electrical inspection RX Date/Time 07/21/2021 09:39 15182731202 P,002
-GJul. 21. 20211 9: 16A4 MDIA No, 7383 P. 2/9
MIDDLE DEPART ENT INSPECTION AGENCY, INC.
ra W that the electrical wiring to the electrical equipment listed below has been examined and is approved as
being in accord with the National Electrical Coc e, applicable governmental, utility and Agency rules in effect on the date
noted below and is issued subject to the followir g conditions.
Owner:
Occupant:McDonalds Date:
Q7/06/2021
Counters Location92 Corinth Rd.
Occupancy: Queensbury,Warren Co. NY
Jon-Residential '
Applicant:I)
Koval Contracting
cG - Deb
110 Button Rd_
Waterford, N.Y. 12188
LG
No_ Joseph A.Holmes JUL 2 1 2021
.-141045152851EL TOWN OF
Equipment: BUILD1N G�� CODES
COD SRY
• . .. . . ES
2-Kiosks;2-Plug Strips;4=Receptacles; 10'-Fixt
This certificate applies to the electrical wiring to the electrical eq ipment 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 bas 3d 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 mechanic al salety,effi- of the property indicated above,this certificate shall be immediately null and void.
cienry or fitness of the equipment for any particular purpose. This c ertificate shall 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. Shouk the Electrical this certificate may be revalidated upon rainspection by Middle Department
system to which this certificate applies be altered In any way,includin g but not limit- Inspection Agency,Inc. An application for Inspection must be submitted to Middle
ed to,the introduction of additional electrical equipment and/or the r placement of Department Inspection Agency, Inc.to initiate the inspection and revalidation
any of the components installed as of the above noted data.this cert ica.ie shall be process. A fee u(i11 be charged for this service.