HomeMy Public PortalAboutMEDDIN DR_33.pdfU.S. DEPARTMENT OF 140MELAN D SECURITY ELEVATION CERTIFICATE OMB Na. 1660 00[38
FEDERAL EMERGENCY MANAGEMENT AGENCY
National Flood Insurance Program Important: Read the instructions on pages 1-9. Expiration Date: JUIy 31, 2015
SECTION A - PROPERTY INFORMATION FOR INSURANCE COMPANY USE
Al. Building Owner's Name North Beach Bar & Gril, LLC Policy Number:
A2. Building Street Address (including Apt, Unit, Suite, and/or Bldg- No.) or P.O. Route and Box No. Company NAIC Number.
33 Meddin Drive
City Tybee Island State GA ZIP Code 31328
A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.)
Pt. Fort Screven Ward PIN 4-0001-13-008 North Beach Bar & Grill building
A4. Building Use (e.g., Residential, Non -Residential, Addition, Accessory, etc.) Non -Residential
A5. Latitude/Longitude: Lat. N 32d 01'18" Long. W 80d 50'38" Horizontal Datum: ❑ NAD 1927 ® NAD 1983
A6. Attach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance.
A7. Building Diagram Number 8
A8. For a building with a crawlspace or endosure(s): A9. For a building with an attached garage:
a) Square footage of crawlspace or enclosure(s) 2264 sq ft a) Square footage of attached garage nia sq ft
b) Number of permanent flood openings in the crawlspace b) Number of permanent flood openings in the attached garage
or enclosure(s) within 1.0 foot above adjacent grade 0 within 1.0 foot above adjacent grade n1a
c) Total net area of flood openings in A8.b 0 sq in c) Total net area of flood openings in A9.b nla sq in
d) Engineered flood openings? ❑ Yes ® No d) Engineered flood openings? ❑ Yes ® No
SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
61. NFIP Community Name & Community Number B2. County Name 83. State
Tybee Island 135164 Chatham GA
B4. MaplPanel Number
65. Suffix
B6. FIRM Index Date
67. FIRM Panel
B8 Flood
B9 Base Flood Elevation(s) (Zone
13051 CO214
F
717114
Effective/Revised Date
Zone(s)
AO, use base flood depth)
® feet
❑ meters
11.1
9126108
VE
15
Bi 0. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item B9.
❑ FIS Profile ® FIRM ❑ Community Determined ❑ Other/Source:
B11- Indicate elevation datum used for BFE in Item B9 ❑ NGVD 1929 E NAVD 1988 ❑ Other/Source:
B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)2 ❑ Yes ® No
Designation Date: ❑ CBRS ❑ OPA
SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED)
Cl. Building elevations are based on: ❑ Construction Drawings* ❑ Building Under Construction* ® Finished Construction
*A new Elevation Certificate will be required when construction of the building is complete.
C2. Flevations - Zones Al -A30, AE, AH, A (with BFE), VE, V1 V30, V (with BFE), AR, ARIA, ARAE, AR/Al-A30, AR1AH, ARIAO. Complete Items C2.a-h
below according to the building diagram specified in Item A7, In Puerto Rico only, enter meters.
Benchmark Utilized: local Vertical Datum: NAVD 1988
Indicate elevation datum used for the elevations in items a) through h) below. ❑ NGVD 1929 ® NAVD 1988 ❑ Other/Source:
Datum used for building elevations must be the same as that used for the BFE.
a) Top of bottom floor (including basement, crawlspace, or enclosure floor)
b) Top of the next higher floor
c) Bottom of the lowest horizontal structural member (V Zones only)
d) Attached garage (top of slab)
e) Lowest elevation of machinery or equipment servicing the building
(Describe type of equipment and location in Comments)
f) Lowest adjacent (finished) grade next to building (LAG)
g) Highest adjacent (finished) grade next to building (HAG)
h) Lowest adjacent grade at lowest elevation of deck or stairs, including structural support
SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION
This certification is to be signed and sealed by a land surveyor, engineer, or architect authorized by law to certify elevation
information. t certify that the information on this Certificate represents my best efforts to interpret the data available.
I understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001. �Q R GZ�
® Check here if comments are provided on back of form, Were latitude and longitude in Section A provided by a TR,
® Check here if attachments. licensed land surveyor? ® Yes 1-1NoCs '
Certifier's Name J. Whitley Reynolds License Number 2249
Title Land Surveyor Company Name
Address 636 St on A City Savannah State GA ZIP Code 31405
Signature 17116 Telephone 912-352-0464
FEMA Form 6-0-33 (7/12) See reverse side for continuation.
all previous editions.
Check the measurement used.
8.9
® feet
❑ meters
11.7
® feet
❑ meters
nla.
® feet
❑ meters
nla.
® feet
❑ meters
11.1
® feet
❑ meters
8.9
® feet
❑ meters
10.3
® feet
❑ meters
8.9
® feet
❑ meters
SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION
This certification is to be signed and sealed by a land surveyor, engineer, or architect authorized by law to certify elevation
information. t certify that the information on this Certificate represents my best efforts to interpret the data available.
I understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001. �Q R GZ�
® Check here if comments are provided on back of form, Were latitude and longitude in Section A provided by a TR,
® Check here if attachments. licensed land surveyor? ® Yes 1-1NoCs '
Certifier's Name J. Whitley Reynolds License Number 2249
Title Land Surveyor Company Name
Address 636 St on A City Savannah State GA ZIP Code 31405
Signature 17116 Telephone 912-352-0464
FEMA Form 6-0-33 (7/12) See reverse side for continuation.
all previous editions.
ELEVATION CERTIFICATE, page 2
IMPORTANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE
Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Policy Number:
33 Meddin Drive
City Tybee Island State GA ZIP Code 31328 Company MAIC Number:
SECTION D — SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED)
Copy both sides of this Elevation Certificate for (1) community official, (2) insurance agent/company, and (3) building owner.
Comments C2.e) is a fan unit.
Unable to get an-6leitation for C2.c) because of skirting around building.
Aea of crawlspace to en property record card.
Date 7/7/16
9�— BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE
For Zones AO and A (without BFE), complete Items E1—E5. If the Certificate is intended to support a LOMA or LOMR-F request, complete Sections A, B,
and C. For Items El—E4, use natural grade, if available. Check the measurement used. In Puerto Rico only, enter meters.
E1. Provide elevation information for the following and check the appropriate boxes to show whether the elevation is above or below the highest adjacent
grade (HAG) and the lowest adjacent grade (LAG).
a) Top of bottom floor (including basement, crawlspace, or enclosure) is ❑ feet ❑ meters ❑ above or ❑ below the HAG.
b) Top of bottom floor (including basement, crawlspace, or enclosure) is ❑ feet ❑ meters ❑ above or ❑ below the tAG.
E2. For Building Diagrams 6-9 with permanent flood openings provided in Section A Items 8 and/or 9 (see pages 8-9 of Instructions), the next higher floor
(elevation C2.b in the diagrams) of the building is ❑ feet ❑ meters ❑ above or ❑ below the HAG.
E3. Attached garage (top of slab) is ❑ feet ❑ meters ❑ above or ❑ below the HAG.
E4. Top of platform of machinery and/or equipment servicing the building is ❑ feet ❑ meters ❑ above or ❑ below the HAG.
E5. Zone AO only: If no flood depth number is available, is the top of the bottom floor elevated in accordance with the community's floodplain management
ordinance? ❑ Yes ❑ No ❑ Unknown. The local official must certify this information in Section G.
SECTION F — PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION
The property owner or owner's authorized representative who completes Sections A, B, and E for Zone A (without a FEMA -issued or community -issued BFE)
or Zone AO must sign here. The statements in Sections A, B, and E are correct to the best of my knowledge.
Property Owner's or Owner's Authorized Representative's Name
Address City State ZIP Code
Signature Date Telephone
Comments
❑ Check here if attachments.
SECTION G — COMMUNITY INFORMATION (OPTIONAL)
The local official who is authorized by law or ordinance to administer the community's floodplain management ordinance can complete Sections A, B, C (or E), and G
of this Elevation Certificate. Complete the applicable item(s) and sign below. Check the measurement used in Items G8—G10. In Puerto Rico only, enter meters.
G1. ❑ The information in Section C was taken from other documentation that has been signed and sealed by a licensed surveyor, engineer, or architect who
is authorized by law to certify elevation information. (indicate the source and date of the elevation data in the Comments area below.)
G2. ❑ A community official completed Section E for a building located in Zone A (without a FEMA -issued or community -issued BFE) or Zone AO.
G3. ❑ The following information (Items G4—G10) is provided for community floodplain management purposes.
G4. Permit Number G5. Date Permit Issued G6. Date Certificate Of Compliance/Occupancy Issued
G7. This permit has been issued for: ❑ New Construction ❑ Substantial Improvement
G8. Elevation of as -built lowest floor (including basement) of the building: ❑ feet ❑ meters Datum
G9. BFE or (in Zone AO) depth of flooding at the building site: ❑ feet ❑ meters Datum
G10. Community's design flood elevation: ❑ feet ❑ meters Datum
Local Official's Name Title
Community Name Telephone
Signature Date
Comments
Check here if attachments.
FEMA Form 086-0-33 (7/12) Replaces all previous editions,
ELEVATION CERTIFICATE, page 3 Building Photographs
See Instructions for Item A6.
IMPORTANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE
Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Policy Number:
33 Meddin Drive
City Tybee Island State GA ZIP Code 31328 Company NAIC Number:
If using the Elevation Certificate to obtain NFIP flood insurance, affix at least 2 building photographs below according to the instructions
for Item A6_ Identify all photographs with date taken; 'Front View" and "Rear View'; and, if required, 'Right Side View" and "Left Side
View." When applicable, photographs must show the foundation with representative examples of the flood openings or vents, as
indicated in Section A8. If submitting more photographs than will fit on this page, use the Continuation Page.
FEMA Form OMO-33 (7112) Replaces all previous editions.
ELEVATION CERTIFICATE, page 4 Building Photographs
Continuation Page
IMPORTANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE
Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Policy Number:
33 Meddin Drive
City Tybee island
State GA ZIP Code 31328
Company MAIC Number:
If submitting more photographs than will fit on the preceding page, affix the additional photographs below. Identify all photographs
with: date taken; "Front VievV' and "Rear View: and, if required, "Right Side View" and "Left Side View." When applicable,
photographs must show the foundation with representative examples of the flood openings or vents, as indicated in Section A8_
FEMA Form 086-0-33 (7/12) Replaces all previous editions.