DOH approval Notice of Intent to Construct,
NEW YORK STATE DEPARTMENT OF HEALTH
Bureau of Community Environmental Health and Food Protection Enlarge or Convert a Facility
Please read instructions on back before completing form.
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Proposed facility name: ..,®...,..�
If existing,current facility name: Homestead Village Mobile Home Park JUN 0 4 202`l
The property vvill be used as: ❑ Food service establishment ❑ Agricultural fairground
❑ Temporary residence Migrant farmworkerhousin TOWN OF QUEENSSURY
❑ Children's camp ❑✓ Mobile home park BUILDING&CODES
Campground ❑ Swimming pool
❑ Mass gathering ❑ Bathing beach
County: Town,Village or City:
Warren County Queensbury
❑ New ❑✓ Renovation ❑ Conversion Are plans attached? 0 Yes ❑ No
Detailed location(e.g.,road,street,building number,distance from well-known point): 80 Alpine Avenue
Name of owner: Address: Phone:
Homestead Village,LP PO Box 159,Avon,NY 14414
Name of operator: Address: Phone:(518 )792-7257
George Drellos 144 Luzern Road Queensbury NY 12804
It is proposed to(describe in detail;use additional sheets if necessary):
See Attached sheet
The following permits or approvals for the proposed construction,enlargement or conversion have been applied for or received:
Name of Local code enforcement officer for facility location: Address: Phone:(518 )761-6256
John O'Brien 742 Bay Road, Queensbury, NY 12804
Signature: Date: 5/19/2020
Title: ❑ Owner ❑ Operator ✓❑other,specify Design Engineer
Mailing Address: I Phone:(518 )371-7621 x115
Environmental Design Partnership,900 Route 146,Clifton Park,NY 12065
DOH-154(4/04)Page 1 of 2 (GEN-140)
JUST 0 4 2020
Homestead Village Mobile Home Park TOWS! OF QUEENSBURY
Septic System Replacement for Lot#80 Alpine Avenue BUILDING&CODFS
Supplemental-Information to NYS DOH Form 154
"Notice of Intent to Construct,Enlarge or Convert a Facility"
May 19, 2020
This application proposes to replace the septic system for Lot 80 Alpine Avenue in the
Homestead Village Mobile Home Park. Approximately 61 systems have been replaced in the
park since roughly 2007. There is presently no home on Lot 79. The park is served by a central
potable water system.
The soils on the park property are very well drained sandy soils with a typical percolation rate of
approximately one minute per inch. Soil and percolation tests were done park wide several years
ago prior to the first replacements. Tests from that era have been accepted by the Town and
DOH and are not repeated when new replacements are proposed.
The septic replacements are done when the prior sanitary facilities show signs of failure. In a
prior agreement with NYS DOH,the design engineer reviewed each site when a new system was
needed. Plans were rapidly developed and submitted to the Queensbury building inspector for a
building permit. Copies of the plans were also submitted to NYS DOH for their records but a
blanket approval for the park had been issued allowing construction to proceed upon issuance of
the building permit. Inspections of the new system were conducted by the design engineer's
representative prior to backfilling and a letter summarizing the inspection-is submitted to the
Queensbury building inspector. This arrangement allowed for the quick replacement of the
failed systems with a new tank and field.
This application is the fourth under new DOH policy to review plans before a building permit
can be issued by the Town. Lot#80 Alpine Avenue requires quick attention as the prior system
has failed. The applicant respectfully appreciates every effort to streamline the approval of the
replacement system.