electrical inspection RX Date/Time 1211712021 11:30 15182731202 P,003
Dec, 11. 2021 11 -.03AIN4 MDIA No. 8501 P. 3/4
MIDDLE DEPARTMENT INSPECTION• AGENCY, INC.
ii5 xWorss 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. Julia Steculk Date:
12/01/2021
Occupant: Basement Location
22 Parkview Ave
OccupancySingle Family Dwg. Queensbury,Warren Co. NY
Applicant r �
Hilltop Construction
Cindy Albrecht
51 Crowley Rd.
L Hudson Falls, NY 12839
Joseph A.Holmes ' �G
No. 1452621:54011 EL
Equipmeni: _ ...
18-Switches; 32-Receptacles;40-Fixtures; 1 _30•Amp-Receptacle; 1 -Vent Fan;10-Smoke Detector's 4-Arc
Fault Breakers
SC.-E0VE
4
DEC.- 1.7 2021
TOWN OF QUEENSBURY
BUILDING&CODES
This certificate applies to the electrical wiring to the aiectrlcal equipment listed immediately null and vain, This eertffieate applies only to the use,occupancy and
above and the instaUstion 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,this certificate shall be immediately null and void.
ciency or fitness of the equipment for any particular purpose. This certificate snail In the event that this cer ificate 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 reinspection by Middle Department
system to which this certificate applies be altered in any way,including 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 replacement of Department Inspection Agency, Inc,to initlate the inspection and revalidation
any of the components installed as of the above noted date,this certificate shall be process. A tee will be charged for this service.