37-083 (13) 266 GROVE ST BP-2019-1229
GIs#: COMMONWEALTH OF MASSACHUSETTS
Mao:Block:37-083 CITY OF NORTHAMPTON
Lot,-WO PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Buildina DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Cateeorv:KITCHEN RENO BUILDING PERMIT
Permit 4 BP-2019-1229
Project# JS-2019-001987
Est.Cost: $17500.00
Fee: $123.00 PERMISSION IS HEREBY GRANTED TO:
Const.Chess: Contractor: Lteense:
Use Grouo: CORBIN CHICOINE 113093
Lot Sizef%.ft.1• Owner: HOUSMAN SETH&ERICA
7aninw Applicant. CORBIN CHICOINE
AT: 288 GROVE ST
AvalkantAddress: Phone: Insurance:
24 PRINCETON AVE (413)214-4659 SOLE PROPRIETOR
EASTHAMPTONMA01027 ISSUED ON."12019 0.00.-
TO
:00:TO PERFORM THE FOLLOWING WORK:REMOVE WALL BETWEEN KITCHEN & LIVING
ROOM, INSTALL NEW CABINETS
POST THIS CARD SO IT IS VISIBLE FROM THE STREET
Inspectorof Plumbing Inspector of Wiring D.P.W. Building Inspector
Underground: Service: Meter:
Footings:
Rough: Rough: House# Foundation:
Driveway Final:
Final: Final:
Rough Frame:
Goa: Fire Department Fireplace/Chimney:
Rough; Qil: Insulation:
Final: Smoke: Final:
THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF
ANY OF ITS RULES AND REGULATIONS.
Certificate of Oxuoanev Signature:
FeeTvoe: Date Paid: Amount
Building 5/3/20190:00:00 $123.00
212 Main Street,Phone(413)587.1240,Faa:(413)587-1272
Louis Hasbrouck—Building Commissioner
File#BP-2019-1229
APPLICANT/CONTACT PERSON CORBIN CHICOINE
ADDRESSIPHONE 24 PRINCETON AVE EASTHAMPTON (413)2144659
PROPERTY LOCATION 266 GROVE ST
MAP 37 PARCEL 083 000 ZONE
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT-APPLICATI NCH I
ENC SED REQUIRED DATE
ZONING
Fee Paid
Building Permit Filled out
Fee Paid
T of Construction, REMOVE WALL BETWFEN KIT R INSTALL NEW C BINETS
New Construction
Non Structural interior renovations
Addition to Existi
Accessory Structure
Buildine Plans Included:
Owner/Statement or License 113093
3 sets of Plans/Plot Plan
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INFO ATION PRESENTED:
Approved_Additional permits required(see below)
PLANNING BOARD PERMIT REQUIRED UNDER:§
Intermediate Project: She Plan AND/OR Special Permit With Site Plan
Major Project: Site Plan AND/OR Special Permit With Site Plan
ZONING BOARD PERMIT REQUIRED UNDER: §
Finding Special Permit Variance'
Received&Recorded at Registryof Deeds Proof Enclosed
!Other Permits Required:
_Curb Cut from DPW Water Availability Sewer Availability
,_Septic Approval Board of Health Well Water Potability Board of Health
Permit from Conservation Commission Permit from CB Architecture Committee
APermit from Elm Street Commission Permit DPW Storm Water Management
Detach ion Delay
5-3-Z019
Sign of Building Oft'ieia] Date
Note: Issuance of a Zoning permit does not relieve a applicant's burden to comply with all zoning
requirements and obtain all required permits from Board of Health,Conservation Commission,Department
of public works and other applicable permit granting authorities.
' Variances are granted only to those applicants who meet the strict standards of MGL 40A.Contact Office of
Planning&Development for more information.
Versionl.7 Commercial Building Permit May 15,2000
Department use only
ity of Northampton Status of Permit:
RECEIVEDB jilding Department Curb Cut/Driveway Permit
212 Main Street Sewer/Septic Availability
MAY 2 Room 100 Water/Well Availability
2019 No hampton, MA 01060 Two Sets of Structural Plane
phone 13-687-1240 Fax 413-587-1272 PlottSite Plans
DFPT OF SUILDINA INSPECTONS Other Specify
EPAIR,RENOVATE,CHANGE THE USE OR OCCUPANCY OF,OR DEMOLISH ANY BUILDING
OTHER THAN A ONE OR TWO FAMILY DWELLING
SECTION i -SITE INFORMATION
1.1 Property Address: This section to be completed by omce
;z 6 / Ao vc ST v _}f /6 Map '7 Let
NOI?711 .nPT�✓ MA Zone Overlay District
O/060 Elm SL District CB District
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record: wt
.5E7'11 SER/CR 1/oSk,i4101 age' GRoUt- Sr -747`7/�
Name(Print) Current Mailing Maness:
NOW,7*05 '1;�'/iW O/aSo
Sgnatuse Telephone —S
2.2 Authorized Agent:
Name(Print) Current Melling Address'.
Signature Telephone
SECTION 3-ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost(Dollars)to be Official Use Only
completed by permit applicant
1. Building 51000 (a)Building Permit Fee
2 Electrical (b)Estimated Total Cost of
Construction from e
3. Plumbing Building Permit Fee
4. Mechanical(HVAC)
5. Fire Protection -
6. Total=(1 +2+3+4+5) 00 Check Number
This Section For Official Use Only
Building Permit Number Date
Issued
Signature: /z
C5-3-2oq
Building Commissionedinspector of Buildings Daft
,a///{ �, f't
&rb)nChl'CU%AB(Yh/�r I/ C
L t IVY i
Vemionl.7 Commercial Building Permit May 15,2000
SECTION 4-CONSTRUCTION SERVICES FOR PROJECTS LESS THAN 36,000
CUBIC FEET OF ENCLOSED SPACE
Interior Alterations ❑ Existing Wall Signa ❑ Demolition Repairs❑ Add Worn ❑ Accessory Building
Exterior Alteration ❑ Existing Ground Sign❑ New Signa❑ Roofing El Change of Use❑ Other❑
Brief Description Enter a brief description here. z 3NI?l�0 �K T 4En/OVC
Of Proposed Work: /J 47'10N or 1* 6✓A// .615 770/r /�':"eWe 4- 4v.-
iti rsi� tiEw :.u�7yae
SECTION 5-USE GROUP AND CONSTRUCTION TYPE
USE GROUP(Check as applicable) CONSTRUCTION TYPE
RHnardll
embly ❑ A-1 ❑ A-2 ❑ A-3 ❑ 1A ❑
A-4 ❑ A-5 ❑ 1 B ❑
iness ❑ 2A ❑
Educational ❑ 2B ❑
tory ❑ F-1 ❑ F-2 ❑ 2C ❑
Hazard ❑ 3Autional ❑ 1-1 ❑ 1-2 ❑ 1-3 ❑ 3B
rcantile ❑ 4idential ❑ R-1 ❑ R-2 ❑ R-3 ❑ 5Aage ❑ S-1 ❑ S-2 ❑ 5Bity ❑ Specify:
ed Use ❑ Specifycial Use ❑ Specify:
COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATIONS,ADDITIONS AND/OR CHANGE IN USE
Existing Use Group: Proposed Use Group:
Existing Hazard Index 780 CMR 34): Proposed!Hazard Index 780 CMR 34):
SECTION 6 BUILDING HEIGHT AND AREA
BUILDING AREA EXISTING PROPOSED NEW CONSTRUCTION OFFICE USE ONLY
Floor Area per Floor(so
1°1
i
2"0
2n°
3,u '
3'0
4e 4e
Total Area(sq Total Proposed New Construction(at)
Total Height(ft)
Total Height it
7.Water Supply IN!G.L.e.40,164) 7.1 Flood Zone Information: 7.3 Sewage Disposal Syetam:
Public ❑ Private ❑ Zone Outside Flood Zone❑ Munidpal ❑ On site tlisposal system❑
Version 1.7 Commercial Building Permit May 15,2000
IL NORTHAMPTON ZONING
Existing Proposed Required by Zoning
This column to befilled N by
Building Depaaneut
Lot Sin
Frenitalle
Setbacks From
Side L: R: L: R:
Rear
Building Height
Bldg.Square Footage %
Open Space Footage
B-ot un a m inus bldg a paved
#of Parking Spaces
Fill:
valumc@Location
A. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO Q DON'T KNOW O YES O
IF YES, date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO O DONT KNOW O YES O
IF YES: enter Book Page and/or Document#
B. Does the site contain a brook, body of water or wetlands? NO O DONT KNOW O YES O
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained O Obtained O , Date Issued:
C. Do any signs exist on the property? YES O NO O
IF YES, describe size, type and location:
D. Are there any proposed changes to or additions of signs intended for the property? YES O NO O
IF YES, describe size, type and location:
E. Will the construction activity disturb(clearing,grading,excavation,or filling)over I acre or is it part of a common plan
that will disturb over 1 acre? YES O NO O
IF YES,men a Northampton Storm Water Management Permit from the DPW is required
Versionl.7 Commercial Building Permit May 15,2000
SECTION 9-PROFESSIONAL DESION AND CONSTRUCTION SERVICES-FOR BUILDINGS AND STRUCTURES SUBJECT TO
CONSTRUCTION CONTROL PURSUANT TO 780 CMR 116(CONTAINING MORE THAN 35,000 C.F.OF ENCLOSED SPACE)
9.1 Registered Architect:
Not Applicable ❑
Name(Regiment):
Registration Number
Address
Expiralian Date
Signature Telephone
9.2 Registered Protesalonal Enginal r(s):
Name Area of Responsibility
Address Registration Number
SignahreTelephone Eiondion Date
Name Area of Responsibility
Add.. Registration Number
Signature Telephone Eviration Dale
Name Area of Responsibility
Address Registration Number
Signature Telephone Eipiration Date
Name Area of Responsibility
Address Registration Number
Signature Teleph Epirelian Date
9.3 General Contractor
Not Applicable ❑
Company Name'.
Responsible In Charge of Construction
Address
Signature Telephone
Versionl.7 Commercial Building Pennit May 15,2000
SECTION 10-STRUCTURAL PEER REVIEW(780 CMR 110.11)
Independent Structural Engineering Structural Peer Review Required Yes O No O
SECTION 11-OWNER AUTHORIZATION-TO BE COMPLETED=
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING
1, S%7/1 t M.-A /IlecSA,d ,as Owner of the subject property
hereby autho e _. O /✓ C�CrC'OL.f/E to
act,
d h f.in matters lative to work authorized by this buikling permit application.
hes
of Primer Date
I, as Owner/Authorized
Agent hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge
and belief.
Signed under the pains and penalties of perjury.
Print Name
Signore of Diner/Agent Dale
SECTION 12-CONSTRUCTION SERVICES
10.1 Licensed Construction/Supervisor: Not Applicable ❑
Name of License Holder .0,61AI G/11&oINE //3 093
License Number
zy 2� �( / 1G- 3
Address/ A� Espiretion Dale
Signature Telephone
SECTION 13-WORKERS'COMPENSATION INSURANCE AFFIDAVIT IM.G.L.c.152,12SC18))
Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result
in the denial of the issuance of the building permit
Signed Affidavit Attached Yes 'A No 0
City of Northampton 212 Main Street, Northampton, MA 01060
Solid Waste Disposal Affidavit
In accordance of the provisions of MGL c 40, S54, I acknowledge that as
a condition of the building permit all debris resulting from the construction
activity governed by this Building Permit shall be disposed of in a properly
licensed solid waste disposal facility, as defined by MGL c 111, S 150A.
Address of the work: 266 ST
The debris will be transported by: 6"eel / de-om P
The debris will be received by: (/ k vCzNe
Building permit number: /�/
Name of Permit Applicant Lo961AI ( fi:(oi rlH
Date Signature of Permit Applicant
iLN
The Commonwealth of Massachusetts
Department of Industrial Accidents
I Congress Street,Suite 100
Boston, MA 02114-2017
www.massgov/dia
UV Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers.
TO BE FILED WITH THE PERMITTING AUTHORITY.
Applicant Information Please Print Legibly
Name (Business'OrgmiratinMndividual): p
Address: .2V I&JV&Titl /9VE
City/State/Zip: 6/}5t1fA-/7f1'snJ Mfl- Phone#: y,q afy
76s9
Are Yov.o employe±Clerk tae.ppoa rife Iwo:
Type of project(required):
101 am a employer with employees(fall and/or part-time)" 7. []New construction
2�lan asole pmpri,nororparhwrship and have no employees working for mem 8.0 Remodeling
any amenity poo workera'comp,insurance required.]
I❑Iamahomeownerdoing all work myself(No worken'mmp.insumrce regmred_1' 9. ❑Demolition
4.❑Ian a homeowner and will be hiring conowtha s to conduct all work on my property. 1 will 10❑Building addition
ensure Natal enianaeurs either have workers'compeneatimarecanceor arc sole I I.X Electrical repairs or additions
proprietors with no employeea. 12.❑Plumbing repairs or additions
5,[]I em a general comments adi I have hired the mbcontrxtms listed ani attached sheet 13.�Roof repairs
'Me.sm-teraactorlav
s a empl,.and hawo
ve rken'comp.tone
6.❑We area et rpmation assistant.have exemissd their right ofexemptim per MGL c. 14.[]Other
152,444),end us hove noemploYees.Mo worker'comp.insurance n gtin,d.l
•Any applicant that cheaks box#1 must also fill not the section helow,showing their wmkers'compensation policy inforrommi.
I Donwowners who submit Nil affidavit indicating they are doing all work and then hire maside cummcmn m,ut submit a new affidavit inhraang such.
:Contractors that cheak this box must mashed an additional sheat showing the mane of the sulatmon dors and state xhether or not those entities have
employeeslithe sub-contmemrs have employees,they must provide their workerscomp.policy number
1 am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site
information.
Insurance Company Name:
Policy#or Self-ins.Lic.#: Expiration Date:
Job Site Address: City/State zip:
Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date).
Failure to secure coverage as required under MGL c. 152,§25A is a criminal violation punishable by a fine up to$1,500.00
and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a
day against the violator.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance
coverage verification.
I do herebycertify ra�d//er the sp ndpenaWes efperjury drat the Information provided/above is true and correct
Signature, 7= Date
Phone#� yf3 ^,2/y- y6rr _
Officid use only. Do not write in this area,to be completed by city or town official.
City or Town: Permit/License#
Issuing Authority(circle one):
1. Board of Health 2. Building Department 3.City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector
6.Other
Contact Person: Phone#:
Information and Instructions
Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees.
Pursuant to this statute,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 ajoint 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 maintenance,construction or repair work on such dwelling house
or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer."
MGL chapter 152,§25C(6)also states that"every state or bed 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,MGL chapter 152,§25C(7)states"Neither the commonwealth nor any of its political subdivisions shall
enter into any contract for the performance ofpublic work until acceptable evidence ofcomplheave with the insurance
requirements of this chapter have been presented to the contracting authority."
Applicants
Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and,if
necessary,supply sub-contractors)murals),address(es)and phone number(s)along with their certificate(s)of
insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the
members or partners,are not required to carry workers'compensation insurance. If an LLC or LLP does have
employees,a policy is required. Be advised that this affidavit 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 ro the city or town that the application for the permit or license is being requested,not the 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. Self-insured companies should enter their
self-insurance license number on the appropriate line.
City or Town Officials
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 the applicant.
Please be sure tn fill in the permit/license number which will be used as a reference number. In addition,an applicant
that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current
policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in_(city or
town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the
applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each
year.Where a home owner or citizen is obtaining a license or permit not related m arty business or commercial venture
(i.e.a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit.
The Department's address,telephone and fax number:
The Commonwealth of Massachusetts
Department of Industrial Accidents
1 Congress Street, Suite 100
Boston,MA 02114-2017
Tel.#617-727.4900 ext, 7406 or 1-877-MASSAFE
Fax#617-727-7749
Revised 02-23-15 www.mass.gov/dia
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C58®2018.90.16 wit 16 Grove St 5-1-19
IeiBanFilpax11899.1 Northalmtal 8:05sm
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Member Data
Description: Member Type:Beam Application:Floor
Top Lateral Bracing:Continuous
Bottom Lateral Bracing: 0.00
Standard Load: Moisture Condition:Dry Building Code:IBCARC
Live Load: 40 PLF Deflection Criteria: Lr"live.L240 total
Dead Load: 15PLF Deck Connection:Nailed Member Weight 12.0PLF
Filename:8 ft 8 in Be
Other Loads
Type Thb. Omar Dead
(Dascriplan) SIB Begin End Within Stan End Sbd End Category
Replacement Un#oml(PSF) Top 0' 000' 10 0.00' 12' O.W 40 10 Live
Additional Unto.(PSF) Top 0' 0.00' 10' 0.00' 12' 0.00' 10 10 Live
Additional Uniform(KF) Top 0' 0.00' 10' 000' 0 56 Live
1000
1000
Bearings and Reactions
input Min Graviry Gravity
laaeon Type Materiel Length Required Reaction Uplift
1 0' 0.000' Wall SPF#3/Stud 2x 9r 4x ErdGran(650psi) N/A 2.025' 4606# -
2 10' 0000' Wall SPF#WSWd 2x 9r 4x End-Grain(650P51) N/A 2.025' 46069
Maximum Load Case Reacdcew
uWaglylm
1.1" aII�wlualb Dud 11 a Dd
t 301411 156ar
z 3014N 1582#
Design spans
10 1]
Product: 1-3/4x11-7/8 VERSXLAM 2.0 3100 SP 2 ply PASSES DESIGN CHECKS
Connect members with 2 rows of led common relhs at 12.0'oc
Minimum 2.02"bearirp requited at bearm,el
Minimum 2.02"bearirgre9uiredattaarirg#2
Designassumescadr lateralbracir aha#eerapcfaxd.
Design assumes maximum urlbraced length of 0.00'alaq t e batWn chard.
Allowable Stress Design
Actual AM,xvibhe Capacity laatm Laaang
PoskNe Moment 11883.'# 21275'# 54% 5' Total Load D-L
Shear 3708.# 7897# 46% 9.57' Total Load D+L
TL Deflection 0.1840' 0.5073' 11661 5' Total Load 0.5D+L
LL Dellecion 0.1484' 0.3382' L1831 5' Total Load L
Carlml. Posh.Manert
DQa: Live=100% So,-115% Rmr=125% Wi 190%
M po1x1rale eetgmw4z a",ni,em eoawr
Csgnds(C)M8 W amara Wa T'reCarvery W,ML RMTS Rr5P14D.
^PutlmIBMMw WvitlemenM,aW lab arm o pram.erwim th.a.,n.eploade del,weir.n Iva,bam Cmdlac.ad Spee lamm
ti s sbY Tlw dNT mut N rwiwl G/s aeMp ealpw p dwlpi aticslml®myrq b grwtl.lMs ddP wns^w aqM I�salam voam b ew
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CS earn 2018.9.0.16 unit 16 Grove St 5-1-19
InnevnEngirs20189A.1 Nodhampmn 804.
Mmeiels DmabYe 1572 1 Of 1
Member Data
Description: Member Type:Beam Application:Floor
Top Lateral Bracing:Continuous
Bottom Lateral Bracing: 0.00
Standard Load: Moisture Condition:Dry Building Code:IBCARC
Live Load: 40 PLF Deflection Criteria: L/360 Hire,L240 total
Dead Load: 15 PLF Deck Connection:Nailed Member Weight 9.8 PLF
Filename:8 it 8 in Be
Other Loads
Type Mb. Other Dead
(Description) Slim Begin End Width Said End Sart End Category
Replacement Unitem(PSF) Top 0' 0.00' 10' 0.00' 12' 0.00' 40 10 Live
Additional Undo.(PSF) Top 0' 0.00' 10' 0.00' 12' 0.00' 10 10 Live
Arlin# iUniform F Top 0' 0.00' 10' 0.00' 0 56 Live
1000
1000
Bearings and Reactions
input Min Gravity GraNty
t68tion Type Material Length Required Reaction Uplift
1 0' 0.000' Wall SPF#3/Stud 2z or 4z EndGrun(650psi) N/A 2.019' 4594# -
2 10' 0.000' Wall SPF#3/Stud 2z or 4z EndGrun(650psi) N/A 2.019' 4594#
Maximum Load Case Reactions
u Y1 a aa'riro pion law 1 a Are is%)m urrtea mme.:
U. Dead
1 304/N 1550N
2 3041# 15501,
Design spans
10' 1,W
Product: 1-3/4x9-1/2 VERSA l-AM 2.0 3100 SP 2 ply PASSES DESIGN CHECKS
Connect members with 2 rims of l6d carman nails at 12.0'oc
Minimum 2.02"bearing required at beading#1
Minimum 2.02"bearing required et bearing#2
Design assumes cadinuoua lateral bracing along the top chard.
Design assumes maximum unaaced length of 0.00'along the bodarn chard.
Allowable Stress Design
Actual Allowable capacity Location Loaddil
Native Moment 11653,W 13958.*# 83% 5' Taal Lead D+L
Shear 3877.# 63171 61% -0.06' Total Load D+L
TL Deflection 0.3589' 0.5073' U339 5' Total Load 0.5D+L
LL Deflection 0.2800' 0.338T U425 5' Teal Lead L
caaml: LLDHNctlon
DDta: trva=1W% Srer-115% Rmf=1]5% Wind=160%
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