Electrical Inspection tl t l��
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that tiv oectricAl wiring to the electrical equipment listod below has been examined and it, pproved a5A,
p� y
being In ttsf�tl with thrw NnlintnV I �,Rn°i�° tl Code, �If ��l ,�
rioted below Slid i issued subject to the tnlinw�in nrandition,%, `tawr�r'n�n�nrtt �, Utility and Age
ncy rule In effect on thedrt " �
Owner Date:
Unlinifted Construction 0 / / 024
cou anti n„
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lweltia
p K t hen � Bedrooms 1560 Ridge Rd,
Is ocu n � Queensbury, Warne Co, DIY
.Single Family D g.
,ppliant�
CK Electric
Waterford, � �
114 Button
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218� �wAm �,��
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'u hael Adams
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i Equipment: 7' ^, � b � 9j l 1 Y � ��/,J A �
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Receptacle Replacement
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This certificate applies to the electrical wiring to the electrical equipment fisted immediately null and void. This certificate applies only to the use,occupancy and
above and the instaftation inspected as of the above noted date based on a visual ownership as indicated herein. Upon a change In the use,occupancy or ownership f l'
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.
ciencyr 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,
be valid for a period of one year from the above noted date,. Should the electrical this certificate may be revalidated upon rainspeellon by Middle.Department
system to which i thus certificate applies be altered In any way,Including but not limit- inspection Agency,Inc. An application for inspection must be submitted to Middle
ad to.,the Introduction of additional electrical equipment and/or the replacement of Department Inspection Agency, Inc, to initiate the inspection and revalidation i
any of the components installed as of the above noted date,this certificate shall be process. A fee will be charged for this service.