electrical inspection •
•
RX Date/Time 09/11/2019 12:56 15182731202 P.005
<,Sep. 11. 2019,12:44P _ MDIA No, 0558 P. 5/13
•._/-`gin.�.f�%i`✓.`:..�, �.���. v �v�v� ? i-?' ^ /
(>> . MIDDLE DEPARTMENT INSPECTION AGENCY, INC. <//<0
C., X s that the electrical wiring to the electrical equipment lis�te below has been examined and is approved as
0, being in accord with the National Electrical Code, 'applicable government.I, utility and Agency rules in effect on the date 7-
4 ��-
9 y
(J noted below and is issued subject to the following conditions. ,.-
�� Owner. Ma Sousis i Date_ i08/30/2019 0(^ ry i i
p
rM
(C:4 Occu ant: locaa' ;�j
(., Pool P�Z Nicole Drive (4,j
Occupancy • 1 Oueensbury,Warren Co. NY ��?
Swimming Pool
Applicant: I !
(e r<,y)
� pp
Mary Sousis . I 1 I QL-0510 — 2CC.l ,���
q",",, 92 Nicole Drive I - 5
fyC &' ���
i
ce' Queensbu NY 12804 r! , '.� l.
• C?
`r •
'HtfsEP..:i..6 2019 r•
Joseph&Holmes �' _ `„.
�� No. •147838113632EL ; EENSBURY ` '�
�, � T®L�il�! OF�6Jr��
F;�1 Equipment:ti i • IYJI!Dll�G& ODES
Ai
i
11 -Switch;3-GFI Receptacles; 1 -Burner, Hiring &'bontrol•For Gas ''• .••- Pi •
;il
l
•
•
•
•
j • ?2
tL) i ^
• a1
(0 1 • I (j
•
(;� I . . • r: .. ;.>;
(� A
This certificate applies to the electrical wiring to the electrical equipment listed Immediate') null nd void. This certificate applies only to the use,occupancy and
() above and the Installation inspected as of the above noted date based dl?a visual ownership as ind cared herein. Upon a change in the use,occupancy or ownership lGv�
0 inspection. No warranty is expressed or imp►ied as to the mechanical safety,effi- of the propi.fly frjcficated above,this certificate shall be immediately null and void.
be ve lid for a period of onei year from r the above noted datee.Should the�te ectrl II gJ this eert f c alto m�fiay cebe rrevvatidat dm pone nssppeclo by Middloe Department ��»
0 system to which this certificate applies be altered in any way,including but not limit- Inspection Agen',Inc. An application for inspection must be submitted to Middle
(„.)) ed to,the introduction of additional electrical equipment and/or the replabement of Departmen Insiaction Agency, Inc.to initiate the inspection and revalidation �1.�j
i\ any of the components Installed as of the above noted date,this certificate shall be process. A"ee wIll be charged for this senlce.
n .. .W. = = 1!.".3 ,v=�:%<'a:.i1,••✓,/.�✓:�� �ti� =�'�•i. . •i. ii i '%•' 4 /< •\.i:✓..i�•,, i.✓.✓, i. 7 •i:`l ii •i...v.•
i
. i
.