electrical inspection RX Date/Time 0610712022 10:44 15182731202 P,002
."Jun. 7, 202210: 15A�MD I A No, 9451 P. 2!4
MIDDLE DEPARTMENT INSPECTION.AGENCY, INC.
Wwxl4 that the electrical wiring to the electrical equipment listed below has been examined and is approved as
being in accord wiih 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: 177 Glen Lake Rd. LLC Date:
12/23/2021
Occupant: 1st&2nd FI. Renovations Location
177 Glen Lake Rd.
Occupancy Ingle Family Dwg. Queensbury,Warren Co. NY
Applicant:
Stay At Lina .,. ._,., •, _
177 Glen Lake Rd. �C
Lake George, NY 12845
L -.J
Joseph A.Holmes
No. 148969169801 EL
Equipment:
52-Switches; 72-Receptacles; 92-FRtures; 1 ='Burribi,Wring&'Controls for Gas;'T-Well Pump;3-20 Amp,
Receptacles; 1 -30 Amp Receptacle;2-Vent Fans; 10-Smoke get=tflrs-11 -50 Amp.Vehicle Charger, 1 -Hot Tub;
21 -Arc Fault Breakers nn E
JU'N. 0 8 2022
TOWN.OF QUEENSSURY
B.UILDfIVG&CODES
This certificate applies to the electrical wiring to the electrical equipment listed immediately null and void. This certificate applies only to the use,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,occupancy or ownership
inspection. No warranty is expressed or implied as to me mechanical safety,ef6- of the property indicated above,this certificate shall be Immediately null and void.
ciency or fitness of the equipment for any particular purpose. This certificate shall In the event that this certificate becomes Invard 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 reinspection by Middle Department
system to which this certificate applies be altered in anyway,including but not limit- Inapeotton Agency,Inc, An application for in specdon must be submitted to Middle
ed to,the introduction of atlditionel electrical equipment and/or the replacement of Oepartmsnt Inspection Agency, Inc, to initiate the inspection and revalidation
any of the components installed as of the abovs noted date,this cert'rflCate shalt be process. A fee will be cTtarged for this service.
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