How do I submit the Application to Access Records?

Email the completed form to ehs@dutchessny.gov, drop it off at the Department of Health office, or mail it to 85 Civic Center Plaza, Suite 106, Poughkeepsie, NY 12601.

What information should I include in my records request?

Provide applicant contact information, parcel details, the types of records requested, and relevant date ranges. The instructions say the department accesses records by tax map number, project name, address, and subject matter.

Are there fees for copies of records?

The form lists fees of $0.25 per letter- or legal-size page, $4.00 for maps, and $4.00 for flash drives if applicable. Copying fees must be paid before records are released.

Dutchess County, NY · Dutchess County

No notary required

Application to Access Records

Dutchess County residents and businesses use this application to request Department of Health records related to parcels, facilities, investigations, and other listed subjects.

At a glance

Issued by: City of Dutchess County · Dutchess County, Dutchess County, New York
Notarization: Not required: file this form without a notary.
Official source: dutchessny.gov
Blank form: Download the PDF
Catalogued: Oct 5, 2026
Machine-readable: JSON record · about the forms index

What this form is

Use this application to request records maintained by the Dutchess County Department of Health, including septic, well, public water, complaint investigation, and regulated facility records. Identify the parcel and specify the record type and any relevant date range to help the department locate the information. The form asks for applicant contact details and parcel information, and the instructions list copy fees that may apply.

Who needs it

Residents, businesses, or other applicants seeking records maintained by the Dutchess County Department of Health can use this application.

How to submit it

Email the completed form to [email protected], drop it off at the department office, or mail it to 85 Civic Center Plaza, Suite 106, Poughkeepsie, NY 12601.

About notarization

No notary is required; the form asks for an application date and does not identify any notarized attachment or sworn step.

How to submit this form

1
Download the Application
Download the Application to Access Records PDF.
2
Complete the Form
Enter applicant details, parcel information, and the specific records and date ranges you are requesting.
3
Gather Relevant Details
Use the parcel tax ID and provide project, address, or subject information as applicable to help locate the records.
4
Submit to the Department
Email, drop off, or mail the completed form to the Dutchess County Department of Health using the contact details on the application.

Frequently asked questions

Do I need a notary for the Application to Access Records?: No. The application asks for an application date and does not identify any notarized attachment or sworn step.
How do I submit the Application to Access Records?: Email the completed form to [email protected], drop it off at the Department of Health office, or mail it to 85 Civic Center Plaza, Suite 106, Poughkeepsie, NY 12601.
What information should I include in my records request?: Provide applicant contact information, parcel details, the types of records requested, and relevant date ranges. The instructions say the department accesses records by tax map number, project name, address, and subject matter.
Are there fees for copies of records?: The form lists fees of $0.25 per letter- or legal-size page, $4.00 for maps, and $4.00 for flash drives if applicable. Copying fees must be paid before records are released.

Need something notarized?

This Application to Access Records doesn’t need a notary, but if you have another Dutchess County form that does, a commissioned online notary can help.