electrical inspection RX Date/Time 12/06/2019 13:08 15182731202 P,003
•r�;5 c 6, 2 119 012 M �,.�MD I A- .. ,,,� .ryA,,-, No.
2010 P. 3/6
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V MIDDLE DEPARTMENT INSPECTION AGENCY, INC. ••,
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[�s3,),I .8 that the electrical wiring to the electrical equipment listed below has been examined and is approved as � '
-hj1 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.
��a� Owner: C�
Hughs Date' 11/19/2019 r�
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•5.. Occupant: Location: [:a
�� Same �6 Wincoma Lane 4
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_'a) Occupancy Queensbury, Warren Co. NY PI
Single Family Dwg.
( 3 Applicant: C�G.
Marlow Electric (4
It Robert D. Marlow . �C�
('� PO box 448 • —....�._.r) 15.1- -� '(�a•
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L Lake Luzerne, NY 12846 L ! _ :
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Joseph A.HolmesIjC� 6 I
No. 001818114501EL •
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equipment: PIP C i ,'., ,.,-�tL'`;;`'
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v4 13 -Switches; 9- Receptacles; 20 - Fixtures; 2 -Vent Fans )
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((�< This certificate applies to the electrical wiring to the erectrIcai equipment listed immediately null end void. This certificate applies only to the use,occupancy and ;:%
t above end the installation inspected es of the above noted date based on a visual ownership as indicated herein. Upon a change in the use,occupancy or ownership (�,f
w.) 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.
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ciency or fitness of the equipment for any particular purpose. This certificate shell 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 w
tl 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 t��
1 eel to,the introduction of additional electrical equipment and/or the replacement of Department Inspection Agency, Inc. to initiate the inspection and revalidation i�,
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.
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