electrical inspection RX Date/Time 0111112021 10:21 15182731202 P.003
Jan. 11. 2021 lO;OIA MDIA I . No, 5669 I P. 3/7
MIDDLE DEPARTMENT INSPECTION.AGENCY, IN
emits that the electrical wiring to the electrical equipment listed below has been examined anti is approved as
being in accord with the National Electrical Code, applicable governmental, utility and Agency rules in e, ct on the date
noted below and is issued subject to the following conditions.
Owner RNR Tire Express Date: i
12/23/2020
Occupant: 70 Location
Comm. 8 Glen St
Occupancyon-Residential Queensbury,Warren Co. NY
F
Applicant:
John Carr
9 Halada Dr.
Lake George, NY 12845
L J
Joseph A.Holmes cc-
No. 148048147016EL
Equipment:
1 -100 Amp.Sub panel; 5-Switches;33-Receptacles;•55 Fixtures; 5-Exit/Emergency Combo.
9 �.VE
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FAIN 12 2021
JURY
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This ceiificate applies to the electrical wiring to the electrical equipment listed immediately null and void. This certificate applies only to tne; se,occupancy and
above and the instalietlon inspected as of the above noted date based on a visual ownership as indicated herein. Upon a change In the use,o ancy or ownership
Inspection, No warranty is expressed or implied as to the mechanical safety,effi- of the property indicated above,this certificate shell be iram�ciately null and void,
ciency or fitness of the equipment for any particular purpose. This certificate shall In me event that this certificate becomes invalid based upon above conditions,
be valid for a period of one year from the above noted date, Should the electrical this certificate may be revalldated upon reinspection byf4liddle Department
system to which this certificate applies be altered in any way,including but not limit- Inspection Agency,Inc. An application for inspection m bmitted to Middle
eb to,the introtluction of additional electrical equipment and/or the reDlaeement or Department Inspection Agency, lne, to initiate the inspseti In and revalidation
an of the corn onents installed as of Me above noted date,tills certificate shalt be 'Y p process, A tee Mill Bs charged for this service.
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