final electrical inspection RX Date/Time 12/0812020 10:14 15182731202 P,005
Dec, 8. 20201 9:54AN MDIA No, 5507 P. 5/5
MIDDLE DEPARTMENT INSPECTION•AGEN'CT, IN
that the electrical wiring to the electrical equipment listed below has been examined an is approved as
being in accord with the National Electrical Code, applicable governmental, utility and Agency rules in a I ct on the date
noted below and is issued subject to the following conditions.
Owner: Date:
Holly Lewis 11/25/2020
Occup t.B Location:
21 Heintick St
Occ n S Queensbury,Warren Co. NY ingle Family Dwg.
Applicantll
Holly Lewis
21 Heinrick St
Queensbury NY 12804
L J•
Joseph A.Holmes r - ---
-31.8.014148667EL
Equipment: DEC 0 9 202
�1
2-Switches; 5-Receptacles;2-Flxtures
-I L11-.Ili`il l,l.I',' _ ... •? _ , I,
This certificate applies to the electrical wiring to the electrical equipment listed Immediately null and void. This certificate applies only to the u ,occupancy and
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, ep coo ney or ownership
inspection. No warranty is eressed or implied as to the mechanical safety,effi- of the property Indicated above,this certificate shall be Imm i� ely Wulf and void.
ciency or Illness of the equipment for any particular purpose. This ceniticale shall In the event that this certificate becomes invalid based upon t e above conditions,
be valid for a period of one year from tho above noted date. Should the electrical this certificate may be revalldated upon reinspection by 0i dle Department
system to which this certificate applies be altered in any way,including but not limit- Inspection Agency,Inc. An application for inspection must bo bmitted to Middle
ad to,the introduction of additional electrical equipment and/or the replacement of Department Inspection Agency, Inc. to initiate the inspecti n and revalidation
any of the components installed as of the above noted date,this certificate shall be process. A fee wilt be charged for this service.