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%OFU(,feoG� Town of Southold 9/21/2017 P.O.Box 1179 a 53095 Main Rd Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 39207 Date: 9/11/2017 THIS CERTIFIES that the building ALTERATION Location of Property: 11292 Route 25, East Marion SCTM#: 473889 Sec/Block/Lot: 31.43-9.1 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated �f 11/12/2015 pursuant to which Building Permit No. 40269 dated 11/16/2015 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: ALTERATIONS INCLUDING FRONT PORCH REPAIR TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR NOTE: CORRECTED FOR ELECTRIC CERTIFICATE NUMBER AND DATE The certificate is issued to O'Ferrall,Kirk&Cerasani,Denise of the aforesaid building. SUFFOLK COUNTY,DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 40269 08-30-2017 PLUMBERS CERTIFICATION DATED 03-01-2017 rad Piecuch 1 007 ed ignature 4gUFPaL,��oG. Town of Southold 9/11/2017 P.O.Box 1179 f 53095 Main Rd .qj®1 �4� Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 39207 Date: 9/11/2017 THIS CERTIFIES that the building ALTERATION Location of Property: 11292 Route 25, East Marion SCTM#: 473889 Sec/Block/Lot: 31.43-9.1 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 11/12/2015 pursuant to which Building Permit No. 40269 dated 11/16/2015 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: ALTERATIONS INCLUDING FRONT PORCH REPAIR TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR The certificate is issued to O'Ferrall,Kirk&Cerasani,Denise of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 37718 12-02-2013 PLUMBERS CERTIFICATION DATED 03-01-2017 Br d Piecuch oriz Signature o�SUFFOI�co TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE o . SOUTHOLD, NY BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES WITH ONE SET OF APPROVED PLANS AND SPECIFICATIONS UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permit #: 40269 Date: 11/16/2015 Permission is hereby granted to: O'Ferrall, Kirk 15 W 75th St Apt 9A New York, NY 10023 To: Alteration to an existing second story space and repairs to an existing covered porch, as per Trsutee approval. Replaces BP# 37718 At premises located at: 11292 Route 25, East Marion SCTM # 473889 Sec/Block/Lot# 31.-13-9.1 Pursuant to application dated 11/12/2015 and approved by the Building Inspector. To expire on 5/17/2017. Fees: PERMIT RENEWAL $100.00 Total: $100.00 Bui in spector rSUFn�K TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE o • SOUTHOLD, NY y�ol BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES WITH ONE SET OF APPROVED PLANS AND SPECIFICATIONS UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permit #: 37718 Date: 1/2/2013 Permission is hereby granted to: Ungerleider, Robert & Ungerleider, Ruth 9 Jones St New York, NY 10014 To: Alteration to an existing second story space and repairs to an existing covered porch, as per Trsutee approval. At premises located at: 11292 Route 25, East Marion SCTM # 473889 Sec/Block/Lot# 31.-13-9.1 Pursuant to application dated 12/12/2012 and approved by the Building Inspector. To expire on 7/4/2014. Fees: SINGLE FAMILY DWELLING-ADDITION OR ALTERATION $200.00 CO -ALTERATION TO DWELLING $50.00 Total: $250.00 uilding Inspector L Form No.6 �C�✓''� TOWN OF SOUTHOLD BUILDING DEPARTMENT $a 163 TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY This application must be filled in by typewriter or ink and submitted to the Building Department with the following: A. 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 from 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 I%lead. 5. Commercial building,industrial building,multiple residences and similar buildings and installations,a certificate of Code Compliance from 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 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$50.00,Additions to dwelling$50.00,Alterations to dwelling$50.00, Swimming pool$50.00,Accessory building$50.00,Additions to accessory building$50.00,Businesses$50.00. 2. Certificate of Occupancy on Pre-existing Building- $100.00 3. Copy of Certificate of Occupancy-$.25 4. Updated Certificate of Occupancy- $50.00 5. Temporary Certificate of Occupancy-Residential$15.00,Commercial$15.00 Date. 12 - 1,2 - 12- New Construction: Old or Pre-existing Building: V (check one) Location of Property: //2�9.2 klOWA.) S7-E Q - EAJ! P �dJ- House No. Street Hamlet Owner or Owners of Property: O I ll�� 44,L Suffolk County Tax Map No 1000, Section f Block Lot Subdivision q n- Filed Map. Lot: Permit No. Date ofTermit. Applicant: `TI z7u ik Zlelzeaale Health Dept.Approval: Underwriters Approval: Planning Board Approval: / Request for: Temporary Certificate Final Certificate: V i (check one) Fee Submitted: $ i pplicant Signature �®,oF SOUjy®l Town Hall Annex ® Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 Q roger.richert(cD_town.southold.ny.us Southold,NY 11971-0959 ®l�C®UNrI BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATE OF ELECTRICIAL COMPLIANCE SITE LOCATION Issued To: Kirk O'Ferrall Address: 11292 Rt 25 City: East Marion St: NY Zip: 11939 Building Permit#: 41b-A,69 Section: 31 Block: 13 Lot. 9.1 WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE contractor: DBA: Paul Burns Electric License No: 3897-e SITE DETAILS Office Use Only Residential X Indoor Basement Service Only X Commerical Outdoor X 1st Floor Pool New Renovation 2nd Floor Hot Tub Addition Survey Attic Garage INVENTORY Service 1 ph 200a Heat Duplec Recpt Ceding Fixtures HID Fixtures Service 3 ph Hot Water GFCI Recpt Wall Fixtures Smoke Detectors Main Panel A/C Condenser Single Recpt Recessed Fixtures CO Detectors Sub Panel A/C Blower Range Recpt Fluorescent Fixture Pumps Transformer Appliances Dryer Recpt Emergency Fixtures Time Clocks Disconnect 200a] DD Switches Twist Lock Exit Fixtures TVSS Other Equipment. 200a underground service, meter and main disconnect on "H" frame Notes: Inspector Signature: Date: Dec 2 2013 81-Cert Electrical Compliance Form.xls CC: file,Z.B.A., planning h O Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 �� roger.richert(aD_town.southold.ny.us Southold,NY 11971-0959 Ql�c®um�� BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATE OF ELECTRICIAL COMPLIANCE SITE LOCATION Issued To: Kirk O'Ferrall Address: 11292 Route 25 city-East Marion st: New York zip: 11939 Budding Permit* 40269 Section: 31 Block: 13 Lot: 9.1 WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE Contractor: DBA: All Pro Electric License No: 33703-ME SITE DETAILS Office Use Only Residential X Indoor X Basement Service Only Commerical Outdoor 1st Floor Pool New Renovation X 2nd Floor X Hot Tub Addition Survey Attic Garage INVENTORY Service 1 ph Heat Duplec Recpt 24 Ceiling Fixtures 3 HID Fixtures Service 3 ph Hot Water GFCI Recpt 2 Wall Fixtures 4 Smoke Detectors Main Panel A/C Condenser Single Recpt Recessed Fixtures 13 CO Detectors Sub Panel A/C Blower Range Recpt Fluorescent Fixture Pumps Transformer Appliances Dryer Recpt 30A Emergency FixtureTime Clocks Disconnect Switches 20 Twist Lock Exit Fixtures TVSS Other Equipment: 3- Paddle Fans, 2- Exhaust Fans, 1- Combination Smoke/ CO Detector. Notes: Inspector Signature: Date: August 30, 2017 0-Cert Electrical Compliance Form.xls CC: file, Z.B.A., planning oF SO(/jyOl® Town Hall Annex Telephone(631)765-1802 54375 Main Road cn Fax(631)765-9502 P.O.Box 1179 aQ roger.richert(a)-town.Southold.ny.us Southold,NY 11971-0959 Q lycOUN�Y,� BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATE OF ELECTRICIAL COMPLIANCE SITE LOCATION Issued To: Kirk O'Farrall Address: 11292 Route 25 city,East Marion st: New York zip: 11939 Building Permit* 40269 Section: 31 Block: 13 Lot: 9.1 WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE Contractor: DBA: Paul Burns Electric License No: 3897-E SITE DETAILS Office Use Only Residential X Indoor X Basement Service Only Commerical Outdoor X 1st Floor Pool New Renovation 2nd Floor Hot Tub Addition Survey Attic Garage INVENTORY Service 1 ph 200A Heat Duplec Recpt Ceiling Fixtures HID Fixtures Service 3 ph Hot Water GFCI Recpt Wall Fixtures Smoke Detectors Main Panel 200A A/C Condenser Single Recpt Recessed Fixtures CO Detectors Sub Panel A/C Blower Range Recpt Fluorescent Fixture Pumps Transformer Appliances Dryer Recpt Emergency Fixture Time Clocks Disconnect 200A Switches Twist Lock Exit Fixtures TVSS Other Equipment: 200A Service Upgrade Notes. Inspector Signature: Date: August 30, 2017 0-Cert Electrical Compliance Form(1).xls �WZ`0E 3Nnr S3HIdX3 NOISSIWWOO Siunoo `aTlgnd kmjoM A1Nnoo NlOddnS NI o3ldnvno 00690E9M(Il0'ON NHOA M3N d0 31`d1S'oiisnd AHdlON H3Anna A30dal -T Ll oz ��� jo st sup om ojojoq o;uzomS (am s szaqumld) = = 'pal %I Jo OI/Z ump-sml sam4uoa uzals is.Alddns.iolviA otguI pasn iaplos aqI 4mp f I H-)nC p� :�agiunId (4uud osmld) b - 'ox}fid 2utpling L! t :04ea AIOIJLV3IAIJLHaa (I'loRiaosm KMO L Uaamaama LIOZ - an (rzo$.Laos 3o MAUL - - Cl 6.960-1 L61 I 'V0X MON`PloIRnoS 6LI 1 xog-Ud Z09"9L'(J�9)XR3 N PEo?I UO N SL£VS Z08I=S9L(I£9)oiuoydap.L xauud IMH UA%OL so41) �lyolo - TOWN OF SOUTHOLD BUILDING "DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLUMBING [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING / STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION Y. ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ \] CODE VIOLATION [ ] CAULKING REMARKS: DATE INSPECTOR olyco 0 TOWN OF SOUTHOLD BUILDING DEPT: 765-1802 INSPECTI [ /FNDATION 1ST OUG UMBING DATION 2ND [ SOLATION j���- ING / STRAPPING [ ] FINAL �5 [ ] FIREPLACE-& CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIO Q TION [ f] CAULKING R ARKS: s r &I DATE INSPECTOR Of SOUly�lo cou 1 N TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION . [ ] -FOUNDATION 1ST [ ] ROUGH PL13G. [ ] FOUNDATION 2ND [ ] SOLATION [ ] FRAMING / STRAPPING [ FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)I. REMARKS: p �/�+ o✓ C �.✓G -f--qoivq.. �V- F*pwk DATE INSPECTOR SOF SO(/lb l (6(,l l TOWN OF SOUTH LD i O BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING /STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) ELECTRICAL (FINAL) REMARKS: /4�z- DATE INSPECTOR Vr o�a0f SOUlyO TOWN OF SOUTHOLD BUILDING DEPT. 765.1802 1 NSPECTION [ FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING /STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) REMARKS: DATE J13 INSPECTOR INNER 1=1 E� ROUGH 11 PLUMING �. fm WIPPYA STATE ENERGY . ! ► «� t ADDITIONa COMMNTS roTill rpm I • TOWN OF SOUTHOLD ` D ;E C E � V E BUILDING PERMIT APPLICATION CHECKLIST BUILDING DEPARTMENT, —" i Do you have or need the following,before applying9 TOWN HALL DEC 12 202Board of Health SOUTHOLD, NY 11971 f' 4 sets of Building Plans TEL: (631) 765-1802 ` _ I Planning Board approval !!! FAX: (631) 765-9502 Tang•+BLDG�S ,DEPT ITHODD Survey SoutholdTown.NorthFork.ne � , V '' Check Septic Form N.Y.S.D.E.C. Trustees C.O.Application Flood Permit Examined 120 3 Single&Separate Storm-Water Assessment Form Contact: Approved 1 J Z 120 13 Mail to: fakie Oe-W&Ii Disapproved a/c //,,// n 2 Phone: /j� y 77 - A6 � Expiration 20 VI Building Insp ctor APPLICATION FOR BUILDING PERMIT Date , 20 INSTRUCTIONS a. This application MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 4 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 waterways. 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 issue a Building Permit to the applicant. Such a 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 what so ever until the Building Inspector issues a Certificate of Occupancy. f. Every building permit shall expire if the work authorized has not commenced within 12 months after the date of issuance or has not been completed within 18 months from such date. If no zoning amendments or other regulations affecting the property have been enacted in the interim,the Building Inspector may authorize, in writing,the extension of the permit for an addition six months. Thereafter, a new permit shall be required. 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 demolition as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspections. (Signature of applicant or name, if 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 �/ �—,e (As on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer (Name and title of corporate officer) Builders License No. Plumbers License No. Electricians License No. Other Trade's License No. 1. Location of land on which proposed work will be done: House Number Strq'et Hamlet County Tax Map No. 1000 Section 2 Block (�j Lot i Subdivision Filed Map No. Lot 2. State existing use and occupancy of premises andiintended s ,ALA Rphncy•of proposed construction: a. Existing use and occupancy b. Intended use and occupancy 3. Nature of w�°&(check which applicable): New Building Addition Alteration 1/ RepRemoval Demolition Other Work (Description) 4. Estimated Cost ti 79.tll)() Fee 2Q " (To be paid on filing this application) 5. If dwelling, number of dwelling units A_/ Number of dwelling units on each floor If garage, number of cars 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use. 1 i 7. Dimensions of existing structures, if any: Front "30,4-f Rear e� Depth �✓ / Height e- r�` ' Number of Stories 2— Dimensions of same structure with alterations oY additions- Front Rear Depth Height Number of Stories 8. Dimensions of entire new construction: Front Rear Depth Height Number of Stories 9. Size of lot: Front / �( Rear / `� • ��f Depth 10. Date of Purchase r /2 Name of Former Owner 11. Zone or use district in which premises are situated AP_ 12. Does proposed construction violate any zoning law, ordinance or regulation? YES NO �r 13. Will lot be re-graded? YES NO Will excess fill be removed from premises? YES NO 1� 14. Names of Owner of premises 6`9' lZ+L'A LC Address IjX2 kire`ul Phone No.�'1I7� 923 Name of ArchitectAddress �f ���6 �r�pf Phone No jQ 731 Name of Contractor Address Phone No. 15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? ''YES 'VINO * IF YES, SOUTHOLD TOWN TRUSTEES & D.E.C. PERMITS AY BE REQUIRED. b. Is this property within 300 feet of a tidal wetland? * YES NO * IF YES, D.E.C. PERMITS MAY BE REQUIRED. 16. Provide survey, to scale, with accurate foundation plan and distances to property lines. 17. If elevation at any point on property is at 10 feet or below, must provide topographical data on survey. 18. Are there any covenants and restrictions with respect to this property? * YES NO * IF YES, PROVIDE A COPY. STATE OF NEW YORK) SS: COUNTY OF, lC being duly sworn, deposes and says that(s)he is the applicant (Flame of individual signing contract)above named, (S)He is the (Contractor, Agent, Corporate Officer, etc.) of said owner or owners, and is duly authorized to 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 12 day of 0,,1c 20 1,7 r VICKI TOTH Notary Public,State of New York No.0 1106 10,0 Notar Public Qualified in Suffolk County Signature of Applicant Y Commission Expires July?R.20 l b James F.King, President �QF S0(/ry Town Hall Annex Bob Ghosio,Jr.,Vice-President �� Ol0 54375 Main Road P.O.Box 1179 Dave Bergen Southold,New York 11971-0959 John Bredemeyer N ,c G ® pQ Telephone(631) 765-1892 �yc4UNT`1 Michael J. Domino '� � Fax(631) 765-6641 � ,� BOARD OF TOWN TRUSTEES ® E C E � � E TOWN OF SOUTHOLD DEC2 . 01 Permit No.: 7948A BLDG DEPT. Date of Receipt of Application: November 10, 2012 TOWN OF SDUTHDLD Applicant: Kirk O'Ferrall SCTM#: 31-13-9.1 Project Location: 11292 Main Road, East Marion Date of Resolution/Issuance: November 14, 2012 Date of Expiration: November 14, 2014 Reviewed by: John Bredemeyer, Trustee Project Description: To repair/replace the existing roofed-over porch attached to dwelling. Findings: The project meets all the requirements for issuance of an Administrative Permit set forth in Chapter 275 of the Southold Town Code. The issuance of an Administrative Permit allows for the operations as indicated on the site plan prepared by Robert O'Brien, P.E., last dated on November 8, 2012, and stamped approved on November 14, 2012. Special Conditions: None Inspections: Final Inspection. If the proposed activities do not meet the requirements for issuance of an Administrative Permit set forth in Chapter 275 of the Southold Town Code, a Wetland Permit will be required. This is not a determination from any other agency. i James F. King, President Board of Trustees Michael J.Domino,President Sol Town Hall Annex 54375 Route 25 John M.Bredemeyer 111,Vice-President P.O.Box 1179 Charles J.Sanders Southold,New York 11971 Glenn Goldsmith Telephone(631) 765-1892 A.Nicholas Krupski eou Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD CERTIFICATE OF COMPLIANCE # 1336C Date:May 3,2017 THIS CERTIFIES that repair/replace the exi§ting roofed-over porch attached to dwellin At 11292 Main Road, East Marion Suffolk County Tax Map#1000-31-13-9.1 Conforms to the application for a Trustees Permit heretofore filed in this office Dated November 10,2012 pursuant to which Trustees Administrative Permit#7948A Dated November 14, 2012,was issued and conforms to all of the requirements and conditions of the applicable provisions of law. The project for which this certificate is being issued is for th The certificate is issued to Kirk O'Ferrall owner of the aforesaid property. Authorized Signature (EVE Town of Southold - Chapter 236 - Stormwater Management SWPPP - Storm Water Pollution Prevention Plan Assessment Form GENERAL INFORMATION: (All Requested Information is Required for a Complete Application) APPUCAK NAME: Owner-Agent-Consultant-ContractorcrOther(Circle One) PropertyOVIRML, TfalRemathen AppTream) Address: 17-V/2 !V /!eN.I Address: Z�! Telepho�aa� _ ,`Z Fext� / Telaphoneo /T 023- i�/?\ E-Mail: '� d t/decic1ef— Property dress: 112 72 VIA f�/d srief Desao�ptron of canamuaron At4v;ty,r roposea st:nctnral aMPs.so�1 S C T.M. ! .��"/yy ,� Stahalizatim BNM%Pcied�pe and/or Sequence of Consbn�tion Adi" os er m t TProvldend�mmalPa�esasNeetlea) Name of Contractor and/or Cordect Person Responsible for Implernentallon ofSWPPP.- _-- .___-----___- Address~ Telephone tk FaKlk Y'vv s---- Name of Persons Responsible for installation&M;dntn=ce of Etxdan control Practice. Ad -------------------- ---------_------_--- Telephone Faxes E-Mali: - ------------------------------------------- Total Area WA/ �^� /JF/ Total Area of Landq rig -------------------------------------------- .- --------------------------- ----------- ProjectPerceffi: andlarGmtmdDNkffbance; -------------------------------------------- (3AJAcws) F•f Anes} Project Duration, tea® Start � -------------------------------..__---.-_-_--- (pn}k3pa(�) C./il Date: Date: ta�uneerwrroeni -------------------------------------------- ----------------- -------------------------- Will this Project Disturbs five(5)or More Acres at 0 = Any One Time During the Proposed Development? Yes No ____________________________..__-___--_----_- ll YES:Prease Answerthe Folloarinlil -------------------------------------------- a. ------------------------------------------- a. Does the Applicant have a Qualified Inspector On Staff To Conduct the Required Inspections? Yes No b. Does the SWPPP Indicate How Frequently the Site = O List the NAMES ordesaription of all Potentially fin ted Waterbodies andfor Wet1ands: Inspections will Occur and for What Period of Time? Yes No' c. Does the SWPPP Adequately Identify All Temponny 0 andlor Permanent Permanent Sol]Stabalization Measures? Yes No d. Does the SWPPP Adequately Identify a Complete 0 0 ---__----___--_-___-------------------`--------- Project Phasing Plan? Yes No Status of Impacted waterbody:(eq.TYDI..303(d)Listed.knpaifed-) e. Does the SWPPP Indicate Additional Site Specific = j*„„] Practices that Will be Utilized to Protect Water Quality? ' Yes No _ f. Has the Applicant Submitted a Completed DEC Notice Type of ynp ywaterbod).(eg.fake„geek,say.Pond.sauna,Freshwaterwetmtd-) Of Intent and SWPPP Acceptance Form for Review by the Town of Southold? Yes No S1 A717,OF NF.W YORK, COUNTY OF ..---SS 171at L.Rz y1 k..G� Ili.�!�Lt� L`r........»_...being duly sworn,deposes and says that he/she is the applicant for Permit; (tame of individual a ning ) And that he/she is the ......... ....... , tron,Ciwt ._ c. .._.....(0Amr Coactr Agetopsa O ceret ) ....._............-....»....--._.__.._._... Owner and/or representative of the Owner or Owners,and is duly authorized to 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 here Sworn to before me this; .......I.......� y of. C 4�........,201Z ..V. L.O.- �fgqpbqple ....... . Ki TOTHNotary Public ......... ..............."SfaT�iii idEGvYar, (Signature of No.ON6190696 Qualified in Suffolk County Commission Expires July 28,20C OF SQ�jryOl 5o375 Main Road Hall Annex Telephone(631)7yg65-1802 P.O.Box 1179 • O roger.richert(a o`wri solrtttot nV Its Southold,NY 1197I-0959 BUILDING DEPARTMENT ! TOWN OF SOUTUOLD APPLICATION FOR ELECTRICAL INSPECTION 1 REQUESTED BY: . Jo,���s rti-�S Date: 9 - Co i ipany Nage: c a CI c / ccfTtrc. Cid{s /nG Name: _ License No.: Address: ►tea �3ak !a 6 Sa�rt�d r'� Phone No.: G31 -36 ' x/73 AV JOBSITE fNFORMATION: (*Indicates required information) *Name: ;>--lc O ?�a rre._ Address: * Z,.i �as'F tti'r-rt 44 *Cross Street: i�t 2S_ *Phone No.: Permit No.: -- s Tax-Map District: 1000 . ,Section:_ Block: Jam_ Lot: Q• �� *BRIEF DESCRIPTION OF WORK(Please Print Clearly) r-te, � /hd A S_ry tc.z_ —tic 2,0t.,,c, v nd � (Please Circle Ail That Apply) dna ,-r? . Is job ready for inspection: YES NO Rough in Final *Do-you need a Temp Certificate: ! NO Temp Information Ifn eded) t *Service Size: 1 Pha 3Phase 100 150 20 300 350 400 Other `New Service: Re-connect' Undeig oun_ Number of Mete Change of Service Overhead / Addition Inf rmation: — PAYMENT DUE WITH APPLICATION t, � 6( v 82=Request f6r Inspection Form vb SOUr�QI 0 Town Hall Annex Telephone(631)765-1802 54375 Main Road P.O.Box 1179 G • 0 r0 er. c Southold,NY 11971-0959 'rQCo Ul1i`I, SEP 6 2017 BUILDING DEPARTMENT TOWN OF SOUTHOLD BUMDINC DEPT. APPLICATION FOR ELECTRICAL INSPECTIOTPWNOFSOUTHOLO REQUESTED BY: fit/ PRO -51ge TP Z(�: Date: Company Name: PF(I PRO s tac-ra-1G Name: - POOL Co f2 lilU License No.: 3 3 40 3 1*1 e, Address: P O 80S 2 9 3 19qucboqoe 10Y W731. 3 . Phone No.: Pholic 631 ) 2 t4 J 00 $ JOBSITE INFORMATION: (*Indicates required information) *Name: *Address: Q__q 2 ` n n.i v) J G2S Rrrl 07) , *Cross Street: *Phone No.: 631 q U 6663 Permit No.: Tax Map District: 1000 Section: z 1 Block: Lot: . *BRIEF DESCRIPTION OF WORK(Please Print Clearly) Z"d pl q Ori geno uti, -or) new OJ14s Stu tkhc-s x+Ure tgAs. 0 (Please Circle All That Apply) *Is job ready for inspection: YES / NO Rough In Fina *Do you need a Temp Certificate: YES/ NO Temp Information (If needed) *Service Size: 1 Phase 3Phase 100 150 200 300 350 400 Other *New Service: Re-connect Underground Number of Meters Change of Service Overhead Additional Information: PAYMENT DUE WITH APPLICATION 82-Request for Inspection Form p��L� G)0-71 Y l .8a 4q r V 140 _ 1 f 2 r i p A Y ee(s)i+ qt O L;q p Id 8 x 'J - i fi x � k ,z{Y Y F- { �L ��~�,� � � �#� T` � � ����� �'�t't>��" .� -� �,� � �° .� �. �. �� .��, ��� �� {�` ,.� ., � �. � w r�, �� �. � :. G, �� ..� � , 3 �� ._; �,t } .� y° 1 ` �, d t�, "� _ :'+W� In ��* {x� �'S ., t�`p... '."�' .9 ;�� ;. f - y I u �,- � � =�z ��_�€ �� . 4. #ti w' r' � ,. ��'. ��.�., �, 3 ,� P;�-_' r} �... t fir:. .: s� a f f ore-go 000K 7 f t F t f r r -, . - _: �._ "��`� � r� t °A�;; �, � , 2 _ ,'� �4, �,x�'. .. _ 1 ,:' x ._ t - 'R ^As i h i�'r I� .�� � ��� .� r 1 6-� L., q r ,:t'w z r w � 1 t 1 Y x � I N Southold Town Building Department ���guFFOd,�co�y P.O.Box 1179 Permit#: 37718 53095 Main Rd o _ Southold,New York 11971 Permit Date: 1/2/2013 (631)765-1802 Expiration Date: 7/4/2014 Parcel ID: 31.43-9.1 BUILDING PERMIT RENEWAL LETTER Dated: 8/21/2015 Applicant: Uellehdahl,Frank Location: 11292 Route 25, East Marion Work Description: RESIDENTIAL ALTERATION Alteration to an existing second story space and repairs to an existing covered porch, as per Trsutee approval. A FEE OF $100.00 IS REQUIRED TO RENEW THIS BUILDING PERMIT. Owner: Ungerleider,Robert&Ungerleider, Ruth Address: 9 Jones St New York,NY 10014 The permit listed above has expired. No work is permitted or authorized beyond the expiration date. Please submit the above fee made payable to the Town of Southold. Mail to the Town of Southold Building Department, P.O. Box 1179, Southold, New York 11971 THANK YOU, SOUTHOLD TOWN BUILDING DEPT. � s I N/O/F I ARTEM10S & STELLA TSISMENAKIS j I � I 1 N 61"46'50AE 134.56' 1 , W m 24 N FRAME 1 SARA FE 2Z4 0.2'E i !1 F 1 I N Z +s o ,o o Im v +O rel � Z -q A I m 1� In 0 F G Rt r l0 2 O z �� O v + 03 < m N + O O ;a > r- Z > D t*1 r Z -0f D FR. BLDG _ key-0zooz o oz 1 D ;a D POLE zo f t0 N ha z f 0O - 2 STY: ' �► 27.9 FR. HSE. z+ f m P. -h I N a 2FE 5 CA 0.2E 56.9 1 W Im 03 ce►gso A S D FE C Z x - z �fc m t� Z'W otcy- �'132 Z85 WALL OE S� DAYrn -� ���� rte• "�s v�_�a~' •' 1�, s%'r^T3 CI e E i— ,856 80. % .yam_ �,-_-�•--� , TO TIE LINA ANY AL7F-RA77ON OR ADDITION TO THIS SURVEY/S A VIOLATIONS IC Na 49618 OF SEC77ON 7209OF THE NEW YORK STATE EDUCA77ON LAW. ECON/C VEYORS, P_C. EXCEPT AS PER SEC77ON 7209-SUBDIVISION 2 ALL CERTIFICATIONS (631) 765-5020 FAX (631) 765-1797 4EREON ARE VALID FOR THIS MAP AND COPIES THEREOF ONLY IF P.O. BOX 909 SAID MAP OR COPIES BEAR THE IMPRESSED SEAL OF THE SURVEYOR 1230 TRAVELER STREET WHOSE SIGNATURE APPEARS HEREON. SOUTHOLD, N.Y. 11971 112-2031 ELECTROCAL APPROVED AS TOTED DATE: 12 3 B.P.# FEE: rI BY- PLUMBING, NOTIFY BUILDING DEPARTMENT AT ALL PLUMBING WASTE 765-1802 8 AM TO 4 PM FOR THE -&WATER LINES NEED FOLLOWING INSPECTIONS: TESTING BEFORE COVERING 1. FOUNDATION - TWO REQUIRED FOR POURED CONCRETE 2. ROUGH - FRAMING & PLUMBING RETAIN STORM WATER RUNOFF 3. INSULATION PURSUANT TO CHAPTER 236 4. FINAL - CONSTRUCTION MUST OF THE TOWN CODE. BE COMPLETE FOR C.O. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE CODES OF NEW YORK STATE. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS. COMPLY WITH ALL CODES OF NEW YORK STATE & TOWN CODES AS REQUIRED AND CONDITIONS OF NIS SOIJ7HOLD TOWN ZBA OCCUPANCY OR N I SO'FH,OLC1 TOWN PLANNING BOARD USE IS UNLAWFUL X. SOT'HOLD TOWN TRUSTEES WITHOUT CERTIFICATE N.Y.S.DEC OF OCCUPANCY PLUMBER CERTIFICATION ON LEAD'CnNTENt BEFORE CERTIFICATE OF OCCUPANCY SOLDER,USED IN`WATFR SUPPLY SYSTEM-CANNOT EXCEED, j OFJ%LEAD. • '�:��-.z ',- --+p,�'r;- --..n...----- - -- �';,,�-�` �z�-`o'er �xZ � � .---____ -- � _ ��.�• pN M�II' J.S.Y_- �'7`dL�01 QCT .may,•p� "IV .' _..----- --•-- - - E" I "'S - arJ i5'� :T�� _'-'____ --f rim-,ti-JTa• i•'y 5 T ' i� 7 /1 -a / _�7-- ! � $'' �N ��� �• �,k`�.r��i i 1 1 I ;� '� - I ' � � do •I� -- ---�_.. �� '.��, -..�r7 :' � + � --•-- — -X17 I i l ; ------ �� - -- - -- -- __- is � dFl7`1zTJ=15"- _ till,II - - •--•--_ -- _H --- --- �•--• I- ���`I/'1^'I � N'7a1� Ga-+.'lUz'�lad 5N1 - ---•- � -- ----- '� � I 'r��� `. ������1b1,: d n �-- �� Ira H o 1�N G ___.� � ) y��� r��,��.s•N'$ I - I-171 L C3 -•-�-----r7Nl r.`�-___ _ i__� i��� ��SIK� �/`Ulr^I� -�\" - - •-- Mc�1'VIN rv,�n; idJ.SNi NCO 4 NV gazi it � '—F htfj;,ev 1"c1 / r' - •.wry '�', O L— // ( �T_,. _�_. �^�)_HF_^"L�I� I d� � �•- S� �a'�C�� 't. � �}• ZT+��S�la� 1 7r�r'dL,�bZ �t ` 00-7 tVlt�1)q '"��;" - qW, •1,.— J 7 araS+X315 I-+=Vj - I :9-LCN 7JG276 9X�'`A Nfl 1 ^ 1 n 1� --- :r1IM5, 1s1 31�rx5rzl—.__ 3 + fid JIZ � �• , N11 FJ'r^f�9>I�d 7J��.M1`1 �� � 1i tit 1 r �r�� � r�� 1,r -n*tv NT. 1Ska 'JNC744 721 n19� r r brA 1-13 A ar—..--'o'•- =, ..• _ _-_ --•-a•9-'•_..3"::.e'...r.�-a-.,..`-+i.-.r>,., .,y...� .._. »,•�� - s:Pt�::: - -. �,-^r-' ..��y_..- `. y.Y4ti.^t", .��'.. EX15T GI-1m Ey 0 N Exlsr F�Q5T, R�RMER IJFZ-V4 621CK rWi`,to - -- Gbp 5F ANGLES fz H EXIST — bCrE,uD E�cIST C7�I2MF�v °- 7 NEW 61<YL-GH7 505T. WINDOWS(,ry:"GNL) — _ INFILL EST LJNWW OPENR�'.a NEW'�uTTE _ — 'E C:NWINCY>W a IXISr To (M�TcH HEAD .r.r R f. = c,,i=.XiST, {�T.,�11Np7kl; r •'��� - -- 5 �n < -4 --7 5�0 j 1*REOMt�lAA�IN?HIN.1M OW ,� ROVI✓.•EXIS�'."` -_ r - :� u.P�� - _ '',• t�"t h ;�rq:^ai �;:',�� ' --- I4i,'i_k.<;t; —- E ' =rLc DWING RM;11uFILL' -_ ai �,,'rt a NFi D E I G bE.-01 PNIIN 5 GPE.NINa _ L P N Iv LES �{ To, ExlSr- LATTICF_ - >' �,. r r` P.1. <— 5c s'f" tArTiE MMW L o� vrrouY NEW cca 5TAJrZ - ; EXIST. rvOQME. NEW ACvPIAL7 RGbF - --- ---- -J/ d M- .TGH EXIST.G NEW rx�eMeRs oti�Y PN'C�Oks(TI 2F-M^oun :�i>OS"" r-iih Vo� NEW 5-f g } � _ W—W FR - WINR7lJ r � I DR TRIM 4°rF Ta MATcH EXI T. a 5CIST IJEhI C4^STP.R GENERAL NOTES DESIGN CRITERIA: =1 ALTERATIONS m TO THE o 1. ALL WORK MATERIAL, AND EQUIPMENT SHALL BE IN GROUND SNOW LOAD - 45 PSF. ACCORDANCE WITH THE NEW YORK STATE UNIFORM LIVING AREAS AND DECKS - 40 PSF. BUILDING CODE, AND THE NEW YORK STATE ENERGY SLEEPING AREA - 30 PSF. W CONSERVATION CODE, AND LOCAL AUTHORITIES. WIND SPEED - 120 MPH o V■ 2. ALL CONCRETE SHALL BE STONE AGGREGATE WITH A SEISMIC DESIGN CATEGORY - B Q MINIMUM 28 DAY STRENGTH OF 3000 PSI WEATHERING - SEVERE w 3. ALL LUMBER SHALL BE GRA E STAMPED DOUGLAS FIR- FROST LINE DEPTH - 36" J El LARCH STRUCTURAL GRADE2 OR BETTER. DECAY - MODERATE TO HEAVY N DECAY - SLIGHT N !1 r 4. PROVIDE DOUBLE HEADERS AND TRIMMERS AT ALL ICE SHIELD UNDERLAYMENT REQUIRED - YES 1 W/0 Q R SI�LI ACL STAIR AND FLOOR OPENINGS POSTS AND PARALLELPE PARTITIONS, EXCEPT AS NOTEb ON DRAWING. DESIGN IN ACCORDANCE WITH AMERICAN FOREST UTILITY RM BATH 2 0 EAST MARION, NY 5. BRIDGING TO BE PROVIDED FOR ALL JOISTS AND PRODUCTS WOOD FRAME CONSTRUCTION MANUAL FLOOR BEAMS. SPACING NOT TO EXCEED 8.0 FT. FOR 1&2- FAMILY HOUSE - PRESCRIPTIVE DESIGN METHOD i o O BEDROOM 3 11292 MAIN ROAD 6. ALL DIMENSIONS AND GRAPE CONDITIONS TO BE VERIFIED BY CONTRACTORS PRIOR TO START OF CONSTRUCTION AND ORDERIING OF MATERIALS. THIS Z ARCHITECT FOUNDATION HAS BEEN D IGNED FOR A SOIL o BEARING CAPACITY OF TWO 22 TSF AND GRADES _ CD FRANK UELLENDAHL LESS THAN 5%. CONTRACT R SHALL VERIFY THAT a 123 CENTRAL AVENUE THESE CONDITIONS ARE MET. ALL FILL BENEATH m P.O.BOX 316 CONCRETE SLABS TO BE COMPACTED TO 95% o GREENPORT, NY 11944 RELATIVE DENSITY. HALLWAY TEL: 631-477 8624 7. ALL HEADERS 6.0 FT IN LENGTH AND OVER TO BE SUPPORTED BY DOUBLE UPRIGHTS, 9.0 FT AND OVER B 1H 1 OWNERS BY TRIPLE UPRIGHTS. ALL HEADERS TO BE MINIMUM OF 2-2x8 OR AS SHOWN ON DRAWING. KIRK & DENISE O'FERRALL 8. PROVIDE FIRESTOPPING AT ALL LEVEL o 11292 MAIN ROAD PENETRATIONS I EAST MARION, 11939 TEL: 917-922 3-1767 9. PROVIDE FLASHING AT ALL ROOF BREAKS, I 3 CHIMNEYS SKYLIGHTS, EXTERIOR DOORS, WINDOWS AND DECKS ETC.. 10. DO NOT SCALE DRAWINGS. 11. DESIGN CONSULTANTS OR RECORD ARCHITECT- \ ENGINEER ARE NOT RESPONSIBLE FOR THE BEDROOM 2 MBR SURE INSPECTION SUPERVISION OR ADMINISTRATION OF THIS CONSTRUCTION PRbJECT. FEDERAL, STATE AND LOCAL BUILDING CODE COMPLIANCE SHALL BE THE1Z RESPONSIBILITY OF THE CONTRACTOR. , z • " PROPOSED 2ND FLOOR PLAN 12. THIS DRAWING IS AN INSTRUMENT PREPARED TO FACILITATE CONSTRUCTION AND SHALL NOT BE CONSTRUED AS A CONTRACT BETWEEN BUILDER AND o IV OWNER. 13. THIS STRUCTURE HAS BEEN DESIGNED IN 2ND FLOOR ALTERATIONS: f ACCORDANCE WITH THE NEW YORK STATE ENERGY EXITING HOUSE TO BE RENOVATED AND CONVERTED FROM 4 BR'S TO 3 BR'S CONSERVATION CODE. BR 4 TO BECOME MASTERBATH; EXT'G CORNER BATH TO BECOME UTILITY ROOM; s 14. ARCHITECT TO BE NOTIFIED IN WRITING OF ALL CHANGES PRIOR TO AND DURING CONSTRUCTION. PORCH REPAIR; 95 15. ELECTRICAL AND MECHANICAL COMPONENTS TO BE o DESIGNED AND SPECIFIED BY OTHERS. IST FLOOR PORCH COLUMNS AND FOOTINGS TO BE REPLACED ACCORDING TO 9 16. CONTRACTOR SHALL OBTAIN ALL PERMITS AND ENGINEER'S DETAIL; EXISTING PORCH GIRDER TO BE SISTERED WITH NEW GIRDER INSURANCE NECESSARY TO PROTECT THE ENGINEER TO PREVENT ADDITIONAL SAGGING AND OWNER. 17. DO NOT BACKFILL AGAINST FOUNDATION WALLS ADMINISTRATIVE WETLAND PERMIT FOR PROPOSED REPAIR ISSUED IN DEC. 2012 UNTIL FLOOR SYSTEM INSTALLATION IS COMPLETE. o a DATE- 12/12/2012 2E SCALE: NTS DRAWING SCHEDULE _ BUILDING PERMIT APPLICATION Q Design TITLE SHEET A-1 TITLE SHEET - DESIGN CRITERIA - GENERAL NOTES DECEMBER 12, 2012 'R General Notes A-2 AS-BUILT 2ND FLOOR PLAN DWG. NAME A-3 PROPOSED 2ND FLOOR PLAN FRANK W. UELLENDAHL, ARCHITECT P.O. BOX 316 GREENPORT, NEW YORK 11944 A-4 PORCH DETAIL BY ROBERT O'BRIEN, P.E. A-1 0 o DWG NO =J ALTERATIONS TO THE 32'-4" 11 -3" 4 1 2" 8'1'9'11" 4 1 2"I IN J 3 " W X W D W V Z W U D N IIIN D Z W RLSDLCL BATH 1 BATH 2 fo co EAST MARION, NY 0 oj _7e z DBEDROOM 3 U 11292 MAIN ROAD ARCHITECT o FRANK UELLENDAHL C"iW�p 123 CENTRAL AVENUE P,O.BOX 316 GREENPORT, NY 11944 TEL. 631-477 8624 N N w OWNERS d KIRK & DENISE O'FERRALL Z 11292 MAIN ROAD EAST MARION, NY 11939 -1767 UP HALLWAY I BEDROOM 4 cc co M � 0 N202 1, I W � co CXD o N D BEDROOM 1 BEDROOM 2 N � � o RpZ o DATE: 12/12/2012 SCALE: 1/4" = l'-O" 3 AS-BUILT 0 2ND FLOOR PLAN 19'-5 1/2" 4 ,1�2 11'-8" i DWG. NAME IN IN 32'-4" AS-BUILT 2ND FL. PLAN A-2 DWG. NO SCALE: 1/411 = 1'-0" ©¢ J ALTERATIONS LEGEND J TO THE 321-411 " NEW WALL 11,-3„ 4 1 2" g'_0" 4 1 2 11 -6 EXISTING WALL DEMOLITION W IWi U Cl J N N Z a RLSIDLH L cWi _ UTILITY RM BATH 2 EAST MARION, NY REMOVE PLUMBING FIXTURES STORAGE Ir 11292 MAIN ROAD BEDROOM 3 TO REMAIN AS IS W s D ARCHITECT o FRANK LIELLENDAHL LINEN CL. m 123 CENPROLBOXENUE 316 00 6'-2" o GREENPORT, NY 11944 1/2" 4 1 2" 2'-6° tE N TEL; 631-477 8624 _ OWNERS d KIRK & DENISE O'FERRALL 11292 DN LINEN CL. W EAST MARION,MYN1R1939 TEL: 917-923-1767 .� '' HALLWAY F urrLC TO REMAIN AS IS N B JH 1 1 S D cn oN _ _ w a CD m I cV N � N O O ❑ ❑ p 00 D ❑ cf go W W I cn co Fes— I CD M � 2-D I a —� o °o — — — — — co z — J co CV LINE OF 1ST FL. EXTERIOR WALL BELOW E BEDROOM 2 MBR SUITE DATE' 12/12/2012 s D c I REMOVE WALL s D SCALE: 1/4" = 1'-0" co I PROPOSED oZ 2ND FLOOR PLAN N 6 11'-2" 4 1/2" 21-0„ 4 1/2" 17,-7„ N DWG. 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