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83.72 -1 -63
BOX 31
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ffi. SEP* 2 -98 WED 2:10 PM PUNAM CTY ENV HEALTH FAX N0, 19142787921 P. I
DEPARTMENT OF HEALTH
Division of Environmental Health Services
4 Geneva Road
Brewster, New York 10509
Tel. (9r4) 278-6130 Fax (914) 278.7921
Public health Director
PROPOSED ADDITION APPLICATION (R SIDENTIAL ONLY
STREET l I a TOWINI -A e�'� P/6 MAP #
NAME h h1 CAv Il eti PHONE (R/ �a -! PCHD # a � � to
MAILING ADDRESS D, o k G� c��i /�� %fI
DESCRIPTION OF ADDITION
,/- Ada d 'm
NUMBER OF EXISTING BEDROOMS I PROPOSED # OF BEDROOMS
(FROM CERT. OF OCCUPANCY OR
CERTIFICATION FROM BUILDING INSPECTOR)
*Any addition which is considered a bedroom requires formal approval of plans (Construction
Permit) prepared by a Professional Engineer or Registered Architect in accordance with
-
app licabiP sections f iiie`P.0 i m.Counfy� Sariiar w rode:
'lease submit this form and the following to Putnam County Health Dept., 4 Geneva Rd.,
Brewster, NY 10509, Phone 278 -6130.
1. Certified check or money order for $100.00
2. Sketches of existing floor plan (drawn to scale, all living area including basement)
* Non - professional sketches are acceptable
3. Two sets of proposed floor plan (drawn to scale, with name, street, and tax map #)
* Non - professional sketches are acceptable
4. Copy of survey showing well and septic location, to the best of your knowledge. Include date
of installation if known. Label all wells and septic systems within 200 feet of the property
line.
Contact this office with any questions.
5. Copy of Cert. of Occupancy from Town or Certification from Building Dept. with legal
bedroom count of dwelling.
Q= USE
Comments
v r/4 /rf
R
Joel Greenberg, R.A.
Muscoot North
Mahopac NY 10541
Dear Mr. Greenberg:
DEPARTMENT OF ]HEALTH ,
Division of Environmental Health Services
4 Geneva Road
Brewster, New York 10509
Tel. (914) 278-6130 Fax (914) 27ep ember 17, 1998 .
Re: Addition - Ralph McMullen, 12 Hillair Road
Increase in Number of Bedrooms
(T) Putnam Valley, TM# 83.72 -1 -63
BRUCE- R..:FOLEY.
Public Health Director
I have received and reviewed the plans for the proposed addition to the above mentioned residence.
The proposal for the addition has been approved as per plans bearing the latest revision date of
September 17, 1998 and this Department's approval stamp.
Based on the information submitted, the above mentioned addition is approved with the following
conditions:
�r...._
�._
1. total number;-of bedrooms rem als :,at one.:: ithot- .prioi ap roy: l by this
Department.
2. The area of the existing sewage disposal system, and its expansion area, must be
maintained.
I All plumbing fixtures must be updated with water saving devices, i.e., new low
flush toilets, restructures for shower heads and faucets, etc.
Any other permits or variances required are the responsibility of the applicant and the jurisdiction
of the Town of Putnam Valley.
If you have any questions, please contact me at your convenience.
Very truly y�
William Hedges
Sr. Public Health Sanitarian
WH:tn
cc: BI (T)
SEN 2-98 WED 2:11 PM PUNAM CTY ENV HEALTH
FAX NO, 19142787921 P. 2
q,1 -I 1:--/
DEPARTMENT OF HEALTH
Division ,Of Environmental Health Services
4 Geneva' Road, Brewster, New York 10509
(914) 278-6130
Putnam County Dept. of Health
4 Geneva Road
Brewster, NY 10509
Gentlemen:
MC At u. p
Re: I I
Residence
Tax Map It
Town L&
— � e -
BRUCE R. FOLEY, R.S.
Acting Publio Health Director
,?-3,7,14-613
)qv�AO, Ke'. I
According to records maintained by the Town, the above noted dwelling
Is
IS NOT
in compliance with wn code and the total number of bedrooms on record
is otve-- tjl
This information has been obtained from:
CERTIFICATE OF OCCUPANCY. _
ASSESSORS RECORD'
OTHER
Building Inspector
4
SEP- 2 -98 WED 2:10 PM PUNAM CTY ENV HEALTH FAX N0, 19142787921. P. 1
C
BRUCE R. FOLEY
Public Arealth Director
DEPARTMENT OF HEALTH
Division of Environmental Health Services
4 Geneva Road
Brewster, New York 10509
Tel. (91'9) 278.6130 Fax (914) 278-7921
PROPOSED ADDITION APPLICATION aESMT_IA_ L ONLY)
J
STREET 1 ! a `� TOiVIi T A%& �ITX MAP N
NAME ek/ PHONIO &E��- /MPCHD # i 455 - fe
MAILING ADDRESS 20, Oor /ce ek
DESCRIPTION OF ADDITION_,*Jj 4n .d f,tew 0- ZJ,11^„S f a v( Aec( —odin v�of ; f
NUMBER OF EXISTING BEDROOMS ../ PROPOSED # OF BEDROOMS �
(FROM CERT. OF OCCUPANCY OR
CERTIFICATION FROM BUILDING INSPECTOR)
4Any addition which is considered a bedroom requires formal approval of plans (Construction
Permit) prepared by a Professional Engineer or-Repist €red Architect in accordance with ...
applicable sections of the Putnam County Sanitary Code.
lease submit this form and the following to Putnam County Health Dept., 4 Geneva Rd.,
Brewster, NY 10509, Phone 278 -6130.
1. Certified check or money order for $ 100.00
2. Sketches of existing floor plan (drawn to scale, all living area including basement)
* Non - professional sketches are acceptable
3. Two sets of proposed floor plan (drawn to scale, with name, street, and tax map #)
* Non - professional sketches are acceptable
4. Copy of survey showing well and septic location, to the best of your knowledge. Include date
of installation if known. Label all wells and septic systems within 200 feet of the property
line.
Contact this office with any questions.
5. Copy of Cert. of Occupancy from Town or Certification from Building Dept. with legal
bedroom count of dwelling.
Q= USE
Comments
DEPARTMENT OF HEALTH
Division of Environmental Health Services
4 Geneva Road, Brewster, New.York 10509
(914) 278 -6130
APPLICA`ft6N d tbNSTROCT'_ A"In1ATER 'WELL'
PCHD
PERMIT U&I-5-4-g6
WELL LOCATION
S
eet Add
Ci
x Grid Number r
WELL OWNER
Name
Maili Address
jOrivate
O Public
USE OF WELL
1 - primary
2- secondary
IDENTIAL ❑ PUBLIC SUPPLY
D BUSINESS O FARM
D INDUSTRIAL O INSTITUTIONAL
❑ AIR /COND /HEAT PUMP O ABANDONED
O TEST /OBSERVATION 0 OTHER (specify
O STAND -BY O
AMOUNT OF USE
YIELD SOUGHT ,S� gpm /# PEOPLE
SERVED- /EST. OF DAILY USAGE SAD Sal
REASON FOR
DRILLING
❑ REPLACE EXISTING SUPPLY O TEST /OBSERVATION
❑ NEW SUPPLY NEW DWELLING 0 DEEPEN EXISTING WELL
16 ADDITIONAL SUPPLY
DETAILED
REASON FOR
DRILLING
WELL TYPE
®DRILLED
ODRIVEN
EIDUG
D
GRAVEL
0
OTHER
IS WELL SITE SUBJECT TO FLOODING? YES NO
IF WELL IS LOCATED IN A REALTY SUBDIVISION, NAME OF SUBDIVISION:
Lot No.
IS PUBLIC WATER SUPPLY AVAILABLE TO SITE: YES -Ze-- -NO
NAME OF PUBLIC WATER SUPPLY: TOWN /VIL /CITY
DISTANCE...TO PROPERTY . FROM .N9AREST. -WATER: MAaN:
LOCATION SKETCH & SOURCES OF CONTAMINATION PROVIDED
ON SEPARATE SHEET
q &A4
(dat ) y ignature)
as
�t�D�i�/G
PERMIT TO CONSTRUCT A WATER WELL
This permit to construct one water well as set forth above is granted under the provisions
of Subpart 5 -2 of Part 5 of the New York State Sanitary Code, and provided that within
thirt3, (30) days of the completion of water well construction, the applicant shall:
1. Pump the well until the water is clear.
2. Disinfect the well in accordance with the requirements of the Putnam County Health
Department attached to this permit..
3. Submit a Well Completion Report on a form provided by the Putnam County Health Department.
During all well drilling operations, the applicant shall take appropriate action to assure that
any and all water or waste products from such well drillum operations be contained on this
property and in suc a manner as not to degrade or oth rw' a cont 'nate surface or groundwater.
Date of Issue: 19 i
Date of Expiration 2 4e 19.18 Permit Issuing Official
`,Permit is Non - Transferrable White copy: HD File Pink copy: Owner
1/89 Yellow copy: Bldg. Insp. Orange copy: Well Driller
I
DEPARTMENT OF HEALTH
Division Of Environmental Health Services
4 Geneva Road, Brewster, New York 10509
(914) 278 -6130
PROCEDURE FOR NEW WELL PERMIT APPLICATIONS
BRUCE R. FOLEY, R.S.
Acting Public Health Director
1. Well permit application is to be submitted along with fee, if required.
2. Locations of all sources of possible contamination within 200 feet Of" the
proposed well location are to be shown on a plan or tax map.
3. Contiguous neighbor notification is required.
4. Feasibility of well location is to be confirmed by a representative of this
Department.
5. If the proposed well is.within 15 feet of the property line the approved well
location is to be staked by a licensed surveyor. If the proposed well
location is within 100 feet of any source of contamination the well location
is to be staked by a Licensed Engineer, Registered Architect or Land Surveyor
prior to drilling.
6. As built and well log to be submitted no later than 30 days after completion,
by permittee.
BRF /RM /jp
August 1995
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BRUCE R. FOLEY. R.S.
Acting Public Health Director
DEPARTMENT; OF HEALTH
Division Of "Environmental-- Health Services
4 Geneva Road,;, Brewster, New` York 10509
(914) X278 =6130 .
BRUCE R. FOLEY. R.S.
j w . Acting Public — Health . D je.Gtor,,.
DEPARTMENT OF HEALTH
Division Of Environmental Health Services
4 Geneva Road, Brewster, New York 10509
(914) 278 -6130
FORMAT
NEIGHBOR NOTIFICATION
CO?v'STRUCTION PER_N -11T
I"
Dear
DATE
Department of Health ReNiew of
Proposed Sewage Disposal System and/or Well
ADDRESS:
TOWN:
TAX MAP:
o a 3_"
Please be advised that an application for a Construction Permit relative to the construction of a
sewage system and/or well proposed for the above captioned property has been made to the
Putnain-Coutnty Department of Health Attached please�f�id a�opy,of the.latest -.site plan„
If you have any questions, concerns or information which may bear on the Health Department's
review of this application, you may call Mr. Hedges or Mr. Morris of the Health Department at
278 -6130.
RECEIVED BY:
ADDRESS:
TAX MAP:
BRF /jp
Very truly yours,
PUTNAM COUNTY DEPARTMENT OF HEALTH
DIVISION OF ENVIRONMENTAL HEALTH SERVICES
-IV/
APPLICATION TO CONSTRUCT A WATER WELL r C,
... ,: ,,__ � ......- G_ ., � ^pl'ekc`e print`of Type . -, . .. _ . ... ., ... r.. ,.. . , n _ .. -� . ,:PC�IU �t�'' eli`ITflt`� ol.�' . '':)a' .. • • .
F ::.. -
Well Location:
Street Address: ' Town/Village Tax Grid #
/
n ,C J Ma Block ! Lot(s) 3 ~
�% z � 4� elv s �6 p S 3,7,I 7i
Well Owner:
Name:
Address:
Use of Well:
I_ Residential Public Supply Air /Cond/Heat Pump Irrigation
1- primary
Business Farm Test/Monitoring Other (specify)
2- secondary
Industrial Institutional Standby
Amount of Use
Yield Sought gpm # People Served Est. of Daily Usage _gal.
Reason for
Replace Existing Supply Test/Observation Additional Supply
Drilling
New Supply (new dwelling) Deepen Existing Well
Detailed Reason
Jet e 2
for Drilling
„L' �,c� ¢� 2 m4' °
Well Type
Drilled Driven Gravel Other
Is well site subject to flooding? ............................................... ...........................'.'. Yes No
--�
Is well located in a realty subdivision? ...................................... ............................... Yes No
Name of subdivision Lot No.
Water Well Contractor: Address:
Is Public Water Supply available to site? .................................. ............................... Yes No
Name of Public Water Supply: Town/Village
Distance to property from nearest water main:
Proposed well location & sources of contamination to be provided on separate sheet/plan.
,Date:.- Applicant_Signature: _ .. �... _: _ _.....:. < ....... _ r....
PERMIT TO CONSTRUCT A WATER WELL
This permit to construct one water well as set forth above, is granted under provisions of Article 10 of the
Putnam County Sanitary Code and Subpart 5 -2 of Part 5 of the New York State Sanitary Code and provided
that within thirty (30) days of the completion of water well construction, the applicant or their designated
representative shall: 1) Pump the well until the water is clear. 2) Disinfect the well in accordance with the
requirements of the Putnam County Health Department. 3) Submit a Well Completion Report on a form
provided by the Putnam County Health Department. During all well drilling operations, the applicant and/or
well driller shall take appropriate action to assure that any and all water and waste products from such
well drilling operations be contained on this property and in such a manner as not to degrade or otherwise
contaminate surface or groundwater.
APPROVED. FOR CONSTRUCTION: This approval expires two years from the date issued unless
construction of the well has been completed and inspected by the PCHD and is revocable for cause or may be
amended or modified when considered necessary by the Public Health Director. Any revision or alteration
of the approved plan requires a new permit. Well to be constructed by a water well driller certified by Putnam
County.
Date of Issue /271 V /.Zf /! FJ Permit Issuing Offici :
Date of Expiration cz V If, �� Title:
Permit is Non - Transferrable
White copy - HD file; Yellow copy - Building Inspector; Pink copy - Owner; Orange copy - Well driller
Form WP -97
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HOULIHAN/LAWRENCE ROBERT-DAVID
ROUTE 6, P.O. BOX 650 JEFFERSON VALLEY, NY 10535 PHONE 914/962-4900 FAX 914/962-6249
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FORMAT Date
NEIGHBOR NOTIFICATION
CONSTRUCTION PERMIT
0
Re: Department o'f''Heal ih Review.-. .0
'-."',-.:*t,
Proposed Sewage ',Disp*osal�,,Sys'tem,,h:�i'i.," .
for property:
Name: " W—
Address: /�Z.-'/zth�
Town:
-Tag. Map;
Dear
a o
Please be advised that an
o
application for a Construction Permit re.- at i ve 50
to the construction of a sewage
system and/or well proposed, for the capti env
property has been made to
the Putnam County Department of Health. Attach d
please find a copy of the
latest site plan.
If you have any questions,
concerns or information which may bear on the
Health Department's review
of this applicat- on, you may call Mr. Hedges
or Mr. Morris of the Health Department at 225-0310.
Very trV!y. yours.
;Y;
.BL
Title �w- e
RECEIVED BY:
Address:
Tax MaP� �3; �a —1 — le/ �3: 7�?�/ —�� /�3; ��• - /._�" : ;1: '.,,��,
0
Sheet of z— ,�-
Pl� TTN A M: COUNTY DEPARTMENT OF HEALTH
DIVISION OF ENVIRONMENTA1C; iiEA.TLH--SVRVICES- -;, ....,.:•...:.�.o,...b:. ;,:: .:;.:
FIELD ACTIVITY REPORT
NAME: TPI:
AT)T)RF S: ��'►� �ir�t.Lr�� ��
Street Town State Zip
PERSON IN CHARGE
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Name and Title
TYPE OF FACILITY:
FINDINGS:
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Signature and Title
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I acknowledge receipt of this report: SIGNATURE.,
Sheet of
�IPUTia!N7AY��77I' M COUNTY
(lJ�DEPARTMENT
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VISggr �.,•v:..; "�, y':
FIELD ACTIVITY REPORT
NAME: e-,-) Tel;
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Street Town State
PERSON IN CHARGE
Name and Title
TYPE OF FACILITY:
FINDINGS:
Zip
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I acknowledge receipt of this report: SIGNATURE:
I 02/96 Title;
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FEB-17-1998 14:26
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REMARKS:
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Century 21 Robert-David Real Estate, Inc.
Route 6-jefferson Valley -New York-10535
(91AV1 962-4900 (914) 962-619-Fax
FEB -17 -1998 14:26 CENTURY 21- ROBERT DAVID 914 962 6249 P.O2
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TYPE OF FACILITY:
FINDINGS:
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PUTNAM COUNTY DEPARTMENT OF HEALTH
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02/96 Title:
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MLS #:0094279p SF ACT Area:9 LP: $29,000
Addr:12 HILLAIR RD
PO:LAKE PEEKSKILL Zip Code:10537
City/,Town:PUTNAM VALLEY (�rid:E" Map.
Village:NONE Sch:Y1
Rooms: 3 Est SgFt: 391 YrBlt:1938/
Bedrooms: 1 Elem School:PUTNAM.VALLEY
Baths:1.0 Jr High School:PUTNAM VALLEY
Levels: 1 High School:PANAS
---------------------------------------- - - - - --
%:. Style:COTTAGE
...........:.......
E x t e r: WOOD
Levell:LIVING ROOM, BEDROOM, EI KITCHEN, BATH,
:DECK
Model:
Color:WHITE
Living: X
Dining: X
Level2: Mst BR: X
Leve13:
Basemt: Attic:
Neighborhd Assn:N Additional Fees:N Homeowners Assn:N Att /Det:D
Complex:LAKE PEEKSKILL Est Tax$: $1,695 Front: 161
Tax ID #: Tax Year:1997 Depth: 75 Shape:R
Zoning:RES Assmt: $39,900 Est Acres: .25
_ --------------------------------------------------------------------------------
AmenitieS:EIK, VIEW, CLUBHSE,LAKE /PND,WTRACC,MOORING
includes':R- ANGE,REFRIG
kxcnudes
{ Elec CO:NYSEG
1Ta�<S ?ELFC Fuel:ELEC A/C
"P`arTc':`STREET Wall : SROCK Roof :ASPHALT
Water :1,RT NICIPA Sewer.: SEPTIC Garbage : PUBLIC
n / T 1ART ?n �c << DIP, „- r -- - .''--f
,
Y�C::ili "171Y.L'�%.':'. 7 Ji ° •!"+' L.)V, JL iJ �l.0 \rG .�'1 ri <
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COMT,!U`E TO WHITE- PLAINS, DANBURY, OR NYC VIA TACONIC OR METRO
NORTH RR. APX 1 -HR TO NY. PRIVATE. ,
Directions:OSC LK,ENLOE,CHESTER,LAKE,BECKER
TANGLE.,ASPEN, L HILLAIR, ON L.
-----------------'------------------------------------------------------- - - - - --
Owner:PROVINO Possession:NEGO
List Office . :JONELL JONELLE REALTY,
List Agent :1329 REX COSTON
LA Email:
Co -List Office:
Co -List Agent
Sub Agent Comp:3% - - - - - -- Buyers Agent C`om
------------- - - - - -- -- - - - - -- -..__
Modif /Excl:X03,X04,X07
INC. (914) 526 -2112 LD:09/16/1997
XD:
CIA Email:
-------------- -
Data believed accurate /not warra ect
Copyright: 1997. by Westchester
MLS, Inc 12
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Prepared by: anderson may on December , 1997
LiPt ^Type: ,r--- .....•
tiate Thru: LA
Is
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verification,,”
/1997 10:49 -
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JVkIP/
#32747 Area:01 SF ACT Lp:$219,900
"V
Ad: 3102 WHARTON DRIVE
PO:YORKTOWN HEIGHTS Zip.10598
t A'a... -
£ , as a$C � 25
.,_ .. :z- - . «- sf_�— p_�e..... =.... �.- ....,-:: ... Y,..:. �... ,.'.:...:_.._::.c:�:aG <ia�l`s•.
Mun:YORKTOWN Grid:H4 Map:11
Rms:8 Est SF:2,400 Sch:Y1
Br:4 Lr: Es:JEFFERSON
Bth : 2 . 1 Dr: Jh : COPPER BEECH
:".
:Lev: 3 Mbr : Hs': LAKELAND
----------------------------------------
F\
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Styl:COL Color:WHITE Att / Det:D
Modl. Front:154 Dep:179
Extr : WOOD Acre • 0.9 8 Sha p e . R
;L1:EH,DR,LR W FPL,FAM RM,EIK,.5BTH YrBlt:1966 Cmplx:
Home Asn:N Tx #:5.23,59,31
L2:MBR,W BTH, 2 BR, BTH
Nbad Asn:N EstTx$:8,867 TxYr:1995.
:131
_. Addl Fee:N Asmt$:12,200
Bsmt:FULL
Atti'c:Y Poss:ASAP Zoning:R1 -20
includes: RANG REF DW W/W
STRM SCRN;CFAN LTFX
`_-gxcludes:WSHR DRYR FREZ
:Amenities:PWDR EIK FENC FPL
POOL Elec Co:NYSE
. °Roof:ASBS Walls:SROC
Parkg:2CAR Water:MUNI
Heat:HW
Fuel:OIL Garbage:PUBL Sewer:SEWR
:z=---------------------------------------:---------------------
-Rems:LARGE 4 BR COL IN GREAT
- -----------------
FAMILY NEIGHBORHOOD WITH OLYMPIC IN- GROUND
POOL, ROOF 1 YR,FURNACE
12 YEARS,2,IZONE HT,
HUGE UN 'FIN BASE HAS WATER PROOFING WARRANTY.
...Dir
QUINLAN TO LONDON TO WHARTON
- ---------------------------------------,------------------------------
D:`07 /09!95 LT:1A Neg Thru:LA Sub Agent �/$.3 Open House:
.f' >Owner::YQUNG =;.
Buyers Agent %/$:3 # # # # ## to
Mod %Excl�:X03'X04 X07
See Glossary & Contact Listing Agt for Detail
CENTURY 21 ROBERT DAVID REAL LA:620,8 JORDAN, TERRY 962 -4900
CL6.CENTURY..21 ROBERT DAVID REAL CLA 7025 ROCHFORD, PATRICIA 962 -4900
� PPiTA .: BEL I�E VED ,ACCURATE�NO�T _.WARRANTED _ ALL_ BATA, SUBJECT,: TO. VERI.F-IC.A.TION.
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