inspections 05/21/2019 11: 35 7981584 • RON MUMBLO PAGE 01
COMMONWEALTH ELECTRICAL INSPECTION SERVICE,INC.
.0. . . lkililri Office 176 Doe Dun Itoad-Manho'im,PA 17546 . ,..
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• MUNICIPAL CERTIFICATE - ELECTRICAL APPROVAL
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Permit No. Cert No 4 2 4 3 7 Cut in Call'No., • :..:.,...!,
Owner 1,../dirA.14..5-c ,,,,/7/°.Q.67.5.40 ft•-• ' •,'
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Location Si6 AS,A, 4 4_ <7 5a .c...eiv4. 4) u
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:1: • Installation Consisting of , *•'..!i:.:
S•ap 7,-,ts,. p ,,,p S:evs/c01.-
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Installed By..S.M9..to i.0.4.5:14/47/("el -5 Lie:.No.
The conditions following governed the issuance of this certificate,And:Any coriiielrfe previously issued is
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cancelled:-
This certificate only covers the electrical equipment and installation cOrditiOne ar; of doe- Upon the
' • introduction of additional equipment or alterations,application shall be promptly made for inspection.
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Inspectors of this Company shall have the privilege of making inspections at any time, and if its
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• noes are violated,the Company*hall have the right•to revok.e this certificate, •
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• Date 67-2/.4 9 INSPECTOR
. •• • Member N.F.P.A.,LA,E.I- • ' '•':
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1 MAY 2 1 2019
TOWN OF QIJEeNSBURY
BUILDING&CODES
be-P- 0 Oc)(o - 11-)
INSPECTION WORKSHEET (SEP-002712-2019)
Town of Queensbury - Building and Codes - Fire Marshal
742 Bay Road - (518) 761-8256 Building (518) 761-8206 Fire Marshal
Case Number:SEP-0006-2019 Case Module:Permit
Inspection Date:Wed May 15, 2019 Inspection Status:Failed
Inspector:Mark Smith Inspection Type:Septic
Job Address:Parcel Number:86 ASH DR
Lake George, NY 12845
289.17-1-9
Contact Type Company Name Name
Applicant Hodgson, H.
Primary Owner Hodgson, H.
Engineer Murdock, PE, Eric
Granted Permission Hodgson, H.
Checklist Item Passed Comments
Building Inspector Notes YES 5/15/19 septic system approved. 500 gallon plastic pump
station with alarm to a clarus fusion ZF450 system with UV
light unit. Existing septic tank and seepage pits size of
seepage pits unknown.
Electric inspection required.
Type of Water: Municipal / Well Water YES Well water
Waterline separation distance YES 50+
Well separation distance YES 50'+
Seepage Pits: Number YES Existing seepage pits
Size:YES Size of seepage pits unknown
May 15, 2019 Page (1)
INSPECTION WORKSHEET (SEP-002712-2019)
Checklist Item Passed Comments
Building to Tank YES Sch 40
InletOutlet Pipes & Baffles YES T baffles on inlet and out let
Foundation to Tank NO Sch40 from house to clarus tank, sch 40 from clarus tank to
septic tank
Separation of Pits NO
Engineer Report and As-Built YES System built as shown on plan
ETU Maintenance Contract provided NO
Location of system on property YES Pump station is front right side near alarm . Tanks at back
yard near driveway right side
System Use Status YES System approved
May 15, 2019 Page (2)
Smith, Mark (Inspector)