final electrical inspection RX Date/Time 06/19/2020 14:00 15182731202 P,003
- Jun. 19. 2020 1 42P ��:;,,� MDIA,�,�a No, 3876 . P. 3/5
(0 MIDDLE DEPARTMENT INSPECTION AGENCY, INC.
A.
;?� ls that •the electrical wiring to the electrical equipment listed below has been examined and is approved as � )
(''� being g in accord with the National Electrical Code, applicable governmental, utilityand Agency rules in effect on the date a,.0. noted below and is issued subject to the following conditions. g y ;�
6:) Owner: •
(5 Joe Tersul Date: ���
��� 06/05/2020
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F)
L�) Occupant; Same Locatio c>
n572 Luzerne Rd. �`
(e�J Occupanc •y- rv)
p ySwimming Pool Queensbury,Warren Co. NY
( .- Applicant: )
GBM Electrical l
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Attn:Matthew Wing • •. <<�)
41). 69 Peggy Ann Road
.,� L Queensbury NY 12804 . . r5
•
(e,) A,Holmes . ���
Joseph
No. 147923120606EL
Equipment: . ' . ��
1 -Switch;2-GFCI Receptacles; 2 Fixtures; 1 -Burner, Wiring&Controls for Gas;1•-Twist Lock Receptacle; 1 -60 >>V Am Sub Panel with Time Clock
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Thlt is certificate applies to the electrical wiring to the electrical equipment listed immediately null and•void. This certificate applies only to the use.occupancy and �".
10 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 0
(r.:j" 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. �(
b), teeny or fitness of the equipment for any partiwlar purpose- Thie certificate shall . In the ever t that this certificate becomes invalid based upon the above conditions. 22
be valid for a period of one year from the above noted date. ShoiLld the electrical this certifi:ate may be revalidated upon reinspection by Middle Department )
L�) System to which this certificate applies be alterec in any way.incn4 rig but not limit- , Inspection Agency,Inc, An application for inspection must be submitted to Middle ��
(J�j ed to,the introduction of additional electrical equipment and/or the replacement of : Department Inspection Agency, Inc, to initiate the inspection and revalidation• ,A
Z,.11t 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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