electrical inspection RX Date/Time 09/18/2019 10:27 15182731202 P.002
\' ^- Sep, 18. 2019 .10: 14A ,,-,,MDIA-, No, 0685 P. 2/2
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MIDDLE DEPARTMENT INSPECTION AGENCY', INC. s.;
�`� ce that the electrical,wiring to the electrical equipment listed below has been examined and is approved as %(L�l Cr being in accord with the National Electrical Code, applicable governmental, utility and Agency rules in effect on the date `a-
(:.j noted below and is issued subject to the following conditions. ;-'
Owner: Thomas KingDate: • ���
�� 09/10/2019 •��=9)
('.j Occupant:Pool • Location:5 Be Drive '��
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�< OccupancyS�Nimming Pool Queensbury, Wan-en Co. NY t--
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(j Applicant: 7 Q
t1. Thomas King • . �:)
0 15 Berry Drive
Queensbury NY 12804 • • . . •. . .... •• . . .• • i v)
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=- Joseph A.Holmes •
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L� No. •318014113958EL• • • •
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Equipment:�'
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1 -Switch-2-GFI Receptacles;2-Fixtures;•'I-Pool.Pump;Pr• 1 =Smart Panel With 60 Am• Time
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(,; . .. .. • SEP �.8 :�019 �''
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`C� TOWN QF.QUEENSBURY (��)
C� ' -.... • . •' . • • ... UII Dli l 3&CODES ?;
r.- . . • . Ply- _ 0 51� - 1 ^')
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:,i S This certificate applies to Incthe electrical wiring to the electrical equipment listed immediately null and void. This certificate applies only to the use,occupancy and j
C above and the instslletion inspected as of the above noted date based on a visual ownership as 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 indicated above,this certificate shall be immediately null and void. `(j
?.» ciency or fitness of the equipment for any particular purpose. This certificate shall In the event that this certificate becomes invalid based upon the above conditions, ;:�
. be valid for a period of one year From the above noted date. Should the electrical this certificate may be revalidated upon reinspection by Middle Department 's
�� system to which this certificate applies be altered in'any way,including but not limit-' Inspection Agency,Inc. An application for inspection must be submitted to Middle (�
ted to,the introduction of adoitionel electrical equipment and/or the.replacement of Department Inspection Agency, Inc.to initiate the Inspection and revalidation 0
any of the components installed as of the above noted date,this certificate shall be process. A fee will be charged for this service. -,
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