electrical inspection D ECEOWE
MAR 0 4 2021
TOWN OF QUEENSBURY
BUILDING&CODES
p p LB 20 LZ
4.x11Y41V9UNWl4At.:l H ELECTRICAL INSPECTION SERVICE,INC. i
;n'<'•,• Maiii Me 176 Due Rum Road-Manhaim,PA 77545
Nd1U1 ICIPAL CEtruiCATE - ELECTRICAL APPROVAL
hermit No.......................................C`,ett, NO 4 2 2 5 4 Cut-in Card No.....................................
Owner.......................... .!t r... .. .+�.+ .?....... ............................... ......... ........................................
Location.........2... .:lt ......t� . ..tl au........ .......r' 4 .. L �'
... .. .�....5r.....�..�73f:
InstallationConsisting of..................................................................................................................................... 1 ,
V. a 4.....fl.. .A......*.......................................................... 9
........................ ..........r..........................................................................................................................................
=: 'Installed By......... :.. .... aa�ezl?-.............I..................................Lie.No....... ........... ........................... ! `i
;. The condition.following gaycrned the issuance of this certificate,and any certificate previously issued is I i
cancelled:-
'••� This ccrtificid'ir outy covers the electrical cquiptnent mid installation condition-, as of date. UJ oo the <
introduction of hilt,ibotta)equipn0nt or alterations,application shall be promptly made tbi'inspection. � :•;i
Inspectors or this Company sli:ill have the privilege of inaking inspections at any time, and if its
t'V rules are violated_the Crtn anv shad have the ri hi 1p t°evoke this certificate. 'P b' f:
Date...........:3.�: :;�..>1.. .............. INSPECTOR. ""/'���(.�`7 �`�.................................. f
•; 4M G' Memi►er NSAA.,I.A.F..I. 1
TO 3!DVcl O-1swnW N08 P89186L ZO:LT TZOZ/EO/EO