112/~
tM^
FOR INTERNAL USE ONLY
Received by: Chris Masterson ^
Christine Fulton ^
Date Receiv ~ /
FOIL Ser. #:
DEPARTMENT:
ASSESSOR C~
ACCOUNTING ^
CODE ENFORCEMENT L'F
PLANNING ^
ZONING ^
FIRE INSPECTOR C~
HIGHWAY ^
RECEIVER OF TAXES ^
RECREATION ^
SUPERVISOR ^
TOWN CLERK C~
WATER/SEWER ^
DOG CONTROL OFFICER ^
TOWN ENGINEER ^
TOWN ATTORNEY ^
2009-10-16 JCM
TOWN OF WAPPINGER
Application for Public Access to Records
F~IL REQUEST,
Jfu tonQtowriofwappinger.us
FOR DEPARTMENT USE ONLY
Date Received by Dept
Department Head approval: ~ / ~ /
t~~-
(init)
Date Applicant Contacted: ~ / ~Y'/
Date FO fulfille ~ denied: ~ / ~~/
Closed by: ~ ~ ~'
Date: N~ /~ /
Notes:
Amount Due: Pages for a total of $
Name: Sharon Froedden for Emily Pereira [~ check here if you are
Address: 21 Fox street requesting that the records
Poughkeepsie, NY 12601 be mailed to this address.
Agency or firm: The Chazen Companies
Telephone#: ( 845)454 - 3980 FAX#: (845) 454 -4026
Email address: epereiraUchazencompanies . com
SPECIFIC DESCRIPTION OF RECORD:
All records for the Agustin and Jane Rodriguez Property (Fomer LaFonda Del Sol
Restaurant) located at 601 Old Route 9N. Tax ID~6157-02-542585. Pertinent informa
from the Assessors office, Building Department, and Fire Departments includes
current and historical ownership cards, ownership history, building permits,
site plan maps, records of fires, records of petroleum/chemical storage, etc.
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
C~ I request that the records be sent via a-mail to the address listed above
C~ I request that the records be faxed to the number listed above
ion