electrical inspection RX Date/Time 09/11/2019 12:56 15182731202 P.006
Sep. 11. 2019,12:44PM MDIA No. 0558 P. 6/13
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MIDDLE DEPARTMENT INSPECTION AGENCY, INC. -
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that the electrical wiring to the electrical equipment lilted below has been examined and is approved as >j
Ee being in accord,with the National Electrical Code, applicable govemnientil, utility and Agency rules in effect on the date ,v
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(<"5 noted below and is issued subject to the following conditions. i ' 0
t� Owner: Adirondack Urgent Care I Date:; <<
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08/30/2019 • (�J�
`c1, Occupant: Comm./1St Floor i Loca or
59 Rt 9
�C OccupancyNon-Residential I ? C�ueensbury,Warren Co. NY 0
( ) Applicant: Central New York Electrical • )
Contractors, Inc. I I IrEICELIVE, C>>
lc: 19 Solar Dr i I <j
C`,�'\j Clifton Park, NY 12065 • '• ,; SEP 6 2019 .
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e No. Joseph A.Holmes • ! BUI & CODES�U�Y C.:)
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140320112744EL i ��•
Equipment:
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8-Switches;32-Receptacles; 19-•Fixtures;2-Emergency.Lights;2.- Exi Lights; 1--.Exit/Emergency Combo. C%�
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Th1is certificate applies to the electrical wiring to the electrical equipm€nt listed immediatelyinull and void, This certificate applies only to the use,occupancy and
I J above and the installation Inspected as of the above noted date based an a visual ownership 4 indicated herein. Upon a change in the use,occupancy or ownership ))
(,,�) Inspection. No warranty is expressed or implied as to the mechanical safety.effi- of the property II dlcated above,this certificate shall be immediately null and void. (J)
g. ciency or fitness of the equipment for any particular purpose. This certificate shall In the even pall this certificate becomes Invalid based upon the above conditions, .c ,
"3! be valid for a period of one year from the above noted dale. Should the'electrical this certificate May be revalidated upon reinspection by Middle Department �tr
L.Ci) system to which this certificate applies be altered in any way.including but'not limit- Inspection April*,Inc. An application for Inspection must be submitted to Middle C�J'
0 ed to,the introduction of additional electrical equipment and/or the replacement of Dcpartmen.,ins action Agency. Inc.to initiate the inspection and revalidation 06- any of the components installed as or the above noted date,this certificate shall be process. A flee v ti be charged for this service.
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