inspectionsINSPECTION WORKSHEET (SEP-006993-2018)
Town of Queensbury - Building and Codes - Fire Marshal
742 Bay Road - (518) 761-8256 Building (518) 761-8206 Fire Marshal
Case Number:
Inspection Date:
Inspector:
Case Module:
Inspection Status:
Inspection Type:
SEP-0627-2018
10/01/2018
John O'Brien
Permit
Partial Pass
Septic
Job Address:Parcel Number:17 OAK VALLEY WAY
Queensbury, NY 12804
266.1-1-14.10
Contact Type Company Name Name
Granted Permission Ellsworth & Son Excavating [Ellsworth & Son Excavating] ,
Primary Owner JAEGER, KURT
Contractor Ellsworth & Son Excavating [Ellsworth & Son Excavating] ,
Engineer Hutchins Engineering [Hutchins Engineering] ,
Checklist Item Passed Comments
Building Inspector Notes NO 10/1/18 Septic System Partial Approval
Remaining Items:
- Submit Engineer's Inspection Report & As-Built
- Provide Final Electrical Inspection
Soil Type: Sand YES Fill material
Soil Type: Loam YES Fill material
Type of Water: Municipal / Well Water YES Well
Waterline separation distance YES
Well separation distance YES 150' +/-
Absorbtion Fields: Total Length YES 360'
Septic system field above flood plain YES
Length of Each Trench YES 6@60'
Depth of Trenches YES 18"-24"
Size of Stone YES #2
Building to Tank YES 4" sch40 pvc
Tank to Distribution Box YES Pump Tank
1-1/2" force main to 4" sch40 pvc
Distribution box to Field / Pit YES 4" pvc to 4" pvc perforated
Opening Sealed:YES
End Cap YES
Oct 01, 2018 Page (1)
INSPECTION WORKSHEET (SEP-006993-2018)
Checklist Item Passed Comments
InletOutlet Pipes & Baffles YES
Manholes 12 or less below grade YES
[Provide extension collar if Yes]YES
Locations / Separations YES
Foundation to Tank YES As per plan
Foundation to Absorption YES As per plan
Conforms as per Plot Plan YES
Engineer Report and As-Built NO 10/1/18 Septic System Partial Approval
Remaining Items:
- Submit Engineer's Inspection Report & As-Built
- Provide Final Electrical Inspection
Location of system on property YES
System Use Status NO 10/1/18 Septic System Partial Approval
Remaining Items:
- Submit Engineer's Inspection Report & As-Built
- Provide Final Electrical Inspection
Oct 01, 2018 Page (2)
O'Brien, John (Inspector)
INSPECTION WORKSHEET (SEP-001710-2019)
Town of Queensbury - Building and Codes - Fire Marshal
742 Bay Road - (518) 761-8256 Building (518) 761-8206 Fire Marshal
Case Number:SEP-0627-2018 Case Module:Permit
Inspection Date:Mon Apr 1, 2019 Inspection Status:Partial Pass
Inspector:John O'Brien Inspection Type:Septic
Job Address:Parcel Number:17 OAK VALLEY WAY
Queensbury, NY 12804
266.1-1-14.10
Contact Type Company Name Name
Primary Owner JAEGER, KURT
Engineer Hutchins Engineering
Contractor Ellsworth & Son Excavating
Granted Permission Ellsworth & Son Excavating
Checklist Item Passed Comments
Building Inspector Notes NO 10/1/18 Septic System Partial Approval
Remaining Items:
- Submit Engineer's Inspection Report & As-Built
- Provide Final Electrical Inspection
1/11/19 Septic System Partial Approval
Remaining Items:
- Submit Engineer's Inspection Report & As-Built
- Provide Final Electrical Inspection
4/1/19 Septic System Partial Approval
Remaining Items:
- Submit Engineer's Inspection Report & As-Built
- Provide Final Electrical Inspection
Soil Type: Sand YES Fill material
Soil Type: Loam YES Fill material
Type of Water: Municipal / Well Water YES Well
Apr 01, 2019 Page (1)
INSPECTION WORKSHEET (SEP-001710-2019)
Checklist Item Passed Comments
Well separation distance YES 150' +/-
Absorbtion Fields: Total Length YES 360'
Length of Each Trench YES 6@60'
Depth of Trenches YES 18"-24"
Size of Stone YES #2
Building to Tank YES 4" sch40 pvc
Tank to Distribution Box YES Pump Tank
1-1/2" force main to 4" sch40 pvc
Distribution box to Field / Pit YES 4" pvc to 4" pvc perforated
Foundation to Tank YES As per plan
Foundation to Absorption YES As per plan
Engineer Report and As-Built NO 10/1/18 Septic System Partial Approval
Remaining Items:
- Submit Engineer's Inspection Report & As-Built
- Provide Final Electrical Inspection
1/11/19 Septic System Partial Approval
Remaining Items:
- Submit Engineer's Inspection Report & As-Built
- Provide Final Electrical Inspection
4/1/19 Septic System Partial Approval
Remaining Items:
- Submit Engineer's Inspection Report & As-Built
- Provide Final Electrical Inspection
Apr 01, 2019 Page (2)
INSPECTION WORKSHEET (SEP-001710-2019)
Checklist Item Passed Comments
System Use Status NO 10/1/18 Septic System Partial Approval
Remaining Items:
- Submit Engineer's Inspection Report & As-Built
- Provide Final Electrical Inspection
1/11/19 Septic System Partial Approval
Remaining Items:
- Submit Engineer's Inspection Report & As-Built
- Provide Final Electrical Inspection
4/1/19 Septic System Partial Approval
Remaining Items:
- Submit Engineer's Inspection Report & As-Built
- Provide Final Electrical Inspection
Apr 01, 2019 Page (3)
O'Brien, John (Inspector)
INSPECTION WORKSHEET (SEP-000268-2019)
Town of Queensbury - Building and Codes - Fire Marshal
742 Bay Road - (518) 761-8256 Building (518) 761-8206 Fire Marshal
SEP-0627-2018Permit
Case Number:Case Module:
Fri Jan 11, 2019Partial Pass
Inspection Date:Inspection Status:
John O'BrienSeptic
Inspector:Inspection Type:
17 OAK VALLEY WAY266.1-1-14.10
Job Address:Parcel Number:
Queensbury, NY 12804
Contact TypeCompany NameName
EngineerHutchins Engineering
Primary OwnerJAEGER, KURT
Granted PermissionEllsworth & Son Excavating
ContractorEllsworth & Son Excavating
Checklist ItemPassedComments
Building Inspector NotesNO10/1/18 Septic System Partial Approval
Remaining Items:
- Submit Engineer's Inspection Report & As-Built
- Provide Final Electrical Inspection
1/11/19 Septic System Partial Approval
Remaining Items:
- Submit Engineer's Inspection Report & As-Built
- Provide Final Electrical Inspection
Soil Type: SandYESFill material
Soil Type: LoamYESFill material
Type of Water: Municipal / Well WaterYESWell
Well separation distanceYES150' +/-
Jan 11, 2019Page (1)
INSPECTION WORKSHEET (SEP-000268-2019)
Checklist ItemPassedComments
Absorbtion Fields: Total LengthYES360'
Length of Each TrenchYES6@60'
Depth of TrenchesYES18"-24"
Size of StoneYES#2
Building to TankYES4" sch40 pvc
Tank to Distribution BoxYESPump Tank
1-1/2" force main to 4" sch40 pvc
Distribution box to Field / PitYES4" pvc to 4" pvc perforated
Foundation to TankYESAs per plan
Foundation to AbsorptionYESAs per plan
Engineer Report and As-BuiltNO10/1/18 Septic System Partial Approval
Remaining Items:
- Submit Engineer's Inspection Report & As-Built
- Provide Final Electrical Inspection
1/11/19 Septic System Partial Approval
Remaining Items:
- Submit Engineer's Inspection Report & As-Built
- Provide Final Electrical Inspection
Jan 11, 2019Page (2)
INSPECTION WORKSHEET (SEP-000268-2019)
Checklist ItemPassedComments
System Use StatusNO10/1/18 Septic System Partial Approval
Remaining Items:
- Submit Engineer's Inspection Report & As-Built
- Provide Final Electrical Inspection
1/11/19 Septic System Partial Approval
Remaining Items:
- Submit Engineer's Inspection Report & As-Built
- Provide Final Electrical Inspection
O'Brien, John (Inspector)
Jan 11, 2019Page (3)
'ewe 9 � o:4:.� _ aee e`�5:.:'r:�- e't:6• :•i°e` v: = =°-•��.: :ate: � - e .jt e e:•.�� �r.+ se.' � r e.•Se � O«'0� oa q
I°.�oee i'm� N+4.. —..,f.s�r9.. .... ..a.`mes -:d'°.a 3•. a.....d,e - 1 o e:•� :rei'«: ei i...i.•'•N:i:..:de a:'..... t e e:b.
1,ir® : �0'j ee°,m v''S eo°0�s'v p s�q�a'`O sae9 rr yO�soe�i e'i je°°yrir o.ep•i�ii^ee6e••r'r o°0°S'�r°e v.°i•1s r'rs eee. 'vwOe♦ s.e e10 a^e e•'r'.v eee•il
.s I o A9 069 0.®0A P°!000 .,/{!P.0 06!P.°m,if!Ieo°a OAp P°.°te AOi+Pe.°,e1{f iP e6�bP e�°eemirblB•:mya O'ptaJ° Oa OAIPP.e,V PAO eP�:0 'blPPee0e0r{�PPee°le�A9eP..°Oe 0'ef OP.,°,1/gp Pp eo°®imp\
Pe:e tt t�eit elr A{A+ee ;S i�Afoir k AAA*tt 4AAAAfO`1y� AABA/fAfA f�C PAA/i .) PA4+011 PAAA:#;' AA4iAi0I A4Ai et b'AAdier bPAA er *�OAIpRpiA9F AABpAeril 4f4iti4¢A' lib4AA9P Q�AAAiRi`A4��AtAiRiRpA,� f4Apt t r 1 a 64
�hO.S.:10�}$44'/ P$$+$4$'6,\4$$$4t}/ \�}b41P�b4 $b4$$bI �,04, $bNb! 4$4$14 �46$$1}b� b4$9k b4P$4b ,�, VNif� fsf% \�641b� b k,' 414 it''b4$$4}y ��`if4fe'40$$b}$�� 4R4iR p�*iiil
f a�o- 0$ Miff r 4if tlf ,i if ii¢tttS4 Itf tlf( Pltf tf4 t4ffftt$ ftf ttff 14�4p1$10 �tt94f+ , 4¢41$tft 4W414¢tif ¢$14�d¢1 r Stf8t4$$44 Silttlf' 4tnIff ,$9#$tf ff `tgf$fb ff�gz `e
Otaoa Y 0t4
!I,ere �olil/
;f;,;.a Insp. Date: 10/3/2018 '°s• >}
e w _ ®`.p{�
ra>o Appi#: M18659 �a�°=
ao 4<Z
Wiz: A4
flye l .. ti1�"4�ei 4
°e{}I
\ ELECTRICAL CERTIFICATE —` ''
1:1 egm�- ),4°eR}
lere �•r 'a--"v,
`°`°ea ate }
COMMONWEALTH ELECTRICAL sae-e
• — aml
INSPECTION SERVICE, INC. 6,1
_ p`/
176 DOE RUN ROAD;MANHEI-M, PA 17545 ,'
lye°e�/^9•-
;,° ,� b TELEPHONE: (717) 664-2347 ' >;}
It - aAI<
rl+ New York Office: (585) 624-2380 ol,
lie`• f10.4
i!;s _ -.o. dl,r
;; Premises of LYNN JAEGER as '▪ ° jam
l0 4k«ems _ "°e�,el
\+, Address: 17 OAK VALLEY WAY,QUEENSBURY NY 4 :`I
f�4;�ti, County of: WARREN Permit#: �; }
dOW
i11
y1 am Installed by: TROMBLEY ELECTRIC LLC • ,o;;�rf
�1�A � Apparatus: SEPTIC PUMP SYSTEM ,e O cp • _440/
/1e'i.. ''t
t}deer... RE (�
!t" Inspected by: RON MUMBLO C E II V E _ r ;oi
'Is>, p lt `4 >>t9
22019 1 ;
Nttl• ¢i-LT T WN OF QUEENSBURYi1C
•v,�A
a
,e'
Vittp 0.
The conditions following governed issuance of this certificate,and any certificate previously =If\
riyoe '1 �4�aose°5i
1,,, __ issued is cancelled.Failure to have the property reinspected when additional equipment or wiring is +r}
added;or within one year from the date of the certificate shall void the certificate in its entirely and the ,e
Ic
000,1%+� company shall not be liable for any damages whatsoever; ®:el
fff;io � ,4 4
\\lal;t This certificate does not guarantee efficiency, wearing qualities,maintenance or repair and the `'-AA�Pa�O%
company shall not be liable for any damages resulting from any defect or fault in the plans or specifica- , •
6.10� `` lions,including repair,reconstruction,personal injury or for the death of any person;and 1 ▪ °;iAO}
This certificate only covers visual inspection of wiring and does not cover manufacture or use i 1
dl°r, . of wiring. """ 1
\ A.
y� Inspectors of this Company shall have the privilege of making inspections at,any time,and if k, ,. .° 1%
l; its rules are violated,the Company shall have the right to revoke the certificate. a• .h
<°.oe �.:I:
1>mm `e.UI
'�' ♦yr
o,it{�
'o
+p+`P rd tlt ®°i`
.q P-� 'I II ,1,., fti� fII ..,�r� b ����d Imil� 1��. 'mil ♦ � 1.�(; � �.
+' •- 57 r�.f p 4,1, 4b4�f�.,m i 5�$ d,y4 4 :'4�v4 „ � rtm
I+°.> ,� ,, � �,���, \:� 4. �.,�� � ��„ 4 ��:.�, t��t tf�dt4 , 4p�d���,:�4f��84 ••-�4d�t� - a�14��' �$1600�;;� >�t���_ ���td�fa'` �4fddtd �'�tdlt�'atd4��-..; �ft��f�•�-�s�4�ab:°I
�i'°:.�7�44si°84`� ,b,44$94444b1;.y94${44$d, �,4$444b��,��f44404��,G�@bd9�d"� �;yi$4t4$ f4441� if1$4f \�f4f44+ $444$!��fb44$. ;�14f}}�`�f444$� '414} �$4t$$ �/'14$44\ $4141e,�%4$444#�! 44d4� ®+::�I
H,1.°.•0� Af4P4�®%I14N >,/��A4Ab4P4t¢�%a499+-0P461 4f/40A4A4A /b4EA{Fea44t: 0/444bA� /t 1414 t\,i Nbi 1 4014 ._,i 4dNk 4H8 > b44+ 4, •. 84444 da ,6 bbb4 - 444R y�
\I,.°,•m0•.�AAi/eia�.�epa/iie,,.d,ppibie o'?�4iee a��4Aie��B is>®•�b�p4AAAAf�,�d®e4eP4�.�10r44pi44� {4AAAA144y�,h _/®Bi1APA4y\��y._ 44f46Af41A`�.._ 44AA4pP4�.,At (AA4iAAA�(�`y 94A1AA48 :/4AAi8e44 �f46{A4y��4ARP0 .,-y�/y4A4Ab�q.ern.�4b
Ilmmtollee,..�arere;.,,.:eee:.,l...e°o:�9;gem°°m.,:0°eJe°°aP.<p�Js°a°m°.:9:e°.e°e.:p:6 e°o°:/ • P;/;,O."P ypi Doe P!AF OIo�P g p eOsdP �" P°W A . b vt Ag wift d i0'AAd g Ji 0
4•.•.5.-.- .°✓6_'•4.1 et:'_4°Odr>' ...t, °� .ee�se.�._ .:moi9;. .�.°ee. .qs emir ;oee�.9:.e�a;e.:/:.®�a:a.;t:.ea ee°.e.:t:,sr eoss�,0;�ae�ae�9..a,0e°ia.;,A.be oil,+e'II�
w l 9 L.t — e Yie� tiiy' - —''.Sai«Z �.�:s�.1' t°. �G ee°Ji2.•°'e '`-4 a m„m ... •;Ohre°-r
-\^�% . - .e•o °' �:ta�r 4a%°;�Wi'^��ior:��ma''e+'�..q.e•�s....a«ae'� ^°°eer:�•.••: