HomeMy WebLinkAbout23175-z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-26057 Date: 10/23/98
THIS CERTIFIES that the building ADDITION
Location of Property: 1190 THE CRESCENT EAST MARION
(HOUSE NO. ) (STREET) (HAMLET)
County Tax Map No. 473889 Section 30 Block 2 Lot 24
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated NOVEMBER 3, 1995 pursuant to which
Building Permit No. 23175-Z dated DECEMBER 12, 1995
was issued, and conforms to all of the requirements of the applicable
provisions of the law. The occupancy for which this certificate is issued
is GARAGE ADDITION & STORAGE ROOM ADDITION TO EXISTING ONE FAMILY
DWELLING AS APPLIED FOR.
The certificate is issued to TSUNEHIDE & LILA ARAGAKI
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO. N 441209 12/23/97
PLUMBERS CERTIFICATION DATED N/A
Building Ins---'tor
Rev. 1/81
FORM NO.3
TOWN OF SOUTHOL
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD,N.Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHO ED)
Date ............. .. ...`�'.�./'-'?.:.................... 192 ....
N2 23175 Z
Permission Is hereby g n to:
.... 1 .... `�- ......................
�� i... ......... .. ...................
to .. � c��r �........, ... `.. ... -�,.,...
. .......��.. ,.. ....................
� ... .- `. 4= . .........
............ ...c� .. ...... . . . .......
..
at premises located at............/���✓........................ .................................
,
County Tax Map No. 1000 Section ............. �J..�Block...........;:.F7......... ,Lot No. ... �T ............
pursuant to application dated ........................... 13..... 19.... 7...., and approved by the
Building Inspector
Fee$... ...
Buildin Inspect
Rev. 6/30/80
i
Form No. 6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802 t 6 `�e/1,C�
APPLICATION FOR CERTIFICATE OF OCCUPANCY Nj `� IGv)3
A. This application must be filled in by typewriter OR ink and submitted to the building
inspector with the following: for new building or new use:
1. Final survey of -property with accurate location of all buildings, property lines,
streets, and unusual natural or topographic features.
2. Final Approval frQpl, Health Dept. of water supply and sewerage-disposal(S-9 form) .
3. Approval of electrical installation from Board of Fire Underwriters.
4. Sworn statement from plumber certifying that the solder used in system contains
less than 2/10 of 12 lead.
5. Commercial building, industrial building, multiple residences and similar buildings
and installations, a certificate of Code Compliancefrom architect or engineer
responsible for the building.
6. Submit Planning Board Approval of completed site plan requirements.
B. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and
"pre-existing" land uses:
1. Accurate survey of property showing all property lines, streets, building and
unusual natural or topographic features.
2. A properly completed application and a consent to inspect signed by the applicant.
If a Certificate of Occupancy is denied, the Building Inspector shall state the
reasons therefor in writing to the applicant.
C. Fees
1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00,
Alterations to dwelling $25.00, Swimming pool $25.00, Accessory building $25.00,
Additions to accessory building $25.00. Businesses $50.00.
2. Certificate of Occupancy on Pre-existing Buildina - $100.00
3. Copy of Certificate of Occupancy - .25C.
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial) $$155.00
Date S✓. !:iC:f . . A�x.,�!.!.R . . . . . . . . . . . . .
New Construction. .. .. . . .q. . 0.1dOr e-existing Building
.. .. . . . . . . .. . . . . .
Location of Property//,C J �y
House No. Street gamlet
Onwer or Owners of Property
County Tax Map No 1000, Section. . .. . . . . ..Block. .. . . . ?-t . . . . . . .Lot. . . . . 3. . . . . . . . . . . . .
Subdivision. . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . .. . . .Filed Map. . . . . . . . . Lot. . . . . . . . .
Permit No. . �"� I. .. . . . Date Of Permit[f ?.!. . .Applicant. . ./.`.-.T. .. . . ah,. . . . . . . .
Health Dept. Approval. . . . . . . . . . . . . . . .. . . . . . . . . .Underwriters Approval. . . . . . . . . . . . . . . . . . . . . . . . .
Planning Board Approval. . . . . . . . . .. . . . . .. . . . . . . .
Request for: Temporary Certificate. . . . . . . . . . . Final Certicate. . . .:. . . . . .
Fee Submitted: . . . . . . . . . . . . . . . .
n .
C O & A 0 S 7 APPLICANT
o�OgUFF01.t
O
Town Hall, 53095 Main Road y Fax(516)765-1823
P. O. Box 1179 u• Telephone (516)765-1802
Southold, New York 11971 ip
OFFICE OF THE BUILDING INSPECTOR
TOWN OF SOUTHOLD
February 10, 1998
Mr. T. Aragaki
7 Gramercy Park
New York, N.Y. 10003
To Whom This May Concern:
We are unable to complete your Certificate of Occupancy
because of the following reasons :
XX An application for Certificate of Occupancy is
not on file. (Enclosed)
No Underwriters Certificate on file.
XX The check is (not on file. ) $25.00
No Health Department Approval on file.
No final inspection has been made.
No Plumber Solder Certificate on file.
(All permits involving plumbing being
issued after April 1, 1984 ) .
BUILDING PERMIT # 23175-Z
Please contact our office on this matter. Thank you for
cooperation.
SOUTHOLD TOWN BUILDING DEPT.
2 -rj- , a U� .P--e hero 1n
i;-
Mr. T. Aragaki ( MAY 1 31997
7 Gramercy Park
New York, NY 10003 __,
May 12, 1997
Southhold Town Hall
P.O. Box #1179
53095 Main Road
Southold, NY 11971
[ATTN: Building Department]
Re: Permit No. 23175Z
This is in reference to our house renovation at 1190 The Crescent, East
Marion. The captioned Permit was issued on 12/12/95, if my understanding
is correct.
Due to the unavoidable circumstances I was subject to, I hereby request that
the Permit be extended for another six (6) months.
I'd appreciate your kind consideration and please let me hear from you at
your earliest convenience. I'd be furthermore appreciative if you send your
reply to my following address where I can be reached on daily basis for sure.
7 Gramercy Park
New York, NY 10003
Thank you for your attention.
Very truly yours;
W
T. agaki
9
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765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ /ROUH PLBG.
FOUNDATION 2ND [ ATION
FRAMING [
[ ] FIREPLACE & CHIMNEY
RE RKS:
DATE c >2 INSPECTOR
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND ( ] SULATION
[ ] FRAMING [ FINAL
[ ] FIREPLACE A CHIMNEY
REMARKS: #/,
9z-
j DATE INSPECTO
t
3 lis
7"-1802
BUILDING DEPT.
SPECTIQN
[ IV'-F) NDATION IST [ ] ROUGH PLBG.
[ FO NDATION 2ND [ ] INSULATION
[ :"FRAMING [ ] FINAL
[ ] FIREPLACE A CHIMNEY
REMARKS: �, � gel�
y�
DATE INSPECTOR
L__765 .
EPT.
INSPECTION
[ ] FOUNDATION 1ST [ } ROUGH PLBG.
[ ] FOiiiU TION 2ND [ ] INSULATION
[ RAMING [ ] FINAL
REMARKS:
rriC '� �Z c6
ax
DATIp _INSPECTO
765-1802
BUILDING DEPT.
SPECTION
[ OUNDATION IST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ) FRAMING [ ] FINAL
[ ] FIREPLACE & CHIMNEY
REMARKS: C�
DATE INSPECTO
moo" �
M-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLBG.
[ ]
FOUNDATION-2ND [ ] INSULATION
[ FRAMING FINAL
[ ] FIREPLACE & CHIMNEY
REMARKS: zi 7 Ole
DATIf ah 14Z INSPECTO
mommmom-
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLBG.
rOUNDATION 2ND [ ] INSULATION
[ ] FRAMING [ ] FINAL
[ ] FIREPLACES CHIMNEY
REMARKS: � D�
A-1 -_---
DATE INSPECTO
I\
BOARD OF HEALTH . . . . . . . . .
(a i M (2 '� FORM NO. 1 3 SETS OF PLANS
( � f���_ . a.�m��g6 TOWN OF SOUTHOLD SURVEY . . . . . . . . . . . . . . . . . . .
BUILDING DEPARTMENT CIIECh . . . . . . . . . . . . . . . . . . . .
NOV _ 1995 TOWN HALL SEPTIC FORtl . . . . . . . . . . . . . .
SOUTHOLD, N.Y. 11971
TEL.: 7651802
�lO CALL ttofILL 'sA.
-�.. ,T.;' ul. 'n . a.:.�; S
Examined . .(. , 19 M I L T0 :
Approved 19 Permit N
Disapproved a/c . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . I . . . . . . . . .
.
. . . . . . . . . . . . . . . . . . . . . . . . . . . .
(Building Inspector)
APP I ATION FOR BUILDING PERMIT
Date . . . . . . . . . . . . . . . . . .. 19 . . .
INSTRUCTIONS
a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3
sets of plans,accurate plot plan to scale. Fee according to schedule.
b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets
,or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli-
cation.
c. The work covered by this application may not be commenced before issuance of Building Permit.
d. Upon approval of this application, the Building Inspector will issued a Building Permit to the applicant. Such permit
shall be kept on the premises available for inspection throughout the work.
e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy
shall have been granted by the Building Inspector.
APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the
Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or
Regulations, for the construction of buildings, additions or alterations, or for removal or de ition, as herein described.
The applicant agrees to comply with all applicable laws, ordinances, building code, houofiig co e, and,regulations, and to
admit authorized inspectors on premises and in building for necessary inspections<'
. . . . . . . . . . . . . .
(Signature of applicant, or name,,, if a a�corporation)
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer general contractor, electrician, plumber or builder.
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Name of owner of premises . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(as on the tax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer.
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(Name and title of corporate officer)
Builder's License No.�
Plumber's License No. . . . . . . . . . . . . . . . . . . . . . . . .
Electrician's License No. . . . . . . . . . . . . . . . . . . . . . .
Other Trade's License No. . . . . . . . . . . . . . . . . . . . . .
1. Location of land on which proposed work will be done. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . .Z-; --4 7. . v1_-.,A. . . . . . . . . . . . . . .
I-louse Number Street Hamlet
� G
County Tax Map No. 1000 Section . 3. .. ./
. . . . . . . . . . . . . Block . . . . . . . . . . . . . . . . Lot . . . . . . . . . . . . . . .
Subdivision . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Filed Map No. . . . . . . . . . . . . . . Lot . . . . . . . . . . . . . . .
(Name)
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy . . �G. ?i�;�+' C P. . . . :..
-, i . . . . . . . . . . . . . . . . .
b. Intended use and occupancy e. . . . . . . . . . . . . . . . . . . . . . . . . . . : . .c . . . . . . . . . . . . . . . . . .
:,. . _ .. . . . I
3. Nature of work (check which applicable): New Building . . . . . . . . . . Addition f. 'r %teration . . . . . . . . . .
Repair . . . . . . . . . . . . . . Removal . . . . . , . . . . . . . . Demolition . . . . . . . . . . . . . . Other Wolk .l. . . . . . . . . . . . .
(Description)
4. Estimated Cost . . . :. . . . . . . . . . . . . . . . . . . . . . . . . . Fee . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(to be paid on filing this application)
S. If dwelling,number of dwelling units . . . . . . . . . . . . . . . Number of dwelling units on each floor . . . . . . . . . . . . . . . .
Ifgarage,number of cars . . . 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
6. If business, commercial or mixed occupancy, specify nature and extent of each type of use . . . . . . . . . . . . . . . . . . . . .
7. Dimensions 9S existing structures, if any: Front . . . . . . . . . . . . . . . Rear . . . . . . . . . . . . . . Depth . . . . . . . . . . . . . . .
Height . .1. . . . . . . . . . . . Number ofStories . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Dimensions of same structure with alterations or additions: Front . . .'/. . . . . . . . . . . . Rear . .0. . . . . . . . . . . . . . .
Depth . . . . . . . . . . . . . . . . . . . . . . Height . . . . S ^^ '. . . . . . . . . . . . Number of Stories . . . . . . . . . . . . . . . . . . . . . .
8. Dimensions of entire new construction: Front . . . . . . . Rear . . . . . . . . . . . . . . . Depth . . . . . . . . . . . . . . .
Height . . . . . . . . . . . . . . . Number of Stories . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
9. Size of lot: Front . . . . . . . . . . . . . . . . . . . . . . Rear . . . . . . . . . . . . . . . . . . . . . . Depth . . . . . . . . . . . . . . . . . . . . . .
10. Date of Purchase . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Name of Former Owner . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
11. Zone or use district in which premises are situated . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
12. Does proposed construction violate any zoning law, ordinance or regulation: . . . . . . ./IJti... . . . . . . . . . . . . . . . . . . . .
13. Will lot be regraded . . . . . . . . . . . . . . . . . . . . . . . . . . . . Will excess fill be removed from premises: Yes
14. Name of Owner of premises . . . . . . . . . . . Address . . . . . . . . . . . . . . . . . . . Phone No. . . . . . . . . . . . . . . .
Name of Architect . . . . . . . . . . . . . . . . . . . . . . . . . . . Address . . . . . . . . . . . . . . . . . . . Phone No. . . . . . . . . . . . . . . .
Name of Contractor . . . . . . . . . . . . . . . . . . . . . . . . . Address . . . . . . . . . . . . . . . Phone No. . . . . . . . . . . . . . . .
15. Is this property within 300 feet of a tidal wetland? *Yes. . . . . . . No. . . . . . . . .
*If yes, Southold Town Trustees Permit may be required.
PLOT DIAGRAM
Locate clearly and distinctly all buildings, whether existing or proposed, and,indicate all set-back dimensions from
property lines. Give street and block number or description according to deed, and show street names and indicate whether
interior or corner lot.
STATE OF NEW OR S.S
COU jY��OF
7
. �. G? l . . . .
`� . . . . . . . . . being duly sworn, deposes and says that he is the applicant
(Name ofYndividual signing contract)
above named.
Heis the . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(Contractor gent, corporate officer, etc.)
of said owner or owners, and is duly autho ' perform or have performed the said work and to make and file this
application; that all statements contained in this application are true to the best of his knowledge and belief;and that the
work will be performed in the manner set forth in the application filed therewith.
Sworn to before me this
. . . . . . . . . . . . day o . . . . ., 19 1
Notary Public, County a
CL/1►IftE'L �' /
t4ctry public,State of New York
No.4879505 /_ f.. y`°:2'': .Lr. �:c-. . . . . . . . . . . . . . . . . . .
oualified in Suffolk County w (Signature of applicant)
Commission Expires December 8.18
30 -
lam wMagausalm
THE . NEW .YORK BOARD OF FIRE UNDERWRITERS PAr,E
1205047 BUREAU OF ELECTRICITY
' 85 JOHN STREET, NEW YORK, NY 10038
Date DECEMBER 23,1997 Application No.on file 11673996/96 N 441209
THIS CERTIFIES THAT .,
only the electrical equipment as described below and introduced by the applicant named on the above application number in the premises of
H & L- ARAGAKT, 1190 CRESCENT WAY, EAST (MARION, NY
in thefollowing location; ❑ Basement ® Ist Fl. ❑ 2nd FL GAR/OUT .Section Block Lot
was examined on DEC& ER 15 r 1997 and found to be in compliance with the National Electrical Code.
FIXTUREE# F XTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS
ECE%iACIE$ SWITCHES OUTLETS INCANDESCENT FLUORESCENT OiNER AMT. K W. AML K.W "T N.W. AML K W AMT. H P
23 14 13 19 4 1 F
DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS ISPEC#ALREC-PTI TIMECLOCKS I SELL UNIT NEATER$ MULTI.OUTLET DIMMERS
T. K.W. Olt H.P. GAS H.P. AMT NO. A.W G MT AMP .AMT. AMPS TRANS. AMT H p NO.
SYSTEMS
OFF FEET AMAMT WATTS
2 6+00
SERVICE DISCONNECT NO.OF S E R V 1 C E _
AML AMP rypE - METER I-W IW H'3W 3 a 3W 3 p,AN, NO.OF CCGOND A.W G. NO OF NIAEG A'W.EG NO.OF NFUTRAtS A.W G.
f EQUIP. PER! OF CC.CONO OF MIiEG OF NEUTRM
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(
OTHER APPARATUS:
PADDLE FAN-F-1
j ELEC. ROOM HENP'ERSt4-1 K.W.
I G.F,C,TI-2
TRACK LIGHTING:-20
w
THREE BROTHERS ELEC. TNC. LTC.#3792- t�_. L L
94 WESTD AVENUE GENERAL MANAGER
SHIRLEY, y, 11967
11
]S Per
ificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials.
COPY FOR BVi LDING_DEPARTMENT. THIS COPY OF CERTIFICATE,,MUST ,NOT'�SE' ALTERED IN ANY MANNER.
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SURVEY FOR ., TSUNEHIOE ARAGAK/ Q LILA ARAGAK/
LOT NO. 23, "PEBBLE BEACH FARMS MAY /5, /980
MAR. /9, 1980
AT EAST MAR/ON DATE SEPT. /0, /979
TOWN OF 50617-HOLD ,SCALE; / = 40
SUFFOLK COUNTY, NEW YORK ' NO. 79- 501
N UNAUTHORIZED ALTERATION OR ADDITION TO THIS GUARANTEED 70.,SURVEY IS A VIOLATION OF SECTION 7209 OF THE
NEW YORK STATE EDUCATION LAW THE T/TGE GUARANTEE CO.
X COPIES SURVEYOR'S
1L 413 SURVEY NOT BEARING THE LANG EOU/TAN9LE FEDERAL SAV/NGS aLOAN
NOT BE CONSIDERED TOBE A VALID EMBOSSED OR HALL RUE COPYASSOC.
XGUARANTEES INDICATED HEREON SHALL RUN ONLY TO
HEALTH DEPARTMENT-DATA FOR APPROVAL TO CONSTRUCT THE PERSON FOR WHOM THE SURVEY IS PREPARED (E OF NEW N,
AND ON HIS BEHALF TO THE TITLE COMPANY,GOVERN- .•(i'/\ OQ�
K NEAREST WATER MAIN—MI I K SOURCE OF WATER PRIVATE_ PUBLIC MENTAL AGENCY AND LENDING INSTITUTION LISTED l r�i� YOB
K SUFF CO. TAX MAP DIST/OOo SECTION SO BLOCK_2 LOT 24 HEREON, AND TO THE ASSIGNEES OF THE LENDING
)f THERE ARE NO DWELLINGS WITHIN 100 FEET OF THIS PROPERTY INSTITUTION GUARANTEES ARE NOT TRANSFERABLE PQM^ /;c GGT
OTHER THAN THOSE SHOWN HEREON TO ADDITIONAL INSTITUTIONS OR SUBSEOUENT ^ !"41
M
N THE WATER SUPPLY AND SEWAGE DISPOSAL SYSTEM FOR THIS RESIDENCE OWNERSWILL -
7 I(t W
OFHEA HEALTH
SE TO THE STANDARDS OF THE SUFFOLK COUNTY OEPARi MENT K O EXISTING
SHOWN HEREON FROM PROPERTY LINES p
TO STR E NOT T ARE FOR A SPECIFICESTABL ?'
OF HEALTH SERVICES.
APPLICANT PURPOSE AND ARE NOT TO BE USED TO ESTABLISH ew•, ''
PROPERTY LINES OR FOR THE ERECTION OF FENCES
ADDRESS
TEL ---- - - YOUNG a YOUNG RIVERN � , -W YORKE
M eMONUMENT STAKE ALDEN W YOUNG,PROFESSIONAL ENGINEER
SUBDIVISION MAP FILED IN THE OFFICE OF THE CLERK OF SUFFOLK COUNTY AND LAND SURVEYOR N Y.S.UCENSE N0,12845
ON JUNE II, 1975 AS FILE NO.6266 HOWARD W.YOUNG, LAND SURVEYOR
4-THE LOCATION OF WELL(W),SEPTIC TANK(STIB CESSPOOLS(CP)SHOWN HEREON 4 N.Y S. LICENSE NO.45893
ARE FROM FIELD OBSERVATIONS AND OR DATA OBTAINED FROM OTHERS
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