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Home My WebLink About1000-104.-11-14 of SO& TOWN OF SOUTHOLD Rental Permit COO 1455 Owner: Daniel Krueger , Michelle Krueger Occupied as: Single Family Dwelling Located at: 620 Wunneweta Rd Cutchogue 104.41-14 Maximum Permitted Occupancy: 6 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: 05/04/2026 Expiration: 05/03/2028 cod fo g t modal This Notice must be posted by the main entrance at all times w � A 15 2026 TOWN OF SOUTHOLD—BUILDING DEPARTMENT Town Flall ,Annex 54375 Main load P. O. Box 1179 Southold,NY 11971-0%* ,, Telephone (631) 765-1802 Fax(631) 765-9502 litt.s:f/www sotitholdtctwnt1 i�ov c" RENTAL PERMIT APPLICATION Rental Permit Fee $300 (Application must be renewed every two years) Section A. Property Information: Rental Property Address: 620 Wunneweta Rd Cutchogue,NY 11935 Tax Map Number: 1000 SECTION 1000 -BLOCK 104 -LOT 11 _ 014 1000-104-11-014. SECTION B. OWNER INFORMATION: Property Owner Name: Dan and Michelle Krueger Property Owner Legal Address: Property Owner Mailing Address: (Cannot be the same as Rental Property Address) 4051 Preserve Pkwy S Greenwood Village, _ 4051 Preserve Pkwy S CO 80121 Greenwood Village,CO 80121 Telephone Number (s): Daytime 708-932-2144 Evening Emergency Property Owner Email Address: dan@ellysteam.org michelle@ellysteam.org Page 1 of 4 Section C. Authorized Agent Information: / Name of Authorized Agent of dwelling unit, if any: U H N Address of Authorized Agent (no P.O. Boxes): , F� Mailing Address of Authorized Agent: �` Telephone Number (s): Daytime Evening Emergency Email Address: Section D. Managing Agent Information: Name of Authorized Agent of dwelling unit, if any: Address of Authorized Agent (no P.O. Boxes): Mailing Address of Authorized Agent: 91-7 `7 1 Telephone Number (s): Daytime Evening Emergency Email Address: ��/ SECTION E. SITE MANAGER INFORMATION: (required for rental properties containing 8 or more rental units) Name of Managing Agent of dwelling unit, if any: Address of Managing Agent (no P.O. Boxes): Mailing Address of Managing Agent: Telephone Number (s): Daytime Evening Emergency Email Address: Page 2 of 4 SECTION F. PROPERTY DESCRIPTION: Number of Rental Dwelling Units on property: 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, Q 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: Unit 1 Requested Maximum number of persons allowed to occupy Dwelling Unit: 60 Number of rooms in Rental Dwelling Unit: 5 rooms Use and Dimensions of each room in Rental Dwelling Unit: 3 bedrooms (dimensions listed in floorplans) 1 family room 1 kitchen 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. I 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) 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: Yl1►� V Property Owner's Signature: Sworn to before me his 3l day of r d , 20Zp ffi al Notary P lic Signature and Original Notary Stamp GRACE MUNROE NOTARY PUBLIC STATE OF COLD DO NOTARY ID 20234022863 MY COMMISSION EXPIRES June 16,2027 Page 4 of 4 so TOWN OF SOUTHOLD BUILDING DEPT. 631-765-1802 /OX-//-/<1 I N VIM r E 6"�`T 10 N [ ] FOUNDATION 1ST/ REBAR [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION/CAULKING [ ] FRAMING / STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O [ �NTAL REMARKS: ^5 s . & o o rn coo joa DATE INSPECTOR 0 44 A Town Hall Annex Town of Southold 54375 Main Road Rental Inspection Report PO Box 1179 m� " ze Southold, NY 11971-1179 Tel: 631-765-1802 SCTM# - Date M Owner Phone Address ? , " , Visible Hamlet Pnspector Floor Level Quantities Sub 1 2 3 Smoke Detectors (not located in bedrooms) Carbon Monoxide Detectors Fire Extinguishers Exits Bedrooms 1 2 3 4 5 6 Smoke Detectors 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 Pool on Site Surface water alarm Date of CO issuance aool Door alarms Pool completely enclosed Self closing/ latching gates Pool fence to code requirements P- I ' COs for all items presents %/fs. f%j,// t ��%// Comments: i 'SOWN OF UTHOL PROPERTY RECORD CARD � ZLJ � Z lfE f OWNER 'STREET VfLLAGE DIST SUB. LOT At FO RMER fah' iNER ; N 76 b( •t � l �C1lUal Vie:/fit = 5 W l TYPE OF BUILDING RES_ SEAS. VL- rARMA # cis f � - LAND =. IMP- TOTAL GATE REMARKS / (t`GE S- � 8 11�1 'IN ' t� D TjO; - - _a IX- A� of -- rv, If �. Tillable 1 10 Tillable 2 Tillable 3 Woodland Swampland FRONTAGE ON WATER I .Brushlond FRONTAGE ON ROAD Haase Plot EDEPTH _ r . � s - ry ULKHEAD Total (DOCK 3 e �j 7, f v a COLOR _ � a o� . 3 TRIM _` _ _ r r £` c _ s 3 3 a 104,11-14 3/13/2025 f41 ,Bldg. _a 0�.#d_ � _ -- Dinette �� ; s math 'C� tte Extension o w ,i �. �nsernent Roars K. _a� Extension xt, Walls !Interior Finish = �._ to LR�� t o Firt� Place �4 f� v Rooms 1st Floe _ R w _ m •fie R�,a � _ T+ d Floor .1 B Parch � �u ,� ��reot�� ,Rooms `?n: eor' „e. �Fi ^ x T f Dormer � [ rig w . ,e •ay / Garage Patio p 7 4 Total ? +. f f } t 1 FORM NO.4 TOWN•Ol~SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hail Southold,N.Y. Cerfificafe Of Occupancy No. ........ .. Date . . ....$PFM .. .. ... ......... .... THIS CERTIFIES that the building ...geV. del I)q..... ............ .......... ... Location of Property M9 ......... Wur�newa a Rd:......w ,Cutehoq ee .Y w .*G 4 * N M M. ♦• a R rt �'lOOddf '�d?. 1LT County Tax Map No. 1000 Section ...109_ _...Block . . .11..........Lot ...4 ,,,,•,,,,, Subdivision.Mak).A N4spA .point..., ;,.Filed.Map No. x5 ....Lot No. .298...... .. conforms substantially to the Application for Building Permit heretofore filed in this office dated . .... ... 19 84 pursuant to which Building Permit No.,.13415.Z.... w ....... dated ....,Sept;•••••.. ,,..••.... 19 89;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 ......... ......G41►16. � � � iv,�tg,One,Farm}ly,Dwell;in9.. .............. ... ...... ... .. The certificate is issued to ............. 10;ne,• • ........ . ......... of the aforesaid building. Suffolk County Department of Health Approval ...... 14-50 179 ,,,,,,,,,,,, ,,,,,,,,,,, UNDERWRITERS CERTIFICATE NO.. ............ Pending.... ....... .......... .. .. . . .. .. �..... ..... ........ . BaildinWInspector Rev.1/01 FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPART office of the Building Inspector Town Bali Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-32536 Date: 0R 20 07 TBIS (NMTIFINS that the building CR W1ktO POOL Location of Property: 620 RD (ROUSE NO.) (STREET) (HAMLET) County Tax Hap No. 473089 Section 104 Block li Lot 14 Subdivision Filed leap No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 25 2007 pursuant to which Building Permit No. 33111-Z dated JUNE 6 2007 was issued, and conforms to all of-t M-requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is SWIMMING G 1 7he certificate is issued to BAS1L ASCIUTSo (OWNER) of the aforesaid building. SUFFOLK CODNTYDOPARTIGM OF MMTS APPROVAL _ N/A .. S CEr=ICATN NO. 730� 07 23 07 pLMMSRS CNRTIFICATIox nATED N A JAM.,— thorized Signature Rev. 1/81 r P f M, i i a 3N Tj �`— LIX t t t t f1K r LTAll- F Tva 3 s FREDERICK RoBmr WEBER ARCHITECT --------------- -------------------- ----------------------------------- ----------- ------------------- ---------- Awl 41 i r T= it a 1011111ATi011 it 1 5- 71 ------ B, RENOVATION N;; KRUEGER RESIDENCE AICHITVCT, M'T MLA"A-01 RINI I T. TM .1 1—.- -ix, -CUNDA ION F L A N E p! -A- 'I- EGRESS WINDOW DETAIL A2 7Kil�D L .1 Al WUNNeE�� Roar ROAD LINE 19 AN IRREDULAR IX1RVE � '"'�..�.,�, i V m L4 t �+ 11/ Stye 20.17 1 0apL1k x PuW b�tll SrY arE o BA m LOT=a 3 m us m b to LOT 86 2 ON �"AMENDED MAP A OF NASSAU POINT" Z mi ja SITUATE AT CUTCHOGUE TOWN OF SOUTHOLDSUFFOLK �NEW YORK , poAo FILED:AUGUST COUNTY ,,1922.MAP No.156 t430zo CERTIFIED TO:DANIEL JOSEPH KRUEGER MICHELLE RIPPLE KRUEGER CITIZENS BANK FIDELITY NATIONAL TITLE INSURANCE COMPANY mseuavv wieam�r�eswmwkeono�nwxmnrE rnoao..w�cne�aooriraxnawremecanmcu�owm+v nior�sso0wwuwowmaraRs. clannumMmuuiAw oarTona�ma�na�w�tA1s�wmaa�moia amwo��maexarmwrewe naa7lbCiovgon��war.w�ognwwonaworc000.�.wwo►aon�us«mmwrrtm SCALE 1''4P 01 imDllagtl A►A ew rmws e1 a aam�lr =lrM 1OW0120.11A0"4M Sit 16 2= LAND SURVEY LONG ISLAND.COM WARD BROOKS LAND SURVEYOR 11 OCEAN AVENUE . BLUE POINT, NY. 11715 (631)576-7794 (631)363-3179 , WARDBROOKSO@,GMAIL.COM ~ �~ FI.EO 1000 Df r X ��,asatw t x e., l r M AY 202 am A �s 1 v- 1 g ' �� i . ,, f��,� (�� „�� i i///„/ ��%%�� %�/ � /,// � � /,��/,, ;;,i�,`�fa�« �ij / / j„,�„�i�,,,,, /��/ ��iii 6r„i iiii l�i�/i i /��/i � `� riiiiii �� i� �j%✓ �/ji/�� f� /ai r � i �/�ii f��iii/r��l Q //�/ /�� _��/�/%?//�/i//o/ �%�� // !�%1 i�,� ,,, f�/ i t /,/��%i,,,,%�,� l „ �� i�D//i�i///i/�i%i�%//�l �,� ,„ z„ ,� � i: J �� rrrr r,/oir/,rrrr ii j ! /0001