electrical inspection RX Date/Time 07/16/2019 11:10 15182731202
9 01 P. 2i%
P.002
'c„ � 0 AN?y? MD IA IF -A,Y�^ ���� .,7. � �Y? 1r' �7�:Y�•1�oyG1 1. 16. 219046 , .�✓ n.�✓.G?U: �. �y,✓�y>:Ci�n`i � .'• MIDDLE
DEPARTMENT INSPECTION AGENCY, INC. *e
�j� axto z that the electrical wiring to the electrical equipment listed below has been examined and is approved as
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t� being in accord with the National Electrical Code, applicable governmental, utility and Agency rules in effect on the date
,''?-) noted below and is issued subject to the following conditions.
.•ri'•• Owner: (G
��;� Cooper Date: ��
�� 07/08/2019 ��:
Occupant: �y.
4 Pool Location• '''
V) 4 Greenway North Fa
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OccupancySwimming Pool Queensbury, Warren Co. NY
Sa; Applicant: I
.' Dan's Electrical Service •
Zu; Daniel Grogan ^ , �C.'
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C 3 Freight House Rd. :;, .. r j
?j L Corinth, NY 12822 .
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Joseph A.Holmes p.,E
Cam% No. •
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z Equipment: • • • : . . • 16 2019 �
(%'1 -GFf Receptacle; 1 -Pool•Pump; 1 Twist•Lock Receptacle . .. TO�r� OF�'DE�NSBURy
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This certificate applies to the electrical wiring to the electrical equipment listed Immediately null and void. This certificate applies only to the use,occupancy and ;O
above and the installation inspected as of the above noted date based on a visual ownership as indicated herein. Upon a change in the use,occupancy or ownership d'e. inspection. NO warranty Is expressed or implied as to the mechanical safety. effi- of the property indicated above, this certificate shall be immediately null en0 void. ��
(;� clancy 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, r
ybe valid for a period of one year from the above noted dale. Should the electrical this certificate may be revalidated upon relnspection by Middle Department >iry
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
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e to,the Introduction of additional electrical equipment and/or the replacement of Department Inspection Agency, Inc. to initiate the inspection and revalidation rr 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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