INSPECTION WORKSHEET 05012024
INSPECTION WORKSHEET
Town of Queensbury - Building and Codes - Fire Marshal
742 Bay Road - (518) 761-8256 Building (518) 761-8206 Fire Marshal
Case Number: PT-0706-2023 Case Module: Permit
Inspection Date: May 01, 2024 Inspection Status: Passed
Inspector: Charles Dyer Inspection Type: Property Transfer
Job Address: 27 ANTIGUA RD
, Parcel Number: 239.17-1-8
Contact Type Company Name Name
Antigua Resort LLC
Owner Antigua Resort LLC
Checklist Item
Status
Building Inspector notes
PASS
Weather
cloudy
PASS
Temperature (Fahrenheit)
50
PASS
Test each fixture flow to septic tank
PASS
Whirlpool tub, add 250 gallons
N/O
Garbage grinder, add 250 gallons
N/O
Septic tank for bedrooms, whirlpool,
garbage grinder within 250 gallons
N/O
Leaking water fixtures
N/O
Stormwater
N/O
Sump pumps
N/O
Foundation drains
N/O
Roof gutters don't discharge over leach
field
N/O
Roof runoff
N/O
Other
N/O
Plumbing fixtures tested and confirmed
PASS
Holding tank; if yes, include capacity
N/O
Holding tank, verify level rises
N/O
Verify 50 percent and 90 percent floats
N/O
Excavate 18 inches around to verify no
leach field is connected
N/O
Watertight
N/O
Outlet pipe; automatic failure, if yes
N/O
Cesspool; automatic failure, if yes
N/O
Overflow pipe; automatic failure, if yes
N/O
Septic tank; include number of tanks
one / 1500 gallon
PASS
Concrete tank
PASS
Metal tank; automatic failure, if yes
N/O
Plastic tank
N/O
Tank Other
N/O
Access riser; if yes, what is depth to
cover
N/O
Depth below grade to top of tank
less than 12”
PASS
Tank cover
concrete
PASS
Septic outlet cover extension, required 12
inches or more below grade
N/O
Pump station extension, required 12
inches or more below grade
N/O
Septic inlet cover extension, required 12
inches or more below grade
N/O
Inlet baffle
PASS
Outlet baffle
PASS
Effluent filter
N/O
Liquid level at, above or below discharge
invert
below
PASS
Number of tank compartments
one wall
PASS
Visible scum layer
PASS
Main tank cleanout size and location
2o ”
PASS
Capacity in gallons
1500 gallon
PASS
Water tight tank
PASS
Evidence of a pipe bypassing the tank
N/O
Is the tank being pumped more than 4x a
year
N/O
Dosing or pump tank sealed
N/O
D-box material: concrete or plastic
N/O
Baffle and d-box or 45 degree angle
N/O
Cracked, corroded or deformed
N/O
Speed levers in d-box
N/O
Solids in d-box
N/O
Number of drop boxes
N/O
Outflow line invert above leach line
inverts
N/O
Evidence of liquid above outlet inverts
N/O
Sump pump not connected to septic
system
N/O
Water softener not connected to septic
system
N/O
Surface discharge; if yes, to where
N/O
Absorption field
N/O
Absorption bed
N/O
Raised system
N/O
Sand filter
N/O
Mound system
N/O
Seepage pits; how many
one / 8x8
PASS
Apparent structural damage
N/O
Seepage Pit Other
N/O
Weather, lack of information,
inaccessibility
N/O
System appears to have functioned
adequately
PASS
System appears undersized or have
undersized components
N/O
System or components are unacceptable
N/O
No treatment tank or other critical
components
N/O
Recommend upgrade, expand or replace
1 or more components
N/O
As built provided is accurate
PASS
On site as built required before inspection
is complete
PASS
Evidence of prolonged high liquid level
N/O
System needs repais
N/O
System passes all function testing
PASS
Charles Dyer
Code Enforcement Officer