HomeMy WebLinkAbout0340 SEAPUIT ROAD I
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ngineering Dept. (3rd floor) Map Parcel d Permit# / g�
House# 6Q� Date Issued
Board of Health(3rd floor)(8:15 -9:30/1:00-4:30) qs- 1$'/�'��� Fee o���6l
A4', ,B^ARNSrABLL 9?!
TOWN OF BARNSTABLE 'F°
Building Permit Application
7Prd* Ad!dress -34/Q Sec, ��• Rj•
Village
Owner MAI;, 04?1 CA Address 5
Telephone C/o i6/A4 Lde- c-e
Permit Request I-A 2 ��.:�n (Pc.1 Sc®.4-.
First Floor square feet Second Floor square feet
Construction Type
Estimated Project Cost $
Zoning District Flood Plain Water Protection
Lot Size Grandfathered ❑Yes ❑No
Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(#units)
Age of Existing Structure Historic House ❑Yes ❑No ,On Old King's Highway ❑Yes ❑No
Basement Type: ❑Full ❑Crawl ❑Walkout ❑Other
Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft)
Number of Baths: Full: Existing New Half: Existing New
No.of Bedrooms: Existing New
Total Room Count(not including baths): Existing New First Floor Room Count
Heat Type and Fuel: ❑Gas ❑Oil ❑Electric ❑Other
Central Air ❑Yes ❑No Fireplaces: Existing New Existing wood/coal stove ❑Yes ❑No
Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size)
❑Attached(size) ❑Barn(size)
❑None ❑Shed(size)
❑Other(size)
Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑
Commercial ❑Yes ❑No If yes, site plan review#
Current Use Proposed Use
i
Builder Information
Name Llyll 001 Telephone Number a r
Address SS ( /—c(yMy ifT7 k7?,V License#
MCA S /Yj , A C; Home Improvement Contractor#
0196 Ya Worker's Compensation# 1,J C
NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS
PROPOSED STRUCTURES ON THE LOT.
ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO
SIGNATURE ^� DATE �/�y� L
BUILDING PERMIT DENIED FOR THE FOLLOWING REASON(S)
i
The Collinionwealth of Afassachuselly
:+cif _-... -_=�; :- Departlneyit of Industrial Accidents
office ofinyest/921/ons
600 11'a0inl;ton Street
' '� ►:.= �.` Boston. Mass. 02111
Workers' Compensation Insurance Affidavit
,�p�)tcant_tntormatton• _ ;- _ Please PRiNT'leb�jY -r ,
nam
location•
city nhonc#
1 am a homeowner performing all work myself.
_ C3 I am a sole proprietor and have no one working in any capacity
1Vt>.:•^�}�/^!^!!^._gin!".�:•"� AR�+rr._.rw71FT.-cr�m•'�aw...•►^'� _ .w..�w�w!"�."'�'�.�.."f"_"_!�p�.'wM...�-r.'wRse-'" '.' ��
.try.ri--•'-..�:1 +y._.�.:'.',.�....::�.n�..�.�.._........ �.� - _ _ _ - �p�..
m an employer providing workers' compensation for my employees working on this job.
company name:
address. 3 S t tlGr r�C—I If►'t� I `' (L�
l.. M CAI.S 4b,,. i t!'S C. Phone#•cit
insurance co ��' "� ' ` polio.#
Tam a sole proprietor, general contractor,or homeowner(circle one)and have hired the contractors listed below who have
the following workers' compensation polices:
company name: —
address: —
city: ohon #•
insurance co P°
icy# _
t. - � _ _... K.l1!:: •:T�•VO�-�r•�'•:.:�T'�'e•.cr-.t.�T,;; _r;r. :.r�`+•+�b�'�.1,�'{T.f,Rn .:b:.�.�•_•`-`�'.,r,.�.,, .._.�_.r�.Y.�iCy.a.i.:s��u"e
cnm ant•name*
address:
city. nhonc#-
insurance co Policy#
:Attach additional shce't if necessary., i^ _v.> y_ JI"r:afiy�r.�%;a`:_:_ t;.. _- t;+ ?� _•_� yyp��.C,.aa,
Fuilure to sccurr coycr:tgc as required under Scetion 25A of AIGL 152 can lead to the imposition of criminal penalties of a fine up to SISOU.UU andior
one •cars'imprisonment as well as civil penalties in the form of a STOP NVORK ORDER and a fine of S100.00 a day against me. 1 understand that a
cape of this statement may be forwarded to the Office of Investigations of the D1A for coverage verification.
I tlo hereby certify tinder the pains and penalties of perjury that file information provided above is true and correct.
Sianature Date
Print name L.)PeAc-2 C C' i`� Phone#,
ofTicial use unlv do not write in this area to be completed by city or town official `
city or town: permit/license q rlBuilding Department
OLicensing Board
13 check if immediate response is required E3Sclectmen's Office
C3I1ealth Department
contact person: phone#• nOther
IreMlfed 1.05 PJA)
• 4
information and Instructions
Massachusetts General Laws chapter 152 section 25 requires all emplovers to provide workers' compensation for their
employees. As quoted from the "law", an empintlee is defined as every person in the service of another under any
contract of hire, express or implied. oral or written.
An empl(mer is defined as an individual, partnership, association. corporation or other legal entity. or anv two or more
the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the
receiver or trustee of an individual , partnership, association or other legal entity, employing employees. However the
owner of a dwelling house having not more than three apartments and who resides therein. or the occupant of the
dwellin.�house of another who employs persons to do maintenance , construction or repair work on such dwellin= hour
or oft the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer.
MGL chapter 152 section 25 also states that every state or local licensing agency shall withhold the issuance or
rencival of a license or permit to operate a business or`to construct buildings in the commonwealth for any
applicant who has not produced acceptable evidence of compliance with the insurance coverage required.
Additionally. neither the commonwealth nor any of its political subdivisions shall enter into any contract for the
performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter ha
been presented to the contracting authority.
77.
Applicants
Please fill in the workers' compensation affidavit completely, by checking the box that applies to;your situation and
supplying compamr names. address and phone numbers as all affidavits may be submitted to the Department of
Industrial Accidents for confirmation of insurance coverage. .Also be sure to sign and date the affidavit. The
affidavit should be returned to the city or town that tite application for the permit or license is being requested.
not tiie Department of Industrial Accidents. Should you have any questions regarding the "law"or if you are required
to obtain a workers' compensation policy, please call the Department at the number listed below.
City oC rowns
Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of
the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding tite applicant. Pleas
be sure to fill in the permit/license number which will be used as a reference number. The affidavits may be returned to
the Department by,mail or FAX unless other arrangements have been made.
The Office of Investigations would like to thank you in advance for you cooperation and should you have any questions.
please do not hesitate to give us a call.
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The Department's address. telephone and fax number:
The Commonwealth Of?Massachusetts
Department of Industrial Accidents
Office of Investigations
600 Washington Street
Boston,Ma. 02111
fax #: (617) 727-7749 17,-
phone #: (617) 727-4900 ext. 406, 409 or 375
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The Town of Barnstable
Department of Health, Safety and Environmental Services
URNSU= = Building Division
• ih� t►`0� 367 Main Street,Hyannis MA 02601
t�
Office: 508-790.6227 Ralph M.Crossen
Fax: 508-790-6230 Building Commissioner
Home Occupation Registration
Date: cl 3 0 l
Name: r h n 7-)n)\v 12, (AX ICS Phone#: S
Address: 3(-10 S Z C R O TT )20 A-l7 Village: 0 S'�1f 12 U r C.
Type of Business: Lai .T Map/Lot: nq S 0 1 a
RfrFNT: It is the intent of this section to allow the residents of the Town of Barnstable to operate a home occupation
within single family dwellings,subject to the provisions of Section 4-1.4 of the Zoning ordinance,provided that the
activity shall not be discernible from outside the dwelling: there shall be no increase in noise or odor,no visual
Aeration to the premises which would suggest anything other than a residential use;no increase in traffic above normal
residential volumes;and no increase in air or groundwater pollution.
After registration with the Building Inspector,a customary home occupation shall be permitted as of right subject to the
following conditions:
• The activity is carried on by the permanent resident of a single family residential dwelling unit,located
within that dwelling trait.
• Such use occupies no more than 400 square feet of space.
• There are no external alterations to the dwelling which are not customary in residential buildings,and
there is no outside evidence of such use.
• No traffic will be generated is excess of normal residential volumes.
• The use does not involve the production of offensive noise,vibration,smoke,dust or other particular
matter,odors,electrical disturbance,heat,glare,humidity or other objectionable effects.
• There is no storage or use of toxic or hazardous materials,or flammable or explosive materials,in excess
of normal household quantities.
• Any need for parking generated by such use shall be met on the same lot containing the Customary Home
Occupation,and not within the required front yard.
• There is no exterior storage or display of materials or equipment.
• There is no commercial vehicles related to the Customary Home Occupation,other than one van or one
pickup truck not to exceed one ton capacity,and one trailer not to exceed 20 feet in length and not to
exceed 4 tires,parked on the same lot containing the Customary Home Occupation.
• No sign shall be displayed indicating the Customary Home Occupatiom
• If the Customary Home Occupation is listed or advertised as a business,the street address shall not be
included.
• No person shall be employed in the Customary Home Occupation who is not a permanent resident of the
dwelling unit
I,the undersigned,have read and agree o ctions for my home occupation I am registering.
Applicant: Date: 9
• Homeoc.doc
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TO ALL NEW BUSINESS OWNERS
Fill In please:
YOUR NAME:
APPLICANT'S IS I %% YOUR HOME ADDRESS: -�2-In 6-W
BUSINESS �5-►-�N i ►to �'► o ��ems'
TELEPHONE Telephone Number (Home)
:, , ,..
i
l /U//i Cv
rah /� G✓�� �, TYPE OF BUSINESS
NAME OF NEW BUSINESS hip T
IS THIS A HOME OCCUPATION? `-des va E sS r
ADDRE
SS OF BUSINESS 3`IO Sc' �-I- i�.� O >N it h +'n ft- MAP/PARCEL NUMBER OcS 0-1�
When starting a new business there are several things you must do in order to be in compliance with the rules and regulations of the Town of
Barnstable. This form is intended to assist you in obtaining the information you may need. Once you have obtained the required signatures,
listed below, you may apply for a business certificate at the Town Clerk's Office (Ist floor-Town Hall).
# 'S 1. GO TO BUILDING INSPECTOR'S OFFICE (4TH FLOOR TOWN HALL)
This individual h s een informed of any permit requirements that pertain to this type of business.
Authorized igna ure
- --
COMM�NTS: v
'i
2. GO TO BOARD OF HEALTH (3RD FLOOR TOWN HALL)
This individual h ee r ed o �heperQgjt requirements that pertain to this type of business.
Authorized signature
COMMENTS:
3. GO TO CONSUMER AFFAIRS (LICENSING AUTHORITY) - (3RD FLOOR SCHOOL ADMI ISTRATION BUILDING)
This individual h s e informed of the licensing*requirements that pertain to this type of business.
Vr" /U
Authorized Signature
COMMENTS:
' After obtaining the required signatures you must return to the Town Clerk'sown'ce to(which ain your business youmust do by M.G.L.certificate
does not give you
for 4 years). A business certificate ONLY REGISTERS YOUR NAME in the t ( y
h completion of the processes from the various departments involved.
permission to operate -you must get that throug
The Town of Barnstable
Department of Health, Safety and Environmental Services
ttvsretue. Building Division
1619. 367 Main Street,Hyannis MA 02601
Office: 508-790-6227 Ralph M.Crossen
Fax: 508-790-6230 Building Commissioner
Home Occupation Registration
Date:
Name: !//'X 76 Ae Z etc Phone #:
Address: `l D SeG 0 If - Village: Ol/
Type of Business: �10-176 & ,L Map/Lot: 0 9 ( 0 1 D
INTENT: It is the intent of this section to allow the residents of the Town of Barnstable to operate a home occupation
within single family dwellings,subject to the provisions of Section 4-1.4 of the Zoning ordinance,provided that the
activity shall not be discernible from outside the dwelling: there shall be no increase in noise or odor,no visual
alteration to the premises which would suggest anything other than a residential use;no increase in traffic above normal
residential volumes;and no increase in air or groundwater pollution.
After registration with the Building Inspector,a customary home occupation shall be permitted as of right subject to the
following conditions:
• The activity is carried on by the permanent resident of a single family residential dwelling unit,located
within that dwelling unit.
• Such use occupies no more than 400 square feet of space.
• There are no external alterations to the dwelling-which are not customary in residential buildings,and
there is no outside evidence of such use.
• No traffic will be generated in excess of normal residential volumes.
• The use does not involve the production of offensive noise,vibration,smoke,dust or other particular
matter,odors,electrical disturbance,heat,glare,humidity or other objectionable effects.
• There is no storage or use of toxic or hazardous materials,or flammable or explosive materials,in excess
of normal household quantities.
• Any need for parking generated by such use shall be met on the same lot containing the Customary Home
Occupation,and not within the required front yard.
• There is no exterior storage or display of materials or equipment.
• There is no commercial vehicles related to the Customary Home Occupation,other than one van or one
pick-up amck not to exceed one ton capacity,and one trailer not to exceed 20 feet in length and not to
exceed 4 tires,parked on the same lot containing the Customary Home Occupation.
• No sign shall be displayed indicating the Customary Home Occupation.
• If the Customary Home Occupation is listed or advertised as a business,the street address shall not be
included.
• No person shall be employed in the Customary Home Occupation who is not a permanent resident of the
dwelling unit.
I,the undersigned,have read and agree-with the above restrictions for my home occupation I am registering.
Appli • Date: -r l�
> AMZ : The Town of Barnstable
Department of Health Safety and Environmental Services �-
Building Division
367 Main Street,Hyannis MA 02601
Office: 508-790-6227 Ralph Crossen
Fax: 508-790-6230 Building Commissioner
April 11, 1996
Michael Ford
P.O. Box 665
W. Harwich, MA 02671
Re: Site Plan Review Number 31-96
Cape Cod Academy- Designers Showcase
40 3 Seapuit Road, Osterville
Dear Mr. Ford,
The above referenced site plan has been approved at the April 11, 1996 meeting of Site
Plan Review Committee. The conditions are as follows:
Maintain access to residence when show house is open. Driveway
to be kept free of vehicles,
• Temporary fire extinguishers required on each level of the home
open to the public,
• Fire Department and Building Department inspection prior to the
opening of the home.
Please be informed that a building permit is necessary prior to any construction. Upon
completion of all work, the letter of certification required by Section 4-7.8 (7) of the Town
of Barnstable Zoning Ordinances must be submitted.
Should you have any questions, please feel free to call.
Respectfully,
Ralph Crossen
Building Commissioner
RMC/ab
ry . ill
� ' � ✓/xe{aJonr�axa�uae� o�./�aavac�iaeel2 •:
BOARD OF BUILDING REGULATIONS
Uoertse. CONSTRUCTION SUPERVISOR
f Numtier nCS 056174
Btrtinit�te�03/1B%1945 � .
_ f A46/2.001 Tr.no: 8013 '
§Restricted To: 00
RICHARD:E BENOIT` _
54 GUSHING HILL AD-
",
»,,
NORWELL, MA 02061 Administrator
ndividul use
,-
Board of Building Regnlatious and Standards License
fens the registration
date. If found return to only
HOME IMPROVEMENT d for i
CONTRACTOR lations and Standards
/ Board of Building Regu
(/ = Registration: 105485 One Ashburton Place Rm 1301
Expiration: 07/1712002 Boston,Nla.021.08
Type: Supplement Card
SOUTH SHORE GUNITE POOL&
RICHARD BENOIT p�
progress Ave. G'L--+ �✓'" Not vali without signature
Chelmsford,MA 01824 Administrator
t
TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION
Map 5 Parcel f =`'' W fI+ Permit# � 2,0
Health Division \ c APR 2 3 2001 Date Issued Z -_0
Conservation Division /%Sr V/Z3�6 f Fee 7 7. S
Tax Collect r %aiii% 0�//�3/oi c c�
Treasurer SEPTIC SYSTEM MUST BE
Planning Dep. INSTALLED IN COMPLIANCE
WITH TITLE 5
Date Definitive Plan Approved by Planning Board ENVIRONMENTAL CODE !."D
Historic-OKH Preservation/Hyannis
Project Street Address \ S 4-- Iq rpa LT -20Ab Dur-Z4
Village ka"i <
Owner IZtsf r���Z Address 340 S<_4
Telephone
Permit Request ` y
Square feet: 1st floor: existing proposed 2nd floor: existing proposed Total new
Valuation Zoning District Flood Plain Groundwater Overlay
Construction Typ xi, IF
Lot Size 2 Y,31 r- Grandfatliered: ❑Yes ❑ No If yes, attach supporting documentation.
Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(#units)
Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No
Basement Type: ❑ Full ❑Crawl ❑Walkout ❑Other
Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft)
Number of Baths: Full: existing new Half: existing new
Number of Bedrooms: existing new
Total Room Count(not including baths): existing new First Floor Room Count
Heat Type and Fuel: ❑Gas ❑Oil ❑ Electric ❑Other
Central Air: ❑Yes ❑No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑No
Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size
Attached garage:❑existing ❑new size Shed:❑existing ❑new size Other:
Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑
Commercial ❑Yes ❑No If yes, site plan review#
Current Use 9&t Proposed Use ����"� " ADS
�p�— S/ Crvi� ✓� BUILDER INFORMATION
Name eeell-fGr ai-7_ Telephone Number
Address_7_ )0V"G'!�S'S /r"G License# ®��o 17-01
L�CI,f►l sah �� v7 Home Improvement Contractor#
Worker's Compensation#
ALL CO STRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO
SIGNATURE DATE
i
...we FOR OFFICIAL USE ONLY
PERMIT NO.
DATE ISSUED '
MAP/PARCEL NO: r ,
ADDRESS ,,., VILLAGE
OWNER
DATE OF INSPECTION:' `
FOUNDATION
FRAME -
INSULATION
` FIREPLACE ---
ELECTRICAL:-- -`ROUGH' - - FINAL
r PLUMBING: ROUGH: r` FINAL �
GAS: ROUGH FINAL
FINAL BUILDING
r
DATE CLOSED OUT
ASSOCIATION PLAN NO.
i
r ' •
. . � The Town of Barnstable
,�vsrAer.E.
Regulatory Services
Thomas F. Geiler, Director
Building Division
Elbert Ulshoeffer, Building Commissioner .
367 Main Street.Hyannis MA 02601
Office: 508-862-4038 Fax: 508-790-6230
r
Permit no.
Date 3 -0
AFFIDAVIT
HOME IMPROVEMENT CONTRACTOR LAW
SUPPLEMENT TO PERMIT APPLICATION
MGL c:142A requires that the"reconstruction,alterations,.renovation,repair.modernization,conversion,
improvement,removal,demolition,or construction of an addition to any pre-existing owner-occupied
building containing at least one but not more than four dwelling units or to structures which are adjacent to
such residence or building be done by registered contractors,with certain exceptions,along with other
requirements.
Type of Work: OCR l Estimated Cost
Address of Work: ��� 44 -_
Owner's Name:
Date of Application: �' 'Z 3 �o
I hereby certify that:
Registration is not required for the following reason(s):
[]Work excluded by law
OJob Under$1,000
[]Building not owner-occupied
[]Owner pulling own permit
Notice is hereby given that:
OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED
CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE
ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDWMG .142A.
SIGNED UNDER PENALTIES OF PERJURY
I hereby apply for a permit as the agent of the owner. _
DatA Contractor Name Registration No.
OR
Date Owner's Name
g1orms:Affidav
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Information and Instructions
Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their
employees. As quoted from the "law", an employee is defined as every person in the service of another under any contract
of hire, express or implied, oral or written.
An employer is defined as an individual,partnership, association, corporation or other legal entity, or any two or more of
the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or
trustee of an individual,partnership,association or other legal entity, employing employees. However the owner of a
dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of
another who employs persons to do mainteoancx, construction or repair work on such dwelling house or m the grounds or
building appurtenant thereto shall not because of such employment be deemed to be an employer.
MGL chapter 152 section 25 also states that every state or local licensing agency shall withhold the issuance or renewal
of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has
not produced acceptable evidence of compliance with the insurance coverage required. Additionally,neitherthe
commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until
acceptable evidence of compliance with the insurance requires of this chapter have been presented to the contracting
authority.
& }�pIicants
ti
pulease fill in the workers compensation affidavit completejy,by checking the box that applies to your situation and
;,-3upplying company names,address and phone numbers along with a certificate of insurance as all affidavits maybe
;ub`mitted to the D artment of Industrial Accidents for c m fimmtim of insmaacx
ep coverage. Also be sure to sign and
late the affidavit. Tie affidavit should be retamed w the city ar to that the application for the pemut or license is
;eing requested,not the Department of Industrial Accidents. Should you have any questions regarding the`law"or if you
re required to obtain a wort= compensation policy,please call the Department at the number listed below.
:ity or Towns
lease be sure that the affidavit is compift jmd printed legibly. The Department has provided a space at the bottom of the
In—davit for you to fill out in the event the Office of Investigations ins to contact you regarding the applicant. Please
e sure to fill in the pcmiiVi=c number which will be usod as a rafrrea -mimber. The affidavits may be retuuaR'lo
ie Department by mail or. FAX unless other arrang®ents have been made.
ae Office of Investigations would like to thank you in advance for you cooperation and should you have any.questions.
:ease do not hesitate to give us a caL
he Department's address,telephone and fax number.
The Commonwealth Of Massachusetts
Department of Industrial Accidents
Oiice of In SUDBUOns
600 Washington street
Boston,Ma. 02111
fax#: (617)727-7749 -
nhnne#! (6171 727-4900 ezt 406_ dfia nr 37S
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PLOT PLAN FOR BUILDING PERMIT Date: April 13, 2001 Scale: 1." = 40.'
Prepared for: Christopher E. Welch Anderson Surveys, Inc.
340 Seapuit Road Professional Land Surveyors
Osterville, MA 800 High Street
Land Court Certificate #104240 Hanson, MA 02341 -0149
Land Court Plan No.5725-V (781 ) 293-3349 _
Fax 293-0323 JN70136 .
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