A pair of housing developments planned for Wormit and Newport will see a dilapidated farmhouse restored and a derelict hospital torn down.
Wormit Farm house, west of Kilmany Road, will be at the heart of an estate of 42 houses, while the former Netherlea Hospital will make way for 29 modern, high-end flats.
Both projects were given planning permission by Fife Council’s north east planning committee.
Persimmon Homes intends to restore the C-listed house at Wormit Farm and demolish a steading and shed to make way for detached, semi-detached terraced and four-in-a-block houses, including 11 affordable homes.
Newport, Wormit and Forgan community council had voiced fears about the impact on the local infrastructure, including roads and the GP practice.
Conservative councillor Linda Holt also raised concerns the affordable houses, to be built on a smaller site across Kilmany Road and managed by Kingdom Housing Association, were not fully integrated.
However, Tay Bridgehead Liberal Democrat councillor Tim Brett won support for approval of the scheme, saying the site needed to be developed.
He requested the developer be asked for a contribution to the nearby play park, which is in need of investment.
The four blocks of apartments to be built at Netherlea Hospital will feature extensive glazing and monochrome materials.
The site overlooks the Tay from West Road and the homes are likely to be be among the most expensive properties in the town.
A previous planning application lodged four years ago, which would have retained the red sandstone hospital building, was withdrawn.
Mr Brett said: “The thing that concerns a number of local residents and concerns me is the modern style of the development.
“It is very modern and most of Newport is not. On balance, as with the previous application, the site needs to be developed.”
Howe of Fife and Tay Coast SNP councillor David MacDiarmid was assured that the applicant, Dundee-based Law Property Group, had been asked if the building could be retained.
He said: “I prefer what is there.
“People will say in 60 years’ time that these cubes have not stood the test of time.”
Planners said the design of the apartments was distinctive.