl
t i, rl of (
Page S of S
w0 s Maio la
TOWN OF SOUTHOLD BUILDINGT.
765.1802
xLL
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
] FOUNDATION 2ND [ ] INSULATION
] FRAMING /STRAPPING [ FINAL
� !
] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
] CODE VIOLATION [ ] CAULKING
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Town Of Southold
P, 1179 1 /5/21
� w53095 Main Rd
Southold,
eYork 11971
........ ........._.m........ ,..._ .,..
OCCUPANCYCERTIFICATE OF
N®: 37816
Date: 10/5/2015
THIS CERTIFIES that the building SINGLE FAMILY DWELLING
Lai _
I� a Southold
473889 at® 59s 3-16—11 ,2
-..
......... . .. ...........
Subdivision: l p No.
�.....__ ..� ..._.,,,._ .. _., t Nom
conforms substantially to the Application for Building Permit heretofore
filed in this office dated
1/1/1900 Pursuant to which e o. 39986
® _ dated 8/4/2015
was issued, to all of the requirements of the applicable provisions of the law® The occupancy for
which ft is issued is:
lPl�l 11dl_ l "1"w .. I�. l�l'l' f m wllN:
The certificate is issued t o, _ .. e
_. '�...
,.—._a...
®f the aforesaid building,
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
10®05 223 9-11®2015
39986 08-12-2015
PLUMBERS
CERTIFICATION D10-28 1-20..14
�. �ay .
� 1 F0j&- � Town of Southold ..� 4/29/2016
P.O.Box 1179
C5
53095 Main Rd
Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 38278 Date: 4/29/2016
THIS CERTIFIES that the building AS BUILT ALTERATION
Location of Property: 1820 Kenneys Rd, Southold
SCTM#: 473889 Sec/Block/Lot: 59.-3-16.2
Subdivision:
Filed Map No. Lot No.mW.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
2/19/2016 pursuant to which Building Permit No. 40498 dated 3/1/2016
was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for
which this certificate is issued is:
"AS BUILT"BASEMENT ALTAN l' IST] TO ONE T4lIL I3 1 L1 w a T?AN E� I TING
ON r
FAt4&Y DWELLING liTs AS APPLITED bOI
The certificate is issued to Vircillo,Louis
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
. ............ � �. ...
ELECTRICAL CERTIFICATE NO. 40498 0 3-23-2016
PLUMBERS CERTIFICATION DATED
..
Aut ed. Si htut
Town of Southold 8/23/2016
P.O.Box 1179
53095 Main Rd
Southold,New York 11971
CERTIFICATE OCCUPANCY
ran
No: 38459 Date: 8/18/2016
THIS CERTIFIES that the building IN GROUND POOL
Location of Property: 1820 Kenneys Rd, Southold
SCTM#: 473889 Sec/Block/Lot: 59.-3-16.2
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
3/18/2016 pursuant to which Building Permit No. 40563 dated 3/25/2016
was issued,and conforms to all of the requirements of the applicable provisions of the law. The occupancy for
which this certificate is issued is:
ACCESSORY 1N-GROUND SWIMMING MING 1'O(&L,11:NC ED
TO C ODl AS AF4)11ED 1 Old
The certificate is issued to Vircillo,Louis
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 40563 05-10-2016
PLUMBERS CERTIFICATION DATED
Auth -d Sig at c