37-022 (22) 28 MT LAUREL PATH-600 FLORENCE RD BP-2016-0993
GIs #: COMMONWEALTH OF MASSACHUSETTS
Map:Block: 37 -022 CITY OF NORTHAMPTON
Lot: -000 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
Permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
Category: renovation BUILDING PERMIT
Permit# BP-2016-0993
Project# JS-2016-001681
Est. Cost: $39050.00
Fee: $253.83 PERMISSION IS HEREBY GRANTED TO:
Const. Class: Contractor: License:
Use Group VALLEY HOME IMPROVEMENT INC 106006
Lot Size(sq. ft.): Owner: SOERGEL DAVID&ANNAILESE
Zoning. Applicant: VALLEY HOME IMPROVEMENT INC
AT. 28 MT LAUREL PATH - 600 FLORENCE RD
Applicant Address: Phone: Insurance:
P O BOX 60627 (413) 584-7522 Workers Compensation
FLORENCEMA01062 ISSUED ON:2/16/206 0:00:00
TO PERFORM THE FOLLOWING WORK.FINISH BASEMENT W/ 1/2 BATH
POST THIS CARD SO IT IS VISIBLE FROM THE STREET
Inspector of Plumbing Inspector of Wiring D.P.W. Building Inspector
Underground: Service: Meter:
Footings:
Rough: Rough: House# Foundation:
Driveway Final:
Final: Final:
Rough Frame:
Gas: Fire Department Fireplace/Chimney:
Rough: Oil: 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 Occupancy signature:
FeeType: Date Paid: Amount:
Building 2/16/2016 0:00:00 $253.83
212 Main Street, Phone(413)587-1240,Fax: (413)587-1272
Louis Hasbrouck—Building Commissioner
File#BP-2016-0993
APPLICANT/CONTACT PERSON VALLEY HOME IMPROVEMENT INC
ADDRESS/PHONE P O BOX 60627 FLORENCE01062(413)584-7522
PROPERTY LOCATION 28 MT LAUREL PATH-600 FLORENCE RD
MAP 37 PARCEL 022 000 ZONE
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
ENCLOSED REQUIRED DATE
ZONING FORM FILLED OUT
Fee Paid 6 IT LA 7 5 J �
Building Permit Filled out
Fee Paid
Typeof Construction: FINISH BASEMENT W/ 1/2 BATH
New Construction
Non Structural interior renovations
Addition to Existiniz
Accessory Structure
Building Plans Included:
Owner/Statement or License 106006
3 sets of Plans/Plot Plan
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INFO PRESENTED:
pproved Additional permits required(see below)
PLANNING BOARD PERMIT REQUIRED UNDER:§
Intermediate Project: Site 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 Registry of 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
Permit from Elm Street Commission Permit DPW Storm Water Management
D
Signature of Buildi g Official Date 66
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.
Department use only
City of Northampton Status of Permit:
RECEIVED uilding Department Curb Cut/Driveway Permit
212 Main Street Sewer/Septic Availability
5 2016 Room 100 WaterANell Availability
FEB r N hampton, MA 01060 Two Sets of Structural Plans
OF r,u�trnr C IN"FFCTIO s
13 87-1240 Fax 413-587-1272 Plot/Site Plans
DEPT. h1Apt06�
Other Specify
On'YAM'�ON,
APPLICATION TO CONSTRUCT,ALTER,REPAIR,RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWELLING
SECTION 1 -SITE INFORMATION
This section to be completed by office
1.1 Property,Address: \ (� LotT. Unit
\"\&"Ac Ln 1.-.�...l. e �v"�� Map "�
Zone Overlay District
Elm St District CB District
SECTION 2-PROPERTY OWNERSHIPIAUTHORIZED AGENT
2.1 Owner of Record
i v n!-t Q star moo, a
Name(Print Current(Nailing Addre s:
5 Telephone
Signature
2.2 Authorized Agent:
Name(Print) Current Whiling Address:
5 22—
Signature Telephone
SECTION 3-ESTIMATED CWS STRUCTION COSTS
Item Estimated Cost(Dollars)to be Official Use Only
corhfeted by permit applicant
(a)Building Permit Fee
1. Building p, !3e;$0
2. Electrical 3,6 So (b)Estimated Total Cost of
Construction from 6
3. Plumbing 31 W pp Building Permit Fee
4. Mechanical(HVAC) l� 5c>0
5. Fire Protection
6. Total=0 +2+3+4+5) ?)9 C.So Check Number d
This Section For Official Use Only
Date
Building Permit Number: Issued:
Building Commissioner/Inspector or Buildings D2te
Section 4. ZONING All Information Must Be Completed.Permit Can Be Denied Due To Incomplete Information
Existing Proposed Required by Zoning
This column to be filled in by
Building Department
Lot Size
Frontage
Setbacks Front
Side L: R: L: . R: -
Rear
Building Height
Bldg.Square Footage %
Open Space Footage %
(Lot area minus bldg&paved
parking)
#of Parking Spaces
Fill:
(volume&Location) _-:. .......... _._. .,.._... _ _......__.
A. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO DONT KNOW 0 YES O
IF YES, date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO O DONT KNOW Q YES 0
IF YES: enter Book rage and/or Document#
B. Does the site contain a brook, body of water or wetlands? NO DONT KNOW YES
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained 0 Obtained 0 , Date Issued:
C. Do any signs exist on the property? YES NO QC
IF YES, describe size, type and location:
D. Are there any proposed changes to or additions of signs intended for the property? YES 0 NO
IF YES, describe size, type and location:
E. Will the construction activity disturb(clearing,grading,excavation, or filling)over 1 acre or is it part of a common plan
hit will riot irFj neer 1 acre? YES I } i�{O YCaI
f
IF YES, then a Northampton Storm Water Mianagement Permit from the DPW is required.
SECTION 5-DESCRIPTION OF PROPOSED WORK(check all applicable)
New House ❑ Addition D Replacement Windows Alteration(s) Roofing El
Or Doors C]
Accessory Bldg. ❑ Demolition ❑ New Signs [E]] Decks (❑ Siding[p] Other[O]
Brief Description of Proposed
Work: $A�Ik '�-T 1�EAloV�l1oIJ W-1 \'Z ZAP!
Alteration of existing bedroom Yes—X _No Adding new bedroom Yes l No
Attached Narrative Renovating unfinished basement _Ae Yes No
Plans Attached Roll -Sheet
ea. If New house and or addition to existing housing complete the following:
a. Use of building: One Family Two Family Other
b. Number of rooms in each family unit: Number of Bathrooms
c. Is there a garage attached?
d. Proposed Square footage of new construction. Dimensions
e. Number of stories?
f. Method of heating? Fireplaces or Woodstoves Number of each
g. Energy Conservation Compliance. Masscheck Energy Compliance form attached?
h. Type of construction
i. Is construction within 100 ft.of wetlands? Yes No. Is construction within 100 yr. floodplain Yes No
j. Depth of basement or cellar floor below finished grade
k. Will building conform to the Building and Zoning regulations? Yes No.
1. Septic Tank City Sewer Private well City water Supply
SECTION 7a-OWNER A LITHORIZATION-TO BE CORIPiPLE T ED F dHEW
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
as Owner of the subject
property v
by authorize �
c on m half all m tt r relative to work au honzed by this building permit application.
y
Signature of Owner Date
as Owner/Authorized
Agent hereby declare that the stctements and—information on the foregoing application are true and accurate,to the best of my knowledge
and belief.
vn>I:!es/fperk-ir/
dame F
1=71 - 2 (-Z-
SionatLire of Owner/fioe'nc nate
SECTION 8-CONSTRUCTION SERVICES
8.1 Licensed Construction Supervisor` �1J<lJll__a: �y��y Not Applicable ❑
�)
Name of License Holder: nz-\ I y(,r)oC)G
License Number
VioL r716 J:20/1,
Address �- Expiration Date
,Z �
Signature Telep
9.Registered Home Improvement Contractor: Not Applicable ❑
Company Name Registration Number
Address 22 Expiration Date
Telephone
SECTION 10-WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c.162,§25C(6))
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....... ❑ No...... ❑ .
11. Home Owner Exel��t�om
The current exemption for"homeowners"was extended to include Owner-occupied Dwellings of one(1) or two(2)families
and to allow such homeowner to engage an individual for hire who does not possess a license,provided that the owner acts
as supervisor.CMR 780, S!Yth Edition Section
Definition of Homeowner:Person(s)who own a parcel of land on which he/she resides or intends to reside,on which there
is,or is intended to be,a one or two family dwelling,attached or detached structures accessory to such use and/or farm
structures.A person who constructs more than one home in a two-year period shall not be considered a homeowner.
Such"homeowner"shall submit to the Building Official,on a form acceptable to the Building Official,that he/she shall be
responsible for all such work performed under the building permit.
As acting Construction Supervisor your presence on the jab site will be required from time to time,during and upon
completion of the work for which this permit is issued.
Also be advised that with reference to Chapter 152(Workers'Compensation) and Chapter 153 (Liability of Employers to
Employees for injuries not resulting in Death)of the Massachusetts General Laws Annotated,you may be liable for person(s)
you hire to perform work for you under this permit.
The undersigned"homeowner"certifies and assumes responsibility for compliance with the State Building Code,City of
Northampton Ordinances,State and Local Zoning Laws and State of Massachusetts General Laws Annotated.
Homeowner Signature
The Commonwealth of Massachusetts
'—.-- Department of Industrial Accidents
�— Office of Investigations
600 Washington Street
rn r; Boston,MA 02111
www.mass.gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print Legibly
Name (Business/Organization/Individual): Cl�' �±� `(ij 1� �V'lrl QY b\,Yn,)en -- �t�
Address: jyl�
City/State/Zip: \l-p_ C)1 -Phone#: L1
Are you an employer? Check the appropriate box: Type of project(required):
1. I am a employer with I� 4. ❑ I am a general contractor and I
employees(full and/or part-time).
have hired the sub-contractors 6. ❑New construction
2.❑ 1 am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling
ship and have no employees These sub-contractors have g, ❑Demolition
working for me in any capacity. employees and have workers' 9 ❑ Building addition
[No workers' comp. insurance comp. insurance.
required.] 5• ❑ We are a corporation and its 10.❑ Electrical repairs or additions
3.❑ I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions
myself. [No workers' comp. right of exemption per MGL 12.❑ Roof repairs
insurance required.) t c. 152, §1(4), and we have no
employees. [No workers' 13.❑ Other
comp. insurance required.]
*Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information
t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such.
*Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have
employees. If the sub-contractors have employees,they must provide their workers'comp.policy number.
I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site
information.
Insurance Company Name: �jl'-���
Policy 14 Or Self iixi. iii. r�r: v�.^��J�J �' ixpiratitiii tate: r L�
Job Site Address:
lrl ((1 �i�lJ(tel City/State/Zip:`{AQ((Jq)(P C)10(0f�
Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date).
Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a
fine up to $1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDEI?and a fine
of up to $250.00 a day against the violator. Be advised that a copy of this statement may be fonva_rded to the Office of
Investigations of the DIA for insurance coverage v rification.
I do hereby certify the pains a pd penalti perjury that the information provided above is true and correct
V 'Aj 14
Si afore: '
Date:
X1;2
Phone#: —\�"J" � ''�CD c_ D
Official use only. Do not write in this area,to be completed by city or town officiaX
City or Town: Permit/License#
Issuing Authority(circle one):
1.Board of Health 2.Building Department 3. City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector
6.Other
Contact Person: Phone#:
City of hlorthampton 212 Main Street, Northampton, M-A 01060
Solid Waste Disposal Afnda lit
In accordance of the provisions of MGL c 40, S54, I acknowledge that as
a condition of the building permit all debris resulting from the construction
activity governed by this Building Permit shall be disposed of in a properly
licensed solid waste disposal facility, as defined by MGL c 111, S 150A.
Address of the work: '$
The debris will be transported by: AWIL-A V*(Ap�\:Ax D LOejnog
The debris will be received by: cc-rljo 1PI(a
Building permit number: ' Ij
Dame of Permit Applicant 0010 iA
42 ra
Date Signature of Permit Applicant
2016 00002400
RESTRICTIVE COVENANT: Bk: 12195Pg: 153 Page: 1 of 1
Recorded: 02/10/2016 12:19 PM
KNOW ALL MEN By THESE PRESENTS
That David A. W. Soergel and Annaliese K. Beery, owners of the real estate at 28
Mountain Laurel Path, Florence, MA, more particularly shown as
28 Mountain Laurel Path, Florence, MA
Deed date: 08/01/2011
Book/page 10615/146
hereby Covenant and Agree that the basement space at 28 Mountain Laurel Path,
Florence, MA will be used as storage, office„ studio or recreation. It will not be used as
a sleeping space without first obtaining a building permit and meeting all the
requirements of the Massachusetts State Building and Health Code for a newly created
bedroom.
Executed as'a sealed instrument this February 10, 2016
David A. W. Soergel
Annaliese K. B
�nlhis ��) �dayof (?��:"�` l� r ![ �� s0. RqN�
Mf-o e me, the unde_rsi ed no
� �'public,
oo�ay�o�a'�•2
crsonaliy appea�ed((1 �, tl
� �e
-44-490
i . (name of 06,
0,Hent signer),proved to me through 2• ' io
satisfactory evidence of identification, OH�`' ��0
Whichv'�ere 14, � �� z CRY PO6
to be the person%hose name is signed
on the preceding hed document
in my presence. \�.
' �/��//'�/�!�`C { l °1 I x-16 �LE':J�=f^4! �r%�.a�: '.-'..�a�e..�x„i"�%r=��•}�%�?'--'���i� s •-,
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FLOOR PLAN NOTES: Q /�/'(3 G'✓�b City of Northampton N� Pot e,
°m t• ALL EXTERIOR DIMENSIONS ARE TO THE MAIN //� Building Department
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EXTERIOR LAYER. DIMENSIONS TO OPENINGS Plan Review
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ARE TO THE FRAMING,ROUGH OPENING. 212 Main Street =
4 INTERIOR DIMENSIONS ARE TO THE FINISHED Northampton, MA 010�fi0 _ _ �
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m WALL.
a2.CONTRACTOR SHALL VERIFY ALL DIMENSIONS w m
o AND IS RESPONSIBLE FOR ALL DIMENSIONS _ _ >
c (INCLUDING ROUGH OPENINGS). ( N z
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`4 DIMENSIONS ARE TO THE FINISHED WALL. 1T-9 1/4" 11'_2 7/8" U)
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ro 2.LEAD CARPENTER SHALL VERIFY ALL DIMEN51ON5
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s GENERAL NOTES: .. W z
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o IRC AND ALL ADDITIONAL STATE AND LOCAL CODE _ 2"RIGID @ CONCRETE
= REQUIREMENTS.
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o EXT 2613 �EXT 2613
,° WRITTEN DIMENSIONS ON THESE DRAWINGS SHALL HAVE
c PRECEDENCE OVER SCALED DIMENSIONS.THE GENERAL — — _
_ _ _EXT 2668_-�—
( ) A
g DIMENSIONS INCLUDING ROUGH OPENINGS AND VERIFY 51ZE VERIFY SIZE 11(-DRI GORE:
CONTRACTOR SHALL VERIFY AND IS RESPONSIBLE FOR ALL
m CONDITIONS ON THE JOB AND MUST NOTIFY THIS OFFICE OF (-150 SOFT), fi
E ANY VARIATIONS FROM THESE DRAWINGS. �
CARPET PAD
`0 m CARPET COLOR
E THE GENERAL CONTRACTOR IS RESPONSIBLE FOR THE
ro DESIGN AND PROPER FUNCTION OF PLUMBING,HVAC AND TBD
o ELECTRICAL SYSTEMS.THE LEAD CARPENTER OR A Z O
m SUBCONTRACTOR SHALL NOTIFY THE OFFICE WITH ANY
PLAN CHANGES REQUIRED FOR DESIGN AND FUNCTION OF rn
o PLUMBING,HVAC AND ELECTRICAL SYSTEMS. n j ��
X I �%- m L DOM.HOT WATER REMAINS ii
m DESIGN CRITERIA: 2009IRC AND IBC ALONG WITH STATE w
AND LOCAL AMENDMENTS m v BOILER, z
= ROOF: SNOW LOAD DETERMINED BY AMENDED I.R.C. e
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o SOIL: 2,000 PSF ALLOWABLE(ASSUMED). 1 Z HOUSE HEAT
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FLOOR: 40 PSF LL. VINYL OR MARNO ry REMAINS 5
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FROST DEPTH: 4'-0" �
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$ THIS STRUCTURE SHALL BE ADEQUATELY BRACED FOR WIND �
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PERMANENTLY FRAMED TOGETHER AND SHEATHED. X w
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Q� RENDERINGS ARE NOT TO SCALE;ALL RENDERINGS ARE f �I la m W
vi"m FOR ARTISTIC DEPICTION ONLY.PLAN UPDATES MAY NOT BE INSTALL NEW SOFFIT TO ENCASE EXISTING BEAM AND EXISTING DRAIN-- " V —� --EXT.YVASTE PIPE J O
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tyq I Recessed Ceiling Recessed ZSeiling ( I Z
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y ELECTRICAL NOTES: I (\J� Exhaust(light) !_ V° Q Z
c V/ev fFTfTimer _ f
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a o 1.ALL APPLIANCES&UTILITIES TO HAVE DEDICATED I , Four Way Single Pole �'FC Ingle Pole ? 0
c GATbrrV@ TOP OF STAIRS FOR WIFI / I 0 J O
m c CIRCUITS PER CURRENT ELECTRIC CODE
°° SWITCH Q TOP OF 5TAIR5 I W H
m y STANDARDS AT TIME OF INSTALLATION. SEE MF&5 _
E SPECS FOR OTHER REQUIREMENTS ;l m N F
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2.ELECTRICAL RECEPTACLES IN BATHROOMS, I '! ( Four W a - z I O.
o KITCHENS AND GARAGES SHALL BE 6.F.G.1.PER CSR V ) c I
NATIONAL ELECTRICAL CODE REQUIREMENT5.
tSMOLL BE \ <_ —Clothes,Dnyer M
3 3 AND INSTALLED NCO EACCORDANCTECTORS E W TH N�A ED ( \ /�- \ I
°12 REGULATIONS / CNI
W 4.CIRCUITS SHALL BE VERIFIED WITH HOME OWNER Recessed Gelling Recessed Ceiling Recessed Geil(ng ON
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Up I o o 0
t o PRIOR TO WIRE INSTALLATION. Ln
v5.FINAL 5WITGHES FOR TIMERS AND DIMMERS I I < d3 E
S SHALL BE VERIFIED WITH HOME OWNER. Cn 4)
c b.ALL SURFACE MOUNTED FIXTURES TO BE I � I Ct1 >
m m SELECTED AND PURCHASED BY HOMEOWNER. A` a ell
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1.ALL DECORATIVE FIXTURES TO BE SELECTED AND ( Recessed GellingV/ E E
E PURCHASED BY HOMEOWNER. I
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° 5.BATH VENTILATION TO BE BftTH VENT SPEC HERE, I I ` E
AND IS PURCHASED BY VM/OR HOME OWNER I / ,Z
Q 9.UNO-ALL 5WITGHES TO BE 46"OIG ASF. OUTLETS L— — — — — — — — — — — — — _— — — — — — — — — _ — — — — — — J r 4)
TO BE 15"0/6 ASP. OUTLETS OVER O CV
COUNTERTOPS TO BE 3"ABOVE COUNTER FROM p
BOTTOM.(ASF-ABOVE SUBFLOOR)
ELECTRICAL_ PLAN L
° DATA/GABLE:
r
W = � �
1/4 in1 ft �
1.LOCATION OF PHONE/CABLE/ETHERNET GABLES ty Ul
o TO BE CONFIRMED WITH HOWE OWNER PRIOR TO 0 •` Cil 91
Q y INSTALLATION IF APPLICABLE. QN
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