electrical inspection RX Date/Time 06/22/2022 15:54 15182731202 P.003
-Jun, 22, 2022, 3;25P - MDIA— No, 9554 P. 3
MIDDLE DEPARTMENT INSPECTION AGENC`Y INC.
ice&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: Harley Griffis
Date: 06/14/2022
Occupant: 1St Floor
LocationZ98 Cloverdale Rd.
Occupancy:FSingle Family Dwg. Queensbury,Warren Co. NY
Applicant
Dean Electric
Box 4
LC
Glens Falls, NY
L J JUN
Z 4 2022
Joseph A.Holmes." �OwN
OF
No. , 146653156$.00EL .-- _ - — - SUILp NG E CNS$URY
Equipment: ®ES
1 -200 Amp. Sub Panel; 1 =•70 Amp•Sub Panel; 15=Switches;36•-Receptacles; 32=;Fixtures; 1 -Water Heater, 1 -
Well Pump; 1 -Dishwasher,.1 -Vent Fan;2-Smoke Detector; 12-Arc Fault Breakers; 1 -Septic Pump
?-• 21
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 the mechanical safety,efv. 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 invalid baa^ed 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 retnspection 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 initiate the inspection and revalidation
any of the components installed as of the above noted date,this cerdricate shall be process. A fee wig be charged for this service.