
Middletown stands as a significant regional hub on this 1969 survey, characterized by its dense urban center and the extensive grounds of the State Hospital. The city’s institutional landscape is further defined by Horton Hospital, St Alberts College, and the sprawling County Fairgrounds. To the west, the terrain rises toward Sayers Hill, while the Wallkill River meanders through the southeast, passing the settlement of Pellets Island. The transportation network is anchored by the Erie-Lackawanna railroad, which services outlying communities like Howells and New Hampton. This map captures a transition period where traditional agricultural areas in townships like Wawayanda and Wallkill exist alongside expanding residential developments in Washington Heights and East Middletown. Local landmarks such as Randall Airport and several historic burial grounds, including Hillside Cemetery, provide specific points of interest for local history researchers.
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