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2024-370C limcl,, here To Search Our Public Records Database Before Submitting Request Forms Can Be Submitted via Email to Imcconolo trrtowtiof�,valal)in erny.gov or in person/via mail to 20 Middlebush Rd Wappingers Falls, NY 12590 FOR INTERNAL USE ONLY Received by: Joseph P. Paoloni. Lori McConologue Date Received: / / FML Ser. #: cj CD DEPARTMENT: ASSESSOR ACCOUNTING CODE ENFORCEMENT PLANNING ZONING FIRE INSPECTOR HIGHWAY RECEIVER OF TAXES RECREATION S [JPERVISOR TOWN CLERK WATERJSEWER DOG CONTROL OFFICER TOWN ENGINEER TOWN ATTORNEY TOWN OF WAPPINGER Application for Public Access to Records FOIL E0 T EN it f- .j n 71 ra n. " ,- 7 Bu88ding Dej)arir ent rown of UVV,,PP!rlger FOR DEPARTMENT USE ONLY Date Received by Dept Department head approval: Date Applicant Contacted: Date FOIL ilfilled r denied: / 1 Closed by: Date: 1"xe Dotes: 1 '� Amount Due: Pages for a total of Name: check here if you are Address: J requesting that the records be mailed to this address. Agency or film: Telephone #: ( ) - FAX #: ) - Email address: SPECIFIC DESCRIPTION OF RECORD: 4' FORMAT OF RECORD (if available) . I request to be notified when I can come to inspect the record(s) described above I request copies of the records described above and agree to pay the cost of such records in accordance with the fee schedule on the back of this application I request that the records be sent via email to the address listed above I request that the records be faxed to the number listed above VILLAGE OF WAPPINGERS FALLS Office of the Village Cleric Heather McCormick 2582 South Avenue, Wappingers Palls, NY 12590 Phone: (845) 297-8773 Fax (845) 298-2645 Email: foilre nests c,wappiaigersfallsny.gov �vww.wappingersfhlls� og_v .APPLICATION FOR ACCESS TO RECORDS I HEREBY APPLY TO REVIEW THE FOLLOWING RECORD(S): . F ire c1tai`c4L CgieS woWA e 6L -,-t fngi12 Name (Please Print) Representing (Business Name/Sel#) Signature (Original Signature Required) Telephone Date E-mail a 12,,al X601 Mailing Address Zip PLEASE TAKE NOTICE You have the right to appeal a denial of this application to the Records Appeals Officer. An appeal must be made within 30 days from the receipt of the denial and the Appeals Officer must fully explain the reason(s) for such denial in writing withip-10 days of receipt -of an appeal. Access to records is provided through the New York "Freed.orn of Information" Lava (Public Officer's law, Section 84-94), The law is administered by the NYS Committee on Open Gov: ernment (99 Washington Avenue, Suite 650, Albany, New York 1223 1) Telephone: 518-474-2518 'Please mail appeals to: Records Appeal Officer (2582 South Avenue, Wappingers Falls NY 1.25.9.0) .