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5.03 5.3 ELECTRICAUNortheast Electrical Inspections—Add as Electrical Finn and David Near as Inspector—7-20-15 RESOLUTION ADDING NORTHEAST ELECTRICAL INSPECTIONS, LLC TO LIST OF TOWN OF QUEENSBURY APPROVED ELECTRICAL INSPECTION SERVICES FIRMS AND AUTHORIZING DAVID NEAR, LA.E.L, AS RESIDENTIAL ELECTRICAL INSPECTOR RESOLUTION NO.: 92015 INTRODUCED BY: WHO MOVED ITS ADOPTION SECONDED BY: WHEREAS, the Queensbury Town Board previously adopted Local Law No. 4, 87 entitled, "Electrical Law of the Town of Queensbury," and amended the Law at the time the Town Board adopted the Queensbury Town Code(Chapter 80 -Electrical Standards), and WHEREAS, Queensbury Town Code Chapter 80 delineates criteria for businesses and/or individuals to perform electrical inspections within the Town of Queensbury, and WHEREAS, the Town's Director of Building and Codes Enforcement recently received information from Northeast Electrical Inspections, LLC, an electrical inspection service firm, which has requested that it be added to the Town's list of approved electrical inspection service firms, and WHEREAS, Northeast Electrical Inspections, LLC has further requested that the Town Board approve David Near, I.A.E.I, certified electrical inspector, as an approved residential inspector at Northeast Electrical Inspections, LLC, and WHEREAS, the Town's Director of Building and Code Enforcement has reviewed the information from Northeast Electrical Inspections, LLC, as well as Mr. Near's credentials, and has recommended that the Town Board authorize Northeast Electrical Inspections, LLC to make electrical inspections and Mr. Near to make residential only electrical inspections within the Town of Queensbury, NOW, THEREFORE, BE IT RESOLVED, that the Queensbury Town Board hereby approves and authorizes Northeast Electrical Inspections, LLC to make electrical inspections and David Near, I.A.E.I., to make residential electrical inspections within the Town of Queensbury subject to compliance with the standards set forth in Queensbury Town Code Chapter 80, including submission of the required fee and certificate of insurance, and BE IT FURTHER, RESOLVED, that the Town Board further authorizes and directs the Town Supervisor and/or the Director of Building and Codes Enforcement to sign any agreements and take any action necessary to effectuate the terms of this Resolution. Duly adopted this 20th day of July, 2015, by the following vote: AYES NOES ABSENT: RX Datelllme 05!30!2015 1 0:04 r.uu I Jun 30 15 10:04a Dave Near 518-370-1927 p.1 • F 1S 64/sue Fax To ❑ Urgent ❑ For Review ❑ Please Comment ❑ Please Reply vac From: Dave Near 4 Comments: 2 Arrou,t CC yYC4 4 Re: Fax — yi437 1-, 7 1 in s(.� s LG✓/• 1 Phone f U Pages (p P lam-5<- c,. /l dt— do.74 450 /&-5t'Ace.- N (9r ip ,ck NORTHEAST ELECTRICAL INSPECTIONS, LLC Tel:518-852-0826 65 Albermarle Rd www.neillc.com Fax 518-370-1927 Scotia, NY 12302 dave @neillc.com Inspeedens C ./c(1b vt `';2q Itx uate/i ime ubiswcu 1 b i u:u4 r.vu Jun 30 15 10:04a Dave Near 518-370-1927 p.2 DAVID NEAR 65 ALBERMARLE ROAD SCOTIA,NY 12302 518-852-0826 cia a @neilic.com Professional Background January2015 to Present: Owner, Northeast Electrical Inspections, LLC 65 Albermarle Road Scotia, NY 12302 March 2013 to January 2015 Partner:Epergy Solar,dba Altura Solar March 2011 to March 2013 Owner,Allura Solar January 2005 to March 2011 Owner, Near Perfect Water, Dave Near Electric January 2000 to January 2005 CoOwner Sunrise Electric Union Shop- Electrical Construction June 1978 to January 2000 Member IBEW, Local 236 Justin Electric Middleton Electric Schenectady Hardware& Electric George Martin Electric Educational Background Scotia-Glenville High School Graduate 1974 Hudson Valley Community College Associates Degree in Business Administration 1976 Local 166 Apprentice 4 years 1978 to 1982 Licenses/certifications Journeyman Electrician since 1982 Master Electrician since 1996 NABCEP Certified Solar Hot Water Installer 2011 Kx ua&e:i Ime uwiui U 1 1 u:u4 r.uu3 Jun 301510:04a Dave Near 518-370-1927 p.3 NABCEP Certified Solar PV Installer 2013 ICC Certified Residential Electrical Inspector 2015 AFFILIATIONS: ICC-International Code Council NAPF IAEI—International Association of Electrical Inspectors NABCEP NYSERDA REFERENCES: Mark Williams Master Electrician,Solar City 518-488-1315 John DeSieno Pharmacist 518-588-1790 June 29,2015 IA Y.UU4 MI/3WD.!I 3 11.13.14 MILW 518-370-1927 p.4 Jun 30 15 10:04a Dave Near • CITY OF SCHENECUDY,NY License of 149 0 This is to certify that 86 • — has met die necessary retwirernents and paid all tees as rade red bylaw and has scan tadisternd on• Master Lic. Elect. • DI the efece OS the Etactricet eiestaine Dowd at me City ot SCheneciedy.S1Y.g• December 31.1996 unless sooner related as peauded by taw. 30th :Tan 9 6 !reau,1 ati,ete4ye •---.010y " r•• _iteyor BeCtrir.01 LiCOrkarig Board L. • c ''11.°N'∎It r ir1. i#7'sr'„` ""\•4r 'Thi^P"r r' \,ff,r tr'7Nr"!• , ' '"\>^\r , ;rN.r\r' ,^4.,.%. ,oN►:. 0 O x „, License # 86 1 et-t ::d-D1 =) C tta :L :' Dry. ) 0) .,,,„. .,,.et. trttet Itireiti‘utg-1,8 . .. ) 0 • : • P •:C p the first-c a -of January, 2010'=h, :1iet the necessary requirements and:, paid":t e fee as req fired K: l:!..F.;!:•,........and has beep registered::as a ' • • LICENSED EL • ! �CONTI iCTO . .,;;•.:;.."...;:.:...... .1-:.is-.!:'1•,t•'�St,l::: ';.,.;.;;:,...;i,;;;,•'....;;• ii .. .. .. U1 j l s� . ;.:4 •-•''''.•::::':i•••' l' ryo 0 CD • a sis,: ereby ens dt car y•on•-such business . until the '•first:'da� of December :2010 unless.sooner revoked bylaw • :S tar/Elatriaxl Licerwrrg bawd 1��....,eY,Y'....eV'4,/,SIP"1/,VIP' ✓ V' '4!''.4i..e...? 'V'J 4v/. /:��,/:...?V' ......,V• V.'.../"v/..V..V. �%../Nr ./'1 '+1/, O, v NA uatertime U6wLU LU1 b 14:46 bltf S/U 1yi/ P.U05 Jun 291502:36p Dave Near 518-370-1927 p.5 • NORTHEAST ELECTRICAL INSPECTIONS, LLC TO :TOWN BOARD OF QUEENSBURY RE:INSPECTOR QUALIFICATIONS INSPECTOR : Dave Near Owner of Northeast Electrical Inspections, LLC Certified Residential Electrical Inspector by ICC [ International Code Council } In process of becoming Commercial certified Licensed Master Electrician — since 1996 Member IBEW - since 1978 NABCEP certified Solar PV installer— since 2012 Owner Sunrise Electric Inc - 2000—2005 Owner Allura Solar- 2010 —2012 [ Merged with Epergy I Future Inspectors: In process of hiring 2 full time and 2 part time certified inspectors. I will send you their names and credentials upon their employment at NEI • 65 Albermarle Road PHONE S18-852-0826 Scotia,NY 12302 FAX 518-370-1927 FJcevlcd EMAIL lave @neillccom Inspections LLC WEB SITE www.neitic.aom IiA uatel lime ubIC ILU I3 14:30 310 3/U IdZ/ r.VVO Jun 2915 02:36p Dave Near 518-370-1927 p.6 .-----""} NORTI1-4 OP ID:MMA '�'���R CERTIFICATE OF LIABILITY INSURANCE - °'�"�S THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER TIE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certifcats holder is an ADDITIONAL INSURED,the pollay(ies}must be endorsed. If SUBROGATION IS WAIVED, subjeG to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the ' certificate holder In lieu of such endoreement(s). PRODUCER .gMrCT Daniel V Greco D.V.Greco 3 Sons Inc • 2621 Guilderland Ave •ao, 518-3701.4016 I rec.Nam S18-372-6612 Schenectady,NY 123 es Daniel Y Greco • HMSO)AFFORDING COVERAGE HMV INSURER A:Merchants Mutual Insurance Co. esuRE. Northeast Electrical DIMMER R: Inspections LLC I OS Albemarle Road sea RER c: -- i Scotia,NY 12302 INDORRR n: WWS1RIRE: _ INSURER P: . COVERAGES CERTIFICATE NUNIIRER: REVISION NUMBER: • THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE UST=.D BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INCIPATED NOTWITHSTANDING ANY RECUIRETaENT.TERM UR C ONDI1'ION OF ANY CONTRACT OR OTI ICR DOCUMENT WITH Rl".PECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PEI/INN. THE INSLJ ANC E AFFORDEC BY THE POLICIES CESCPJBED i•EREIN IS SUBJECT TO ALL THE TERMS IXCLUISioNS PNC CONDITIONS OF SUCH POLICIES LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. • WPM OP:WORM= AMP PCUCY NUNBEN tNIMIDCVYYYWI t MOOO,Y I LIMITS A X coaraFRCWLGEVEZALUAOILRY tACecoxuRRRt•JRCC 5 1,900,000 cLAP,a41ADF © ccc:IR X BOPI085193 OW08'2015.05/08/2016 PHE., g ny, e1 t 500,000 _ ® R' L9 ERtAro axleonmetri i 15,000 • {f • PERSONAL A ADV:WU me ; Included CE►rLACGREG ATP IS117AAPLL�APE1� l • I RALAOCirREUAIt $ 2,000,000 • 1Pcuc'•'n t El Loc rnaoucrs-COMP'(Pme ; 2,0001COC DIRER' I b JIUTOM aE LIABL7T I OMBNti EInv L_MT E • • ANY AUTO BODILY INJURY(Peg pace $ - AjJ L V O i ccl_D CD BODILY INJURY;Per Ada t) i • •NUN-OWN.-L PROPER:Y WOAD'= IIIRCDAuTOS I;turns IParaetat= $ .__ JI 3 X INIERELLA MD X occvn I LOC:O=AUW4ICE s 5,000,000 • A GAMS LIAR C_AIMs-61A1.3t I UNASSIGNED 05/0812016 860011/2016 Anurgeumt, S 5,00_0,000 mu E X1 ctTENTto.s 10,000 L s woRNERSOOMPENSATION I I�ATII:= 1 x I i F • AND EMPLOYERS'moor/ YIN A AY PROF SEH:UYMFNE:E:GCUTNL c, i WCAI034865 0510612016 0510612016 EL EACHACCIUINT s 1,000.000 OF?ICERL$IEYRFR FXrU Wan A/A INaadrborylnNH) EL DISEASE-SA0.1PLOYF= $ 1,000.000 Uyx'�lTP12 rh.4cn3.Y OCEC.IIPTION OF OPEPATItNUS below ti,RiET&h3E-?DUCT Lam- L 1,000,000 { . Damn=OPDrBRATRCRSI LOCATIONS I IEHICLFS IACORO 105 AddIllonA MITAAIA Schalukk rajdenactedIrmvr.spaceIIIaquL•sdI -Certificate holder is listed as additional insured. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE I . - THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN i Town of Queenstwry . ACCORDANCE WITH THE POLICY PROVISIONS 742 Bay Road Queensbtny,NY 12804 - AUTH011250 ItsPROlssur/MVE ; Daniel V Greco -- ...a...09 .r 'S' I f. 0 1983-2014 ACORD CORPORATION. All rights reserved. ' ACORD 26(2014/01) • The ACORD name and logo are registered marks of ACORD - RX Dareriume Uti 19/1U15 14:55 5113 NU 1U/ P.007 Jun,29 15 02:36p Dave Near 518-370-1927 p.7 A ° CERTIFICATE OF LIABILITY INSURANCE �"u,`" V THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WANED,su bject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER LoVuHo Associates,Inc, ciiA Angers&Litz Associates Inc PRONE 6450 Transit Road (NC. .Erdk (518)3554030 FAX N,L(51B)3550034 •EADDRESS: Depew,NY 14043 INSURERS)AFFORDING COVERAGE RAIDS INSURER A JRONSHORE SPECIALTY INSURANCE CO 25445 INSURED Northeast Electrical inspections LLC INSURER B: 65 Atberrnarie Road INSURER C Scotia,NY 12302 INSURER D: INSURER E: _INSURERF: , COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADM_SUBR POLICY EFF POLICY EXP - LTR MU M& POUCY NUMBER IMWDD/YYYVI IMMIDD/YYYYI LIMITS GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL UABIUTY DAMAGE TO RENTED CLAIMS-MADE OCCUR MEMISE oipno /Ea oaes) MEDDCA( $Anyoneperson) S _ PERSONAL AADV INJURY` S ■ GENERAL AGGREGATE S 064t AGGREGATE LIMITAPPUES PER PRODUCTS-COMP/OP AGO S POLICY n j CT n LOC .S AUTOMOBILE UABDJTY COMBINED SINGLE UNIT YEA accident) ; III ANY AUTO BODILY INJURY(Per person) S ALL OWNED SCHEDULED - AUTOS AUTOS BODILY INJURY(PsraeeMnU = NOMOY/NEO PROPERTY DAMAGE HIREDAUTOS ^AUTOS (Per accident) S _ t _ s UMBRELLA MB ` OCCUR EACH OCCURRENCE S _ EXCEL LIAR CLAIMS-MADE AGGREGATE S • DE3 1 I RETENTIONS S WORKERS COMPENSATION I C WAITS I I FR AND EMPLOYERS'LIABILITY YIN ANY PROPRIETORIPARTNER/EXECUTIVE OFFICER/MENDER EXCLUDED? N/A El.EACH ACCIDENT S (Maedatery in NIN) El.OISEASE-EA EMPLOYEE $ C describe OF EL.DISEASE-POLICY LWI_$ DESCRIPTION OF OPERATIONS below A ESO Liability 002388000 05/08/2015 05/0112011 Each Claim/Aggregate � $1,000,o0WSi,000,000 Deductible I X500 DESCRIPTION OF OPERATIONS 1 LOCATIONS/VEHICLES(Attach ACORD 1St AddIN .d Remarks schedule,If Mire space Is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 742 Town Bay y Queensbury AUTHORIZED REPRESENTATIVE PLA'742 Bar Rd Q I UEENSBURY,NY 12804 ®19882010 ACORD CORPORATION_ All rights reserved. ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD KA uatei l lme UOIZVILU 15 l4:ib 311:1 3/U 1JL/ P.0011 Jun 2915 02:37p Dave Near 518-370-1927 p.8 AGENCY CUSTOMER ID:902000 �..� LOC#: ACORE, ADDITIONAL REMARKS SCHEDULE Page 2 of 2 AGENCY NAMED INSURED Angers&Utz Associates Inc Northeast Electrical Inspections LLC POLICY NURSER 65 Albermarte Road 002388000 • Scotia.NY 12302 CARRIER NAIC COOS Ironshor•Specialty Insurance Co 25445 EFFECTNE DATE 05/00/2015 ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER:25(2010/05) FORM TITLE: Certificate of Liability Insurance This Page Intentionally Left Blank ACORD 101(2008/01) ®2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD RX Date/Time 06/16/2015 17:03 518 3701927 P.007 jun.16 15 05:06p Dave Near 518-370-1927 p.7 n\� Residential Electrical Inspector INTERNATIONAL CODE COUNCIL 3 Candidate ID: ICC00239414 Name: David Near Date: 5/29/2015 Address: 65 Aibermarle Road Scotia NY 12302 EXAMINATION RESULT: PASS Congratulations!You have passed the above-named examination.Your wallet card will be forwarded to you by ICC within six weeks from the last day of the month in which you tested.This certification is current for three years. You may request a wall certificate from ICC as well This certificate will be provided at no cost to you, if ' you request it within 90 days of your exam_Only one wall certificate per exam passed will be provided to you at no charge. For more information on requesting a wall certificate,go to www.iccsafe.org/inspector. It is extremely important that you notify Pearson VUE and ICC of any changes in name and/or address to avoid the possibility of your wallet card and/or certificate not being received. There may be an additional fee if a certification is re-issued due to a misspelled name or incorrect address. Please note that name changes may require additional information. For exams taken in the US: Please contact Pearson VUE at 800-275-8301 and ICC at certexam@iccsafe.org. For international exams: Please go to www.oearsonvue.com/icc/cert/contact/. The authenticity of this score report can be validated by using Pearson VUE's Online Score Report Authentication found at: www.PearsonVUE.com/authenttate Digital embossing eliminates the possibility of unauthorized embossing of counterfeit score reports. Registration Number: 283983235 Validation Number: 939104827 RX DatelTime 06/1612015 17:03 518 3701927 P.ovs Jun'1.61505:06p Dave Near 518-370-1927 p.8 ICC INTERNATIONAL ='t CODE COUNCIL !r! Certified Professional Information: - Last, First MI: Near,David Certified under this name: David Near City, State Zip: Scotia, NY 12302 Certification Type(s): Residential Electrical Inspector(expires 05/29/2018) ICC MEMBERSHIP STATUS: EXPIRED RENEW NOW Upload your image by pressing the 'Upload Your Photo' link on the left side menu. QUICK LINKS Log in to myICC(https://www.iccsafe.org/ iayouts/ICCSafe/login.aspx? Return UrI=%2fmylCC%2fPages%2fdefault.aspx) Renew ray Membership (http Jlwww.iccsafe.org/Membership/Pages/RenewReinstateMembership_aspx) Renew my Certifications(httpJ/www.iccsafe.org/Certification/Pages/renew.aspx) ICC Online Campus(http l/campusoniine.iccsafe.org/) Other search options (https://ay.iccsafe.org/EWEB/DynamicPage.aspx? Site=icc&WebKey=b7afd990-2e14-4013-a186,aeb405641 a95&FromSearchControl=Yes) Upload Your Photo (ver_photo/index.phpkeedbadc(mailto:webmaster @iccsafe.org) Main ICC Websi thitf9 lkeal WRitt*org/Resources/member-lookup.cfm#top) RX DatelTime 06/16/2015 17:03 518 370 1927 P.uu9 Jun 16 1505:08p Dave Near 518-370-1927 p.9 • �5 r_. 10-NORTHEAST ELECTRICAL INSPECTIONS, LLC Elec3-ncal 65 Albermarle Rd Inspections L - C Scotia N.Y. 12302 PHONE: (518)852-0826,ELECTRICAL PERMITS FAX: (518)370-1927 • • ELECTRICAL INSPECTION REQUEST FORM PROJECT OWNERITENANTIBUSINESS PROJECT ADDRESS TOWN/CITY COUNTY CONTACT# BUILDING OCCUPANCY Licensed Electrician Signature S Contractor Business Name License#/City or County Contractor Printed Name Project Contact Person: Phone Number: • NOTE Project drawings approved with the Building Permit are required to be available on site for the inspector. Inspection will not be conducted.if Approved Plans are not made available to the Inspector. Electrical Permit NO. Requested Inspection Date: Inspection Results to be Returned By: • Mailing Address: Fax Number . . Comments REQUESTED INSPECTION TYPE (Check all applicable types)- Residential Commercial ROUGH-IN PARTLY(Inspection of Electrical Wiring or Raceways tpbe Concealed) _ Conduits in Trench Conduits in Slab or Foundation_Wiring or Raceways in Walls, Ceilings or Roof _Low Voltage Alarm or Security System Wiring _Swimming Pool/Spa Bonding/Wiring/Disconnects_Irrigation System or Landscape Lighting Wiring A/C Control Wiring ROUGH-IN COMPLETE(Inspection to Confirm Installation Is Complete and Ready to Be Energized) •Rough in complete SERVICE (Inspection of Service Equipment,'Including Coordinated Inspections for Service Equipment Replacements) . . . _Service Equipment Coordinated.Service Inspection Utility to Disconnect Power at (Time) Utility ESR or J# Ready for Inspection to re-energize' (Time) PHOTOVOLTAIC SOLAR SYSTEM Photovoltaic Solar System FINAL(Inspection to confirm installation is energized,working and structure is ready to be Occupied) Final . . REINSPECTION(Inspection to Confirm Previous Deficiencies Have Been Corrected) _Reinspection (indicate type of Inspection to be rechecked) $50.00 Reinspection fee submitted to Northeast Electrical Inspections, LLC OTHER TYPE OF INSPECTION • INNSPECTION.RES LILTS. o.Eie com_pletec3 by nspecto4 _Approved_Failed, due to the following AHJ has been notified that service inspection is approved and Installation is ready to be energized. 2rd Consecutive Failed Inspection. Inspection Fees Paid.to.Northeast Electrical Inspections, LLC. Mastercard,Visa,Discover,.Check,-Cash InspectorsNotes/NECViolations IAA',mime f 111116 VVfVLfL■ I J I J1V 1.11U 1.0161 I .VVV , J,urr 0z 15 10:42a Dave Near 518-370-1927 p.6 NORTHEAST ELECTRICAL INSPECTIONS, LLC ECtitical 65 Albermarle Rd Inspections j C Scotia N.Y. 12302 PHONE: (518)852-0826, ELECTRICAL PERMITS FAX: (518)370-1927 • ELECTRICAL INSPECTION REQUEST FORM PROJECT OWNER/TENANT/BUSINESS PROJECT ADDRESS TOWNICITY COUNTY CONTACT it BUILDING OCCUPANCY Licensed Electrician Signature • Contractor Business Name _ License#1 City or County •- Contractor Printed Name .. • Project Contact Person: Phone Number: - NOTE:Project drawings approved with the Building Permit are required to be available on site for the inspector. Inspection will not be conducted.if Approved Plans are not made available to the Inspector. Electrical Permit No. Requested inspection Date: Inspection Results to be Returned By: • _ Mailing Address: Fax Number . Comments REQUESTED INSPECTION TYPE (Check all applicable types) • " Residential Commercial ROUGH-IN PARTLY(Inspection of Electrical Wiring or Raceways to be Concealed) _Conduits in Trench_Conduits in Slab or Foundation_Wiring or Raceways in Walls. Ceilings or Roof Low Voltage Alarm or Security System Wiring _Swimming Pool/Spa BondingNVirino/Disconnects Irrigation System or Landscape Lighting Wiring A/C Control Wring ROUGH-IN COMPLETE(Inspection to Confirm Installation Is Complete and Ready to Be Energized) Rough in complete SERVICE(Inspection of Service Equipment,Including Coordinated Inspections for Service Equipment Replacements) Service Equipment_Coordinated Service Inspection Utility to Disconnect Power at (Time) Utility ESR or J# Ready for inspection to re-energize • (Time) PHOTOVOLTAIC SOLAR SYSTEM i Photovoltaic Solar System FINAL(Inspection to confirm installation is energized,working and structure is ready to be Occupied) Final REINSPECTION (-Inspection to Confirm Previous Deficiencies Have Been Corrected) _Reinspection(indicate type of Inspection to be rechecked) _$50.00 Reinspection fee submitted to Northeast Electrical Inspections. LLC OTHER TYPE OF INSPECTION • INSPECT_iONRESI LTSSTo t?e_corripleter by tns�eetor _Approved Failed,due to the following AHJ has been notified that service inspection is approved and Installation is ready to be energized. 2reConsecutive Failed Inspection. Inspection Fees Paid to Northeast Electrical Inspections, LLC. Mastercard,Visa,Discover,Check, Cash InspectorsNotes/NECViolations