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062
I
2009-10-16 JCM
TOWN OF WAPPINGER
Application for Public Access to Records
FOIL REOUEST
FOR INTERNAL USE ONLY
Received by:
Chris Masterson 0
Christine Fulton 0
Sue Rose '~
1L/8~/ & ()
Date Received:
FOIL Ser. #: to ()
DEPARTMENT:
ASSESSOR ~
ACCOUNTING 0
CODE ENFORCEMENT RQ
PLANNING :f9
ZONmNG RQ
FIRE INSPECTOR ~
illGHWAY 0
RECEIVER OF TAXES 0
RECREATION 0
SUPERVISOR 0
TOWN CLERK 0
WATER/SEWER m
DOG CONTROL OFFICER 0
TOWN ENGINEER RQ
TOWN ATTORNEY 0
FOR DEPARTMENT USE ONLY
Date Received by Dept
Department Head approval:
/ /
(init)
Date FOIL
Closed by:
Date:
Notes:
Amount Due:
Pages for a total of $
Name: Robert McCarthy
Address: 54 Tuttle Place
Middletown. CT 06457
Agency or finn: VHB
Telephone#: ( 860)632- -1500
Email address: rpmr.r.;:n--thv@lvnh r.nm
o check here if you are
requesting that the records
be mailed to this address.
FAX #: ( 860) ~- 7879
SPECIFIC DESCRIPTION OF RECOED:
We are comp~et1ng an env1ronmental assessment for the property:
1324 Route 9 (southeast corner of Old Hopewell Road)
and request any historic records related to Site use, ownership,
Occ~ancy. hazardous material storage or handling. and sewer and
water svstem connection details.
FORMAT OF RECORD (if available)
~ I request to be notified when I can come to inspect the record(s) described above
o 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 e-mail to the address listed above
o I request that the records be faxed to the number listed above