Final Electric RX Date/Time 07/30/2019 13:58 15182731202 P.004
:,:Jul• 30. 2019 1_46P -•MDIA 9944
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'•f,' MIDDLE DEPARTMENT INSPECTION AGENCY, INC. y.
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nai eW s 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
\4, noted below and is issued subject to the following conditions. �y�
\� Owner: 1. 1
•t,-�J Takundewide Date:
"�� 07/12/2019
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�JOccupant: Location:
Dock Ext. 40 Boat House Road v'�
GS Occupancy
Services Queensbury, Warren Co. NY v
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Applicant: --..:::...:t
�t Dean Electric :- -. — 9i_,c1'
�� Box 4 :•}::. +'_J _ -
�� Glens Falls, NY 12801 • • ,r
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e1 Joseph A.Holmes 5
No 146653112901EL _ _ — �
,,,1 Equipment:
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6 GFI Receptacles; 3 Fixtures - P
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rc- This certificate applies to the electrical wiring to the electncal equipment listed immediately null and void. This certHlcate applies only to the use.occupancy and ��
CC;:. 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 4:,
� inspection- No warranty is expressed or implied as to the mechanical safety, effl- of the property Indicated above,this certificate shall be immediately null and void p•
�aciency 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 reinspection by Middle Department 4 l
�Ca' 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 cif(
J ed to.the introduction of additional electrical equipment and/or the replacement of Department Inspection Agency, Inc. to initiate the inspection and revalidation ���
' arty of the components installed as of the above noted date,this certificate shall be process. A fee will be charged for this service, .e
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