electrical inspection *: p 2, 2022-11 : 18A MDIA No, 9828 P. 4/6
k) MIDDLE DEPARTMENT INSPECTION AGENCY, INC. �f
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cegivtAa that the electrical wiring to the electrical equipment listed below has been examined and is approved as <<),
0 being in accord with the National Electrical Code, applicable governmental, utility and Agency rules in effect on the date .-��
(e:;j noted below and is issued subject to the following conditions- g y (<<>>
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Owner_ John Graziano Date: •
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07/21/2022
Occupant: Renovations
Location: �,
e, 195 Assembly Pt Rd. (hj
Cy Occupancy_ Queensbury,Warren Co. NY
.>,• Single Family Dwg.
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(.) Applicant: .�5
Herritage Family Construction -
ks.: 209 Sunset Ave . • rc
•
Ballston Spa, NY 12020 ':.. ..:. ..•,., ••
.,....,.....,....... ... . CG 1
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-) Joseph A_Holmes • ' • , r j
�� No_ ••147076158696EL _ _ .• _. _ ����
;F� Equipment: �Fj
ice) " . . r
tacles;
61 -Switches; 98-Rece 118-=-F'
p txtilres; '1"='30AAir Condifidner, 1 =Burner,Wiring &Controls for Gas; 1 - `��
Septic Pump; 1 -20A Dishwasher, 1.=30A Dryer; 3-Vent Fans; 9-Smoke Detectors; 1 - 100A Sub Panel; 20-Arc
Fault Breakers .. re
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- Btl)z Ii�rt; G BURY `�-
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,. 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 C'
(raj inspection. No warranty is expressed or implied as to the mechanical safety,elfi- of the property indicated above,this certificate shall be immediately null and void. (C
Il:�.. ciency or fitness of the equipment for any particular purpose. This certificate shall In the event that this certificate becomes invalid based upon the above conditions, r'4
�•;: 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 W;�.
K'•J 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 (;J!
() ed to.the introduction of additional electrical equipment and/or the replacement of Department Inspection Agency, Inc.to initiate the inspection and revalidation (�
<l any of the components installed as of the above noted date,this certificate snail be process, A tee will be charged for this service" `;
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