electrical RX Date/Time 02109/2021 11:28 15182731202 P,002
Feb, 9. 2021111 :07MtWW DI A— No, 5784 P. 2/5
MIDDLE DEPA1RTME�' INSPECTION AG-713,NCY, INC.
'&,eoo that the electrical wiring to the electrical equipment listed below has been examined and is approved as
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.
Owner: Date:
5 Star Golf Carts 02/01/2021
Occupant: Location:
Commercial, Fit Up 989 Rte. 9
Occupancy: Queensbury,Warren Co. NY
`Pion-Residential i
Applicant:
Bardin Electric
John Bardin
4 Elm St.
LHudson Falls, NY 12839 J
No.
-148110149818EL .._ ___
Equipment: CC- 01 2 0 2 0
-Receptacles D ra E n V E
FEB 10 2021
TOWN OF QUEENSBURY
BUILDING&CODES
This certificate applies to the electrical wiring to the elecMcal equipment listed immediately null and void. This certificate applies only to the use,occupancy and
above and the installedon 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,thia certificate shall be immediately null and void.
cienry or fitness of the equipment for any particular purpose. This certificate small 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 relnspection by Middle Department
system to which this certificate applies be altered in any way,Including but not limit- Inspecion Agency,Inc. An eppllcation for inspection must be submitted to Mlddle
ad to,the introduction of additional electrical equipment andlor the reptacement of DepaMtent Inspection Agency, Inc.to initlew the inspection and revalidation
any of the components Installed as of the above noted date,this certificate shall be process. A fee will be charged for this service.