2009-415 TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
is Community Development- Building &Codes (518) 761-8256
kt*--'.]jE' KT IFICATE CIF OCCURAUNI Y
Permit Number: P20090415 Date Issued: Wednesday, November 03, 2010
This is to certify that work requested to be done as shown by Permit Number P20090415
has been completed.
Location. 79 HAVILAND Ave EXT
Tax Map Number. 523400-309-019-0001-003-000-0000
Owner.. ROBERT A HIGGINS
Applicant: ROBERT A HIGGINS
This structure maybe occupied as a:
Residential Addition By Under of Town Board
TOWN OF QUEENSBURY
Issuance of this Certificate of Occupancy DOES NOT relieve the i �►
property owner of the responsibility for compliance with Site Plan,
Variance,or other issues and conditions as a result of approvals by the Director of Building&Code Enforcement
Planning Board or Zoning Board of Appeals.
TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development-Building&Codes (518) 761-8256
BUILDING PERMIT
Permit Number: P20090415 Application Number: A20090415
Tax Map No: 523400-309-019-0001-003-000-0000
Permission is hereby granted to: ROBERT A HIGGINS
For property located at: 79 HAVILAND Ave EXT
in the Town of Queensbury,to construct or place
at the above location in accordance with application together with plot plans and other information hereto filed
and approved and in compliance with the NYS Uniform Building Codes and the Queensbury Zoning
Ordinance. Type of Construction Value
Owner Address: ROBERT A HIGGINS
79 HAVILAND AVE. Ext Residential Addition $9,500.00
QUEENSBURY, NY 12804 Total value $9,500.00
Contractor or Builder's Name /Address Electrical Inspection Agency
MIKE DANIELS
26 WEST STATE St
NY
Plans&Specifications
2009-415
208 SQ FT RESIDENTIAL ADDITION
$75.00 PERMIT FEE PAID -THIS PERMIT EXPIRES: Friday, September 17, 2010
(If a longer period is required,an application for an extension must be made to the code Enforcement Officer
of the Town of Queensbury before the expiration date.)
Dated at the Town of Queensbury; j T�lurs ay,;` a mber 17, 2009
SIGNED BY for the Town of Queensbury.
Director of Building&Code Enforcement
TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5902 (518)761-8201
Community Development- Building&Codes (518) 761-8256
BUILDIN PERMIT
Permit Number: P20090415 plication Number. A24090415
Tax Map No: 523400-309-019-0001-003-000-0 00
Permission is hereby granted to: ROBERT A HIGGINS
For property located at: 79 HAVILAND e EXT
in the Town of Queensbury,to construct or place
at the above location in accordance with application togeth th plot pla an ther information hereto filed
and approved and in compliance with the NYS Uniform g Codes d e Queensbury Zoning
Ordinance. T e o Construction Value
Owner Address: ROBERT A HIGGINS es' ential Addition $9,500.00
79-MVILAND AVE. xt T al value $9,500.00
QUE NSBURY,NY 8
Contractor or Builders ame Ad e Electrical Inspection Agency
MIKE DANIELS
26 WEST STATE St ;
NY
Plans&Specifications
2009-415
208 SQ FT RESIDENTIAL ADDITION
$75.00 PERMIT FEE PAID- THIS PERMIT EXPIRES: Saturday, September 17, 2011
(If a longer period is required,an application for an extension must be made to the code Enforcement Officer
of the Town of Queensbury before the expiration date.)
Dated at the own o ee uO ay, September 17, 2009
SIGNED BY for the Town of Queensbury.
Director of Building&Code Enforcement
........ .. .... ................................. ..............
OFFICE USE ONLY R
��1•!� 1 � ; _ ilk" � ;-_�� _.. . --A ;�
TAX MAP NO. PERMIT NO.
_
FEES: PERMIT RECREATION ENGINEERING ;
(If applicable) ;
............................................................__--_---
PRINCIPAL STRUCTURE: x µ
APPLICATION FOR ZONING APPROVAL & BUILDING PERMIT
A PERMIT MUST BE OBTAINED BEFORE BEGINNING CONSTRUCTION. APPLICATION IS SUBJECT TO
REVIEW BEFORE ISSUANCE OF A VALID PERMIT FOR CONSTRUCTION.APPLICANT/BUILDER: OWNER: 061
ADDRESS: ADDRESS:
PHONE NOS, PHONE NOS. ��7 d 1 7
CONTACT PERSON FOR BUILDING & CODES COMPLIANCE: n,,/cPHONE: �/—/���
LOCATION OF PROPERTY:
HAS THERE BEEN A SITE PLAN REVIEW; VARIANCE OR SUBDIVISION APPROVAL? ❑ YES 0/NO
IF SO, INDICATE APPLICATION NO. AND DATE OF APPROVAL:
PLEASE INDICATE MEASUREMENTS AS REQUIRED BELOW:
CHECK ALL THAT p
APPLY TO YOUR Z p w O d WW LL
PROJECT O Q O 0 O
LL U- ti w Q a = v
'S _ LL 0 2 I- 0 — Z
Z � Q Q c- U) N U) 0 LL OF LL 0- 06
SINGLE FAMILY SF � h 1 Gl r r
i
TWO-FAMILY
MULTI-FAMILY
j (NO. of UNITS )
TOWNHOUSE
BUSINESS�SINESS OFFICE I`
RETAIL-
MERCANTILE
r FACTORY OR
INDUSTRIAL
ATTACHED Ii
I GARAGE(1,2,3)
! OTHER
IF COMMERCIAL OR INDUSTRIAL- NAME OF BUSINESS:
�c_ n
ESTIMATED CONSTRUCTION COST: ��� c c FUEL TYPE:
HEAT TYPE:_ v %a� *HOW MANY FIREPLACE(S): AND / OR WnnnSTn\/F�/S1
B 3-LGL 11-05
ARE THERE STRUCTURES NOT SHOWN ON PLOT PLAN?
ARE THERE EASEMENTS ON PROPERTY?
I acknowledge no construction activities shall be commenced prior to issuance of a valid
permit. I certify that the application, plans, and supporting materials are a true and
complete statement/description of the work proposed, that all work will be performed in
accordance with the NY State Building Codes, local building laws and ordinances, and in
conformance with local zoning regulations. I acknowledge that prior to occupying the
facilities proposed, I or my agents will obtain a certificate of occupancy. I also understand
that I/we are required to provide an as-built survey by a licensed land surveyor of all newly
constructed facilities prior to issuance of a certificate of occupancy.
I have read and agree tohe abgtie - y F^ �.:
Signed
s
✓ V
Director of Building & Codes: 761-8256 (for questions regarding Building Permits, construction
codes or septic systems)
Zoning Administrator: 761-8218 (for questions regarding required permits, the permit process,
application requirements or to schedule an appointment)
o
o
lo Permission is hereby granted to the above This application / proposed action described
Applicant to erect or alter the building ; herein is found to be in accordance with the
described herein in accordance with said zoning Laws of the Town of Queensbury.
Application:
o BUILDING & CODES APPROVAL ZONING APPROVAL
00
o
DATE 0 '
DATE
,
(--QUESTIONS? CALL 761-8256 OR EMAIL
codes(a)queensburv.net
Office Use Only VISIT OUR WEBSITE FOR MORE INFORMATION
ommuni�y Development Office
007tl or Queensbury • 742 Bay Road Qucensbury, Now York -12904
WINDOW SCHEDULE
JOB SITE/ADDRESS:
OWNER: APPLICATION NO.:
WINDOW- UNIT OR CLEAR CLEAR
NO.OR WINDOW WINDOW STOCK ROUGH ROUGH SQYT� SQ FT. OPENING OPENING SPECIAL HARDWARE OR
LETTER MANUFACTURER MODEL/TYPE NUMBER OPENING OPENING VENT EGRESkLEAR WIDTH IN HEIGHT INSTRUCTIONS
NAME CALL WIDTH HEIGHT OPENING IN
ON PLAN SIZE AINCHES INCHES
w ki
30 161 I
B 26-LTR 11-05
OFFICE USE ONLY ;
PROJECT NAME: %
STAFF INITIALS: ;
DATE:
BUILDING PERMIT SUBMISSION ;
CHECKLIST FOR:
SINGLE FAMILY DWELLING
1. Building Permit Application Completed? YES NO N /A
__................_........_.._..____............._........_...._......._............_.._..._...__............
_ _.._. _._..._...._-- -
2 Energy Form or CheckMate Energy Code Compliance
FormsComplete? (2-copies)........................... .._._...__..._._..;_.......................--.-_.._.._.._....._..._.. ......... ..._. _........... . .........
3 Energy Code Inspector's Report from Checkmate
Program? (2-copies
4 Septic application completely filled out?
If applicable)
---- - - ._.._......._.._...._._..-._._...._..._....._..__.... _ ......_................. -------
5. Electrical Inspection Form complete?
6. Two (2) sets of the plans each of the following: YES NO N /A
a. Floor plans (s)?
b. Foundation plan?
c. Cross sections (s)?
d. Elevations?
___._._.__...._ ----------._._..._.----._._._......_-___._...._..._..............._..._........._.___.___..____..._..............__..._.........._.__........ .... _._........ _.._ _.___....__._____...._........ .. .... .. _
e. Window and door schedule?
_.._....__.._.--=-.--------------------..__......_.._.__....... _ ._..._._.._._....._._..__...._..__._......_.___._....._................__.._............... _.._.
f. Natural Light, Ventilation and Emergency Egress
Requirements? ..----_...---.._....----------
_._..._......_.__.__..._......_._..._...._. ........_.__......_.._.___.__....._..___
_.
g. Plans signed and sealed by registered architect or
I.._.-.____.....__1.,engineer?
................_...................___._...___._......_____.................................------_____..................................
1. ..._...._...._ .......______ _...______I
Two (2) site plans showing location of the structure to be
7. built, location of well or water lines, location of septic
Systemor sewer line? _._._._......._._..._._........_._..__..._.-_-.._ _......._._............... ..........._._..._.._....... _..........
8. Setbacks from property lines to new structure?
r_.. _...._...._.. - .....................................-- ---.._......._...__.............._.........._............__.._._........_.................._. --._._...._._........._.._...
8 Setbacks to neighboring wells and septic systems,
including onsite well and septic systems (if applicable)? __._.-...
9. 1 Driveway Permit?
:.x Town of Queensbury • Community Development Office • 742 Bay Road, QueensbTm-y, NY 12804
B 12-LTR 11-05
if
APPLICATION FOR FUEL BURNING APPLIANCE & CHIMNEYS
Application is hereby made to the Building &Codes Office for the issuance of a Building & Use Permit
pursuant to the New York State Fire Prevention &Building Code. The applicant or owner agrees to comply
with all applicable laws, ordinances,regulations, and all conditions that are part of these requirements and
also will allow all inspectors to enter premises to perform required inspections.
IMPORTANT NOTE TO APPLICANT: ROUGH-IN AND FINAL INSPECTIONS ARE REQUIRED.
OWNER: i�or— yJ
t.c:'n ; y INSTALLER/BUILDER: "C
ADDRESS:_�—C7 (7CtZZ lQ YlC ADDRESS: `G✓� �� �e ��
PHONE NOS. / C! _)(t Tom// PHONE NOS.
LOCATION OF PROPERTY: �fGc ft�, !IV(- SUBDIVISION NAME:
LOCATION OF PROPOSED CONSTRUCTION AND/OR INSTALLATION:
CONTACT PERSON FOR BUILDING&CODES COMPLIANCE: `F� t/ n<< PHONE: -3
✓ FUEL BURNING APPLIANCE WOOD COAL PELLET GAS OIL
INFORMATION
STOVE
FIREPLACE INSERT
FIREPLACE,FACTORY BUILT*
FIREPLACE,MASONRY
FURNACE(GARAGE ONLY)
*IF FACTORY BUILT,PLEASE PROVIDE: MANUFACTURER NAME: MODEL NO.
LISTED BY: NUMBER:
QUESTIONS?
CALL 7614205 or 761-8206
CHIMNEY INFORMATION BLOCK BRICK STONE OR EMAIL:
MASONRY" CHECK ONE ✓ VISIT OUR WEBSITE
TILE STEEL SIZE IN FOR MORE INFORMATION
INCHES -0V--'i=`
FLUE CNECKONE ✓
DOUBLE TRIPLE WALL INSULATED DIRECT VENT CHIMNEY
WALL LINER
CHIMNEY MATERIAL CNECKONE ✓
**IF NON-MASONRY.PLEASE PROVIDE: MANUFACTURER NAME: MODEL NO.
ADDITIONAL NOTE: CONSTRUCTION/INSTALLATION MUST CONFORM TO NYS FIRE PREVENTION&BUILDING CODE AND/OR
MANUFACTURERS REQUIREMENTS. CONSULT AVAILABLE TOWN OF QUEENSBURY HANDOUTS REGARDING REQUIRED
INSPECTIONS.
ommunity Development Of�fice
milli Of Queonsburif - 742 Bay Road - Queoushitry, Ne-w York -12804
BUILDING PERMIT CALCULATION SHEET:
NATURAL LIGHT, VENTILATION AND EMERGENCY EGRESS REQUIREMENTS
R El 01.11'"El 9 ACTUAL LIGHT REQUIRED AG.-14" SQUAREFOOT
HABITABLE ROOM AREA OF ROOM IN LIGHT SQUARE VENTILATION4% VENTILATION OPENING FOR REMARKS
SQUARE FEET 8%OF ROOM FOOTAGE OF ROOM AREA SQUARE EGRESS
AREA FOOTAGE
QUESTIONS 7 CALL 761-8266 OR EMAIL
c2des.@Suejajtgnt49
VISIT OUR WEBSITE FOR MORE INFORMATION
www.guensbury.net 8 10-LTR 11-20
�s —M
Foundation Inspection Report
Office No.(518)761-8256 Date Inspection request received:
Queensbury Building&Code Enforcement Arrive: am/pm Depart am/pm
742 Bay Rd.,Queensbury,NY 12804 Inspector's Initials:
C77
NAME: 17 '� S PERMIT#: D
LOCATION: iz 4V /P1'Vb INSPECT ON: D
TYPE OF STRUCTURE:
Co m n
Y N NA
ootings
Piers
Monolithic Slab
Reinforcement in Place
The contractor is responsible for
providing protection from freezing
for 48 hours following the placement
of the concrete.
Materials for this se on site.
Foundation/Wallpour
Reinforcement in Place
Footing Dowels or Keyway in place
Foundation Dampproofing
Foundation Waterproofing
Footing Drain Daylight or Sump
Footing Drain Stone:
12 inch width
6 inches above footing
6 mil poly for wet areas under slab
Backfill Approval
Plumbing Under Slab
PVC/Cast/Copper
Foundation Insulation Interior/Exterior
R-
Rough Grade 6 inch drop within 10 ft.
L:\Building&Cafes Fo ms\8uiiding&Codes\Inspectlon Forms\Foundation Inspectioon Report.doc
Last printed 12/20/2005 9,24:00 AM
r—� `vim
Foundation Inspection Report
Office No.(518)761-8256 Date Inspection request received:
Queensbury Building&Code Enforcement Arrive: am/pm Depart: am/Pm
742 Bay Rd.,Queensbury,NY 12804 Inspector's Initials: �, l
NAME: d PERMIT#:
LOCATION: INSPECT ON:
TYPE OF STRUC .
4
Commeab
Y N NA
Footings
Piers
Monolithic Slab
Reinforcement in Place
The contractor is responsible for
providing protection from freezing
for 48 hours following the placement
of the concrete.
Materials for this purp9se on site.
Foundation/Wallpour
Reinforcement in Place
Footing Dowels or Keyway in place
Foundation Dampproofing
Foundation Waterproofing
Footing Drain Daylight or Sump
Footing Drain Stone:
12 inch width
es above footing
'1 ly for wet areas under slab
Backf 11 pproval
um ing Under Slab
PVC/Cast?Copper
Foundation Insulation Interior/Exterior
R-
Rough Grade 6 inch drop within 10 ft.
L:\Buliding&Codes Forms\Building&Codes\lnspection Forms\Foundation Inspectieon Report.doc
Last printed 12/20/2005 9:24:00 AM
Foundation Inspection Report
Office No.(518)761-8256 Date Ins ed.
Queensbury Building&Code Enforcement Arrive: Depart: m
742 Bay Rd.,Queensbury,NY 12904 Inspector's Imti
NAME: (� �tS P T#:
LOCATION: IN PECT ON:
TYPE OF STRUCTURE:
Co mnq�,enb_
Y N NA
Footings ,� w
Monolithic Slab
Reinforcement in Place
The contractor is responsible for
providing protection fmm freezing
for 48 hours following the placement
Of the concrete.
Materials for this purpose on site.
Foundation/Wallpour
Reinforcement in Place
Footing Dowels or Keyway in place
Foundation Dampproofing
Foundation Waterproofing
Footing Drain Daylight or Sump
Footing Drain Stone:
12 inch width
6 inches above footing
6 mil poly for wet areas under slab
Backfill Approval
Plumbing Under Slab
PVC/Cast/Copper
Foundation Insulation Interior/Exterior
R-
Rough Grade 6 inch drop within 10 ft.
L:\Building&Codes Forms\Building&Codes\Inspec Lion Forms\Foundation Inspectioon Report.doc
Last printed 12/20/2005 9:24:00 AM
CL?Foundation Inspection Report
Office No.(518)761-8256 Date Inspection request received:
Queensbury Building&Code Enforcement Arrive: am/p Depart: am/pm
742 Bay Rd.,Queensbury,NY 12804 Inspector's Initials:
V
NAME: r FLS PERMIT#: -- 7—
LOCATION: INSPECT ON:
TYPE OF STRUCTURE:
CouFme�
Y N A
Footings
Piers
Monolithic Slab
Reinforcement in Place
The contractor is responsible for
providing protection from freezing
for 48 hours following the placement
of the concrete.
Materia154brddrpWVose on site.
Foundati /Wallpour VIA 0'
Reinforcemen
Footing Dowels or Keyway in place
Foundation Dampproofmg;
Foundation Waterproofing
Footing Drain Daylight or Sump
Footing Drain Stone:
12 inch width
6 inches above footing
6 mil poly for wet areas under slab
Backfill Approval
Plumbing Under Slab
PVC/Cast/Copper
Foundation Insulation Interior/Exterior
R-
Rough Grade 6 inch drop within 10 ft.
L:\Building&Codes Forms\Building&Codes\InspecClon Forms\Foundation Inspection Repottdoc
Last printed 12/20/2005 9:24:00 AM
Framing / Fire t i Insp Ion` e rt
s QPP ng s Po
Office No. (518)761-8256 Date Inspection request received:
Queensbury Building &Code Enforcement Arrive:am/pm Depart4Mt am/pm
742 Bay Road, Queensbury, NY 12804 Inspector's Initials: /4 d k
NAME: PERMIT#: n —
Z�n—
LOCATION: INSPECT ON:
TYPE OF STRUCTURE: �`'i` �
Y N NIA COMMENTS_
Framing
moss 27 x W minimum
Jack Studs/Headers
Bracing/Bridging
Joist hangers
Jack Posts/Main Beams
Exterior sheeting nailed properly
12"O.C.
Headroom 6 ft. 8 in. G-
Stairwells 36 in. or more
Exterior Deck Bracing
Headroom 6 ft. 8 in.
Notches/Holes/Bearing Walls
Metal Strapping for Notches Top Plate
1 % w 16 gauge 8 16D naNs each side
Draft stopping 1,000 sq. ft. floor trusses
6 ft. or less on center or
Ice and water hield 24 inches from wall
paration 1, 2, 3 hour
Fire wall 2, 3, 4 hour
Firestopping
Penetration sealed
16 inch insulation in cav' min.
Garage Fire Separation
House side's inch or 5/8 inch Type X
Garage side 5/8 inch Type X
Celling1wall
Windows Habitable Space/Bedrooms
24 in. (H)
20 in. (W)
5.7 sf above/below grade
5.0 sf grade
L:\BuiidbV&Codes Forms-OLMUNding&GodssVnspWm Fom*\Ftam ng Fkestom g inspe0on ReporLdoc Revwed January 7,2008
Rough Plumbing / Insulation Inspect' n! Report
Office No. (518) 761-8256 Date Inspection request received:
Queensbury Building & Code Enforcement Arrive: am/pm Depart:,ANjj-r!�`am/pm
742 Bay Road, Queensbury, NY 12804 Inspector's Initials: `
NAME: I / PERMIT #:
LOCATION: - t/ INSPECT ON:
TYPE OF STRUeTURE:
Y N N/A
Rough Plumbing/Nail Plates
Plumbing Vent/Vents in Place
1 % inch minimum Drain Size
Washing Machine Drain 2 inch minimum
Cleanout every 100 feet/change of direction
Pressure Test
Drain /Vent
Air/Head
5 P.S.I. or 10 ft. above highest connection for 15 minutes
Pressure Test
Water Supply Piping
Air/Head
. for 15 minutes
Insulationy Residential Check/Commercial Check 00
Similar Exterior Sealant
Prop2r Vent, Attic Vent
Door/Window Sealed! No Insulation
Duct/Hot Water Piping Insulation
If required unheated spaces
Combustion Air Supply for Furnace
Duct work sealed properly/No duct tape
COMMENTS:
Z>
Rough Plumbing insulation Report,revised Nov 17 2003, revised February 15,2005, revised January 7,2008
Queensbury Building,& Code Enforcement - Residential Inspection '
Office No. (618)761-8256 Arrive: am/pm a am/pm
Date Inspection request received: Inspector's Initials:
NAME: (A� &- i PERMIT#: •4�
LOCATION: l DATE:
TYPE OF STRUCTUR
Comments:
,V Building Number Address visible from road
Chimney Hei ht/V Vent/Direct Vent Location
Fresh Air intake
3 inch Plumbing Vent through roof minimum 6 inches
Roof C /Exterior Finish Complete
Platform at aN exterior doors
Handrail 4 or more risers
Guards at stairs decks more than 30 inches above grade
Guard at stairwell at 34 inches or more
Guam at deck,porches 36 inches or more
Handrail Termination at Newell Post or Wall
Interior/Exterior Railings 34 inches to 38 inches
Deck Brad /Handica Ramp Compliant
Grade away from foundation 6 inches with 10 feet
6 inch clearance to sill plate
Gas Valve shut-of /regulator 18 inches above grade
Interior privacy/trim/doors/main entrance 36 inches
Bathroom/Kitchen watertight
Safety /Window in stairwells safetylazkh
Interior Smoke Detectors/Carbon Monoxide Detectors
Every 1": Ev ry Bedroom:
Outside every bed area:
Inter Connected: Battery backup:
Attic access 30 inches x 22 inches x 30 inches(height)in accessible area
Crawl Spaces 18 inch x 24 inch access 1 pg.ft:150 sq.ft.vents
Bathroom Fans if no window
Plumbing fixtures
Foundation insulation/Insulation Certification
Floor truss draft stopping finished basement 1,000 sq.ft.
Emergerm egress below arade
Gas Furnace shut-off within 30 feet or within line of site
Oil Furnace shut-off at entrance to fumaos area
Fumace/F{ot Water Heater operating
Low water shut-off boiler
Relief Valves installed/Heat Trap/Water Temp 110
Enclosed Stairs Sheetrock Underside minimum W Glourn
Basement stairs dosed rise>4 inches
Garage Floor Pitched
Gawe fi roofi /%hour fire door/door closer
Duct work Sealed LwopRft
Gas LW in Sealed or Glass Enclosure
Final Electrical
Final Survey Plot Plan
Arc Fault Breaker in Bedrooms
Flex Gas Pipe Sonding
As Built Septic System/Sewer Dept. ins on Sticker
Site Plan /Variance uired
Flood Plain Certification if required
Okay to issue C I C or C/® Temporary/Permanent
LASuikling&Codes Forms\Buiiding&Codes\inspection ForrnsWesidential Final Inspection Form_revised_100405.doc;Revised
January 7,2008;Revised 8/26/08
bob
(4iy� � 5
V Mmunittl Development Office l � 4 u l �-
Town of Queen.sbury • 742 Bay Rd.
Queensbury, New York •12804 PLOT PLAN
Show all existing and proposed structures. Indicate the setbacks of all structures and bindings from all property lines.
SIDE PROPERTY LINE
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1 SQUARE __2.�2' _FT. j ` SIDE PROPERTY LINE
i � � , � � )�,•14-LTR 11-05
�VttiC� tc. I LV a r+vv F% ( le-LS 1-1 1 lj J)CT �
LAND 100
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