electrical inspection RX Date/Time 12/06/2019 13:08 15182731202 P.005
�_g Dec. 6, 2':i191 ��M �MDIR �. z
2 _.� .4c�a; ":• -NO. 2010 P. 5/6
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`: MIDDLE D a �,��;Si^.�.cc,Y .�D;;
C:a EPARTMENT INSPECTION AGENCY, INC.
Le ye. that the electrical wiring to the electrical equipment listed below has been examined and is approved as 6.;k
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.
Own er.
C0 Harvey Zirofsky Date: cy
10 11/21/2019 f Occupant:
Same • Location: �f�
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59 Richardson Rd. `�v
r4) Occupancy' ,
r, _Single Family Dwg. Queensbury, Warren Co. NY 'a�
r. Applicant:) '
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Harvey Zirosky �C — O �'J�- 2Q -
r. 366 Brigham Rd- -"•. •. ... ...,. ., \0. ?/j7 �� '�
Greenfield Cen1-4 ter, to`�L'
ter, NY 8;33 .- ..:.---•-•..' : _
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.4�1 �r QEC 0 6 2019s i -,.."
Joseph A.Holmes.
r,1 No. TOWN OF OUEENSBURY icid,
•�i _ _ •:.31801411171EL':•••:••::'', • LG&cODES
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Equipment: —,. — — — - — BUIL — _ ck•—
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= 128 -Switches;44 - Receptacles; 38 •RxtureS; 1 -30 Amp Water Heefer,'1 - Bumer, Mitring & Control for Gas; 1 -20
Amp Dishwasher; 2-Vent Fans; 1 -20Q.Amp Sub Panel; 7-Smoke Detectors; 7-Arc Fault Breakers A
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y� This certificate applies to the electneal wiring to the electrical equipment •listed •Immediately •null and void. •This •certificate applies only to the use,occupancy and t;'
�� 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 '64
inspection, No
lIc f P warranty is expressed or implied as to the mechanical safety. effi- of the property indicated above,this certificate shall be immediately null and void. (l
�� cieney ort fitness Of the equipment for any partcular purpose- This Certificate Shall In the event that this certifrate becomes Invalid based upon the above Conditions, ��
`e`1,' be valid for a pe(od of one year tram the above noted date, should me electrical this certificate may be revalidated upon reinspectlon by Middle Department �^,
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 '6,I
(.) ed to,the introduction of additional electrical equipment and/or the replacement of Department Inspection Agency, Inc. to Initiate the Inspection and revalidation
66 any of the components installed as of file above noted date.this certificate mall be process. A fee will be charged for this service.
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