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09-003 (5) File #BP-2022-0778 • APPLICANT/CONTACT PERSON:LAMORE LUMBER CO 724 GREENFIELD RD DEERFIELD, MA 01342413-773-8388 PROPERTY LOCATION KENNEDY RD MAP:LOT 09-003-001 ZONE THIS SECTION FOR OFFICIAL USE ONLY: PERMIT APPLICATION CHECKLIST ENCLOSED REQUIRED DATE ZONING FORM FILLED OUT Building Pe i,' 1 i•• out Fee Paid $96.00 Type of C'nst n: 480 SQ FT EQUIPMENT SHED New Construction . Non StructuralRenovations Addition to Existing Accessory Structure Building Plans Included: Owner/ Statement or License 3 sets of Plans/Plot Plan THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON INFORMATION PRESENTED: Approved 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 Perm its 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 Demolition Delay r Si ture of Building Official I 6 Date 00/Pa 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. 1 ., The Commonwealth of Massachusetts Wt Board of Building Regulations and Standards FOR Massachusetts State Building Code, 780 CMR MUNICIPALITY USE Building Permit Application To Construct, Repair, Renovate Or Demolish a Revised Mar 2011 One- or Two-Family Dwelling ee This SS ction For Official Use Only Building Permit Number: D�/Z 2-7 7 O D.to Applied: I` _ It. , , tf t7 I as Building Official(Print Name) Signature i, to j SECTION 1:SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map& Parcel Numbers '4ap iC- 1�Nr (�y Rc/ acr 60-3 oo I.I a Is this an accepted street?yes r/ no Map Number Parcel Number 1.3 Xoning Information: 1.4 Property Dimensions: . "F' NW5H Oi'YAW t la t0©,F-I- Zoning District Proposed Use l Lot Area(sq ft) Frontage(ft) 1.5 Building Setbacks(ft) Front Yard Side Yards Rear Yard Required Provided Required Provided Required Provided AU ' I50© ` H ' 110 a y , 4V,z5 ► 1.6 Water Supply: (M.G.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Public 0 Private EI Zone: _ Outside Flood Zone? Municipal 0 On site disposal system 6 Check if yeslr SECTION 2: PROPERTY OWNERSHIP' 2.1 O pert of Record: v � s 4 Li BAN ET C-U t L �1)5 e a e(Print City, State,Z � j> NNGOY R4 q78-5th in (KKK 3�3if A GM��iPM ►,um No.and Street Telephone Email Address SECTION 3:DESCRIPTION OF PROPOSED WORK2(check all that apply) New Construction Existing Building 0 Owner-Occupied 0 Repairs(s) 0 Alteration(s) 0 Addition.❑ Demolition 0 Accessory Bldg. 0 Number of Units Other 0 Specify: Brief Description of Proposed Work2: E ak 0.;f 01.6IN-T S C\ G n 411 O 4.2 LA.Mc eoNS-rent, ;rtyl but i.t oN C:.\A.I -tehvN„s ( f (44TT) SECTION 4:ESTIMATED CONSTRUCTION COSTS Item Estimated Costs: Official Use Only (Labor and Materials) I. Building $ WA ? J 1. Building Permit Fee: $ Indicate how fee is determined: l 1 ❑Standard City/Town Application Fee 2.Electrical $ 11u/` � ❑Total Project Cost;(Item 6)x multiplier x 3. Plumbing $ NA 2. Other Fees: $ 4. Mechanical (HVAC) $ Al t1 List: 5. Mechanical (Fire $ I� Suppression) /V A Total All F _ � li Check No. :Check Amoun Cash Amount: 6.Total Project Cost: $ 0 Paid in Full 0 Outstanding Balance Due: 4ka'*t.4i 1 t U fl P?wII , Pe/1 t 1- 7ilf '''')A lea NV g IV CS L 146416eeL 1 City of Northampton /? SAS -� Massachusetts � c. 1 t DEPARTMENT OF BUILDING INSPECTIONS �'• �; " 212 Main Street • Municipal Building yJ Oc's , Northampton, MA 01060 J' %4 PROCEDURE FOR OBTAINING A BUILDING PERMIT FOR NEW 1 & 2 FAMILY DWELLING,ADDITIONS,POOLS,DECKS,ACCESSORY STRUCTURES, FENCES,GROUND MOUNTED SOLAR, ETC. 1. Building Permit Application signed by legal owner and filled out by owner or authorized agent. 2. One set of plans and specification of proposed work(digital and hard copy). 3. Site Plan with location of proposed structure(s)and setbacks. 4. Construction Debris Affidavit filled out and signed by applicant. 5. Worker's Compensation Insurance Affidavit filled out and signed by applicant. 6. Contractors must supply a copy of CS License, HIC Registration and proof of Liability Insurance. 7. Energy Conservation Compliance Certificate(new/replacement windows). 8. Home Owner's License Exemption Form filled out and signed by homeowner(if applicable). 9. Note any Conservation and/or Special Permit requirements (if applicable). 10. Driveway Permit(if applicable). 11. Proof of Water and Sewer entry fees paid(if applicable). 12. Trench Permit-public land by DPW/Private land by Building Dept. 13. Stretch Energy Code—all new construction will require a HERS Rater Affidavit to be submitted with permit application before issuance of permit. BP 2022-0778 420 KENNEDY RD COMMONWEALTH OF MASSACHUSETTS Map:Block:Lot: 09-003-001 CITY OF NORTHAMPTON Permit: Acc Structure. PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A) BUILDING PERMIT Permit# BP-2022-0778 PERMISSION IS HEREBY GRANT TO: Project# shed Contractor: License: Est. Cost: 2169 LAMORE LUMBER CO 076123 Const.Class: Exp.Date:05/23/2024 Use Group: Owner: SALZ CLARK JANET I& NORBERT J Lot Size (sq.ft.) Zoning: WSP Applicant: LAMORE LUMBER CO Applicant Address Phone: Insurance: 724 GREENFIELD RD 413-773-8388 6HUB0248N15A15 DEERFIELD, MA 01342 ISSUED ON:07/01/2022 TO PERFORM THE FOLLOWING WORK: 480 SQ FT EQUIPMENT SHED 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: Final: Final: Final: Rough Frame: Gas: Fire Department Driveway Final: Fireplace/Chimney: Rough: Oil: Insulation: Smoke: Final: THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOL TION OF ANY OF ITS RULES AND REGULATIONS. Signature: I II , 4 t►h A I i A. 4 . I J L.P L Fees Paid: $96.00 • • 212 Main Street,Phone(413)587-1240,Fax:(413)587-1272 Office of the Buildinc Commissioner SECTION 5: CONSTRUCTION SERVICES 5.1 Construction Supervisor License(CSL) 66- d-76 I 7.3 t ' `10�- 4 l Lid M t t 'R,- License Number Ex on ate Name of CSL Holder `W., p List CSL Type(see below) 14- �IW V1Q- Pt No.and Street Type Description U Unrestricted(Buildings up to 35,000 cu.ft.) 1,� 1 A ((3 ©I R Restricted 1&2 Family Dwelling City/Town,State,ZIP l,n' M Masonry RC Roofing Covering WS Window and Siding SF Solid Fuel Burning Appliances I Insulation Telephone Email address D Demolition 5.2 Registered Home Improvement Contractor(MC) 200 52 21/09/DDA9 lL � `h' HIC Registration Number F. ratiDate HIC Company Name or HIC Registrant Name 1^A � �� P- I4w+or4._. mall b�c,vt.(.and S � L t r F-te7� D D•) ^�� T7�1'65 � l �g ma I address City/Town,Sttatte,,YZIPI" ep.F Ii��'i r �J Telephone SECTION 6: WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L,c. 152.§ 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 0 SECTION 7a:OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I,as Owner of the subject property,hereby authorize L•A M D P.e L1.t b ER to act on my behalf,in all matters relative to work authorized by this building permit application. NORWEAWF sAr z 5A+1tPT ZF 7-0 2-Az-1 Print Owner's Name(Electronic Signature () (la ate SECTION 7b NER' OR AUTHORIZED AGENT DECLARAT ON By entering my name below, I hereby attest under the pains and penalties of perjury that all of the information contained in this application is true and accurate to the best of my knowledge and understanding. OR N 3GR i Sk17 Print Owner's or Authorized Agent's Name(Electronic Signature) Date NOTES: 1. An Owner who obtains a building permit to do his/her own work,or an owner who hires an unregistered contractor (not registered in the Home Improvement Contractor(HIC)Program),will not have access to the arbitration program or guaranty fund under M.G.L.c. 142A.Other important information on the HIC Program can be found at www.mass.gov/oca Information on the Construction Supervisor License can be found at www.mass.gov/dps 2. When substantial work is planned,provide the information below: Total floor area(sq.ft.) (including garage,finished basement/attics,decks or porch) Gross living area(sq. ft.) Habitable room count Number of fireplaces Number of bedrooms Number of bathrooms Number of half/baths Type of heating system Number of decks/porches Type of cooling system Enclosed Open 3. `Total Project Square Footage"may be substituted for"Total Project Cost" CITY OF NORTHAMPTON SETBACK PLAN p MAP: I LOT: (7 03 -0 LOT SIZE: 5.3 e bLf-7 REAR LOT DIMENSION: REAR YARD a5 -- pe �-- !roped/ --moo-Sik.'r,c r'� Oa/ Tarsv ucr-r j L PGrtfiged A SIDE YIIRD SIDE YARD St PE-- 1 FRONT SETBACK 05 FRONTAGE City of Northampton -;; r,A MY7c,1.. :tip, = S, -.e" Massachusetts ( � •'g DEPARTMENT OF BUILDING INSPECTIONS ;m y 212 Main Street • Municipal Building ��.r•.... - \. ••e . ,f+ r-.* 4 Northampton, MA 01060 4 -�\�' HOMEOWNERS'EXEMPTION ELIGIBILITY AFFIDAVIT ?)' OkT 3 5-ALZ t SCOT 17 C 04.Pe. (insert full legal name), born a (insert month, clay, year), hereby depose and state the following: 1. I am seeking a building permit pursuant to the homeowners' exemption to the permit requi ements of the Massachusetts State Building Code, codified at 780 CMR 110.R5.1.3.1, in connection with a proj• t or work on a parcel of land to which I hold legal title. 2. I am not engaged in, and the project or work for which I am seeking the aforementioned homeown•rs'exemption, does not involve the field erection of manufactured buildings constructed in accordance with 780 ' 110.R3. 3. I qualify under the State Building Code's definition of"homeowner"as defined at 780 CMR 110. '..1.2: Person(s)who owns a parcel of land on which he/she resides or intends to reside,on w ch there is,or is intended to be, a one-or two-family dwelling, attached or detached structures accesso to such use and/or farm structures.A person who constructs more than one home in a two-year peri•d shall not be considered a home owner. 4. I do not hold a valid Massachusetts construction supervision license and, except to the extent t 't I qualify for and will abide by the Massachusetts State Building Code's requirements for the supervision of the roject or work on my parcel, I am not engaged in construction supervision in connection with any project or ork involving construction, reconstruction, alteration, repair, removal or demolition involving any activity re,: lated by any provision of the Massachusetts State Building Code. 5. If I engage any other person or persons for hire in connection with the aforementioned project 'r work on my parcel,I acknowledge that I am required to and will act as the supervisor for said project or work. Signed under4)e a' s and alties of perjury on this day of 3-UN l% ,20 �" Signatu re) y City of Northampton Massachusetts 4a a.- .,- I.0 i�`,.i ;�•i 11 DEPARTMENT OF BUILDING INSPECTIONS 934.4) +- 212 Main Street • Municipal Building c Northampton, MA 01060 sffrIY ‘-� CONSTRUCTION DEBRIS AFFIDAVIT (FOR ALL DEMOLITION AND RENOVATION PROJECTS) In accordance of the provisions of MGL c 40, S54, a condition of Building Permit Number is that all debris resulting from this work shall be disposed of in a properly licensed waste disposal facility, as defined by MGL c 111, S 150A. H Cc\-Ck\rot\ \kkv\IL\- -/ VA 6e-- 0i)t- \O\F-1 V\cff 1 .-. 13 5 k.‘4€^ The debris will be disposed of in: P&e„ci j ! Location of Facility: `2� w Deev -e1,& , VlAft C) k 34 -2_ The debris will be transported by: Name of Hauler: Lwu vim. L uv \o P V' Signature of t Ap lican :� ate: ; : `� p ZZ The Commonwealth of Massachusetts 50L, _-_--iii Department of Industrial Accidents 1 1 Congress Street,Suite 100 fir, Boston,1L4 02114 201- •-:-- '% ,tww.nrass.gowdia ._ ss.riders'Compensation Insurance Affxdasit:Builders C ontractors.Electricians Flttanbers, TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Legibt+- Name(Buss ev-orpaa n4ondrakaat�f: N ov`he i— �itn acid ry Address: 4 ry �e-v v, y t3� U 7 3 C_Ir., State Zip: e., ‘t--2rW Oi b 5 3 Phone-: ct 7 --6--0S— l 15"I Are volt is empleyer Check the appropnate box: Type.3f project t requited► .01aeraiesp.;ora area etttFurross(fsl:and e:parrsomai' 7 ILEI New construction :❑I as a teie psopnisecr er permit Set!sad hire ao maplowss s riiaag far me sa 8 DR.einakiflInf sir.capacrv.f'Ncwaaian'comp.=swaace aegrarst] 9- 0 Demolition 0 1 on a how doing all sack oneself Pk waskms'coop.sass ssq atll' j ' sor a hemsow= aad will to kma eosin:o wn to coccill soot on lay property t sill 10 El Btulciuig addition ensure that all cosetacton whoa have erosion'on':atopeasatios iwkdars as are soil 11.0 Electrical repai%or addition; proposers with ao.spiaw.., 12.0 Plumbing repairs or additions ❑I eta a!seem;.contraries sad:have h:sad the set-caaAtots Lited«the attached taw13.�]Roof xegaars These sob-ccaera rcrs have employees andhr.a wsae;comp tare ancs c 0 We are a ccapoaanm sad its ot5ars tars exercised;bee eple cf mie ep'sen per 3lc l c 1'� 0 Other .':.11(4).wad to ka;a so amplo ee s (No we:ien'crisp aso aace sagmred 'Any appoint that chocks hot eel n »least also fit:cut the con b ooas w showily their workers'ceavpeasatsea policy mfarmsaan. •Hara.oweart who Sutras oboe affidavit:odic stag they a.'9 dctai a:I weak lad then hue outside coaeacten must i7iibe=a new affidavit iadics'sa!such Ceatextort that cheat this box must areebed as odd:team:sheet thes•iaf swam of the sutreentracte s and sate whsthir et sat snow eateas ire meplcRses Lf;he snb-ccatra_tors ha,.a emplcs..s ;awry mast pn;sde-hew -rc-:hecs cep relic;=Y a et 1111111111110 I am an employer that is providing workers'compensation Insurance for my employees. Belau is the policy and job site infornrano, 'sn.urtrae Cou aaay Name Policy 0 or Self-ms.Lic.0: Ergoration Date: Job Site Address __. __._._._._. C 'State Zap: Attach a copy of the workers'compensation policy declaration page Ishowing the pose-number and expiration date). Failure to:ecwe coverage as requued under MGL c. 152,§25A u a criminal violation punishable by a fine up to S1,500.00 atmd'ot one-year ins :.o t.a: a:civil penalty m the form of a STOP WORK ORDER and a fine of up to S250.00 a day agaan:t the violator. A 1 - state enz may be forwarded to the Office af1n tipncn:of the DIA far insurance cover age reran:ante. I do here rr un ' s hies of Fury at the information provided above is true and conect Si mature a�! 1h �1i2. Daie: c�1� e 2-0 L2 Phone= -4 7.( S` e' ►i Official it se oath. Do not serite in this area,to be completed by city or to.tst official C it1-or Town: Permit License= I--twig Authority (circle one): 1 Board of Health 2. Building Department 3. C it Town Clerk 4.Electrical Inspector 5,Plumbing Inspector 6 Other Contact Person: Phone a: 6/22/22,12:41 PM NSalz WC Paperwork.jpeg The Commonwealth of Massachusetts .-i Department of Industrial Accidents pi v111iN. Office of Investigations s dim ,, I Congress Street,Suite 100 �"1)ts, Boston,MA 02114-2017 www.ntass gov/dia Workers' Compensation Insurance Affidavit:General Businesses Applicant Information p ,,,,, Please Print Legibly Business/Organization Name: (I,Jr)C ,Lt)tUiOill iR, b&1 t a ► ore Cr ri Address: u_.L�A+�,�' > �/ Q City/State/Zip:'t bra; ' �4'- 01342 Phone#: r1 J3-q 13,c3 a g Are 'cm an employer?Check the appropriate box: Business Type(required): I.J I am a employer with 4 employees(full and/ 5. Q Retail or part-time).* 6. 0 Restaurant/Bar/Eating Establishment 2,❑ I am a sole proprietor or partnership and have no 7. 0 Office and/or Sales(incl.real estate,auto,etc.) employees working for me in any capacity. [No workers'comp.insurance required] 8. 0 Non-profit 3.❑ We are a corporation and its officers have exercised 9. 0 Entertainment their right of exemption per c. 152,*1(4),and we have 10.0 Manufacturing no employees.[No workers'comp.insurance required!** t 1.0 Health Care 4.Q We are a non-profit organization,staffed by volunteers. with no employees.[No workers'comp.insurance req.] 12. Other __,____-___ 'Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. "lithe corporate officers have exempted themselves,but the corporation has other employees,a waders'compensation policy is required and such an organization should cheek box dl. I am an employer that is providi rg workers'compensation insurance for no,employees. Below is the policy information. insurance Company Name: �� Q.,Pr� t51�tQ�a.. Insurer's Address: f•0• bo)( 4211 ,` n _--, City/State/Zip: iot?.s/ +�i�e/�K r t ,LQ f/_ onek"c12.D3 - _ Policy#or Self-ins.Lie.# t1/UU6• lJ2LIB IS A z2. _Expiration Date:O 'I to W2 3. Attach a copy of the workers'compensation policy declaration page(showing the policy number Ind ex([ration 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 S 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 S250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. t /do hereby semi/p.mulct the pains and pen res of perjury that the information provided above is true and correct. LULL i 2,022.Signature .-ems•-�ijL,, ._.�__ Date: 44e. :%'Phone It: 14/3' r 3• , 1 1 __ i Official use only. Do not write in this area,to be completed by city or ton official. City or Town: Permit/Licence a_____ ___ Issuing Authority(circle one): I.Board of Health 2.Building Department 3.City/Town Clerk 4.Licensing Board 5.Selectmen's Office 6.Other iContact Person: Phone#: II wuw.tttass.gov/dia 9 hops://mail.google.com/mail/u/0/#inbox/FMfcgzGpGdftcgGRdgrjDjZgTTJKHvSJ?projector-1&messagePartld-0.4 1/1 g70/22,12/0/41,06' 10-/ 14e/4- Office of Consumer Affairs and Business Regulation 1000 Washington Street - Suite 710 Boston, Massachusetts 02118 Home Improvement Contractor Registration Type: Individual Registration: 120052 WILLIAM R. LAMORE Expiration: 10/09/2023 724 GREENFIELD RD DEERFIELD, MA 01342 Update Address and Return Card. SCA 1 0 20M-05/17 .T6 'ceveonsumef X rd&Bt`oot ii/rt6 giion HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only TYPE:Individual before the expiration date. If found return to: Registration Expiration Office of Consumer Affairs and Business Regulation 120052 10/09/2023 1000 Washington Street -Suite 710 WILLIAM R.LAMORE Boston,MA 02118 WILLIAM R.LAMORE 724 GREENFIELD RD ',G/rFf• --' DEERFIELD,MA 01342 Not valid without signature Undersecretary s Commonwealth of Massachusetts Division of Occupational Licensure Board of Building R ulations and Standards Const r Odm Aitlfirisor CS-076123. ,`* Eiii ppires:05/23/2024 WILLIAM RLa1 • 2$WASHBUI�iJ A GREENFIE 's Commissioner 12. '. Conatruchon Supervisor Unrestricted-Buildings of any use group which contain less than 35,000 cubic feet($91 cubic meters)of enclosed space• Failure to possess a current edition of the Massachusetts State Building Code is cause for revocation of this license. • For information about this license Call(617)7273200 or visit www,mass gov/dpi LAMORE LUMBER 724 Greenfield Road, Deerfield, MA 01342-9752 Phone: 413-773-8388 Fax: 413-773-3188 E-Mail: lamore@post-beam.com June 7, 2022 Nort Salz 978-273-5983 420 Kennedy Road _ Leeds MA 01053 ESTIMATE FOR 20 X 24 B&B 20 x 24 B&B with 6/12 Pitch Roof Sliding Door 5' Double Door 3 Windows (4 Pane) Ridge Vent 6 x 6 Pressure Treated Hardware for Sliding Door 6 Tie Downs Sub Total Tax Total PLUS DELIVERY @ $140.00 PER TRIP Payment Schedule: Required Deposit with signed Contract $1,000.00 50% When Job is Started $10,566.03 35% When Rafters are in Place $7,396.22 Balance when job is Completed $2,169.81 X X Customer Date Wiliam R. tamele June 7, 2022 Lamore Lumber Date ANY CHANGES TO THIS CONTRACT AFTER IT IS SIGNED WILL BE ADDED TO THE BALANCE DUI $ 17,280.00 $ 500.00 $ 240.00 $ 375.00 $ 360.00 $ 460.00 $ 394.00 $ 280.00 $ 19,889.00 $ 1,243.06 $ 21,132.06 $21,132.06 E. 6/22/22,12:40 PM NSalz Drawing 1.jpeg.jpeg T-- z ir ma . � T T o -C�® w ti \\\ ' , Z. ={ L INN z E e ___ii o - `' T — I k T) k.\ 6-- r r cis I -1 c R. ,; Ti CP \/ 6.t-re t`-- LP • N rs rl .ice IS- is,x xX, . -F oQ coo https://mail.google.com/mail/u/0/#inbox/FMfcgzGpGdftcgGRdgriDjZgTTJKHvSJ?projector=18,messagePartld=0.1 1/1 6/22/22, 12:41 PM NSalz Drawing.jpeg.jpeg m m Q J Z Z ttl til b �� O a) VI�3 tt a X. 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