HomeMy Public PortalAboutMILLER AV_608.pdfU.S. DEPARTMENT OF HOMELANDS CUITY
Federal Emergency Management Agency
National Flood Insurance Program OMB No.
ELEVATION CERTIFICATE
Important: Follow the instructions on pages 1-9.
Copy all pages of this Elevation Certificate and all attachments for (1) community official, (2) insurance agent/company, and (3) building owner.
SECTION A — PROPERTY INFORMATION FOR INSURANCE COMPANY USE
Al. Building Owner's Name Policy Number:
Catskill Builders
A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and
Box No. Company NAIL Number:
608 Miller Avenue
City State ZIP Code
Tybee Island Georgia 31328
A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.)
Lot 115, Ward 2, Tybee Island Tax Parcel # 40005 13004
A4. Building Use (e.g., Residential, Non -Residential, Addition, Accessory, etc.) Residential
A5. Latitude/Longitude: Lat. 32.00669' Long. -80.84655' Horizontal Datum: 0 NAD 1927 Pfl 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 6
A8. For a building with a crawlspace or enclosure(s):
a) Square footage of crawlspace or enclosure(s) 1821.00 sq ft
b) Number of permanent flood openings in the crawlspace or enclosure(s) within 1.0 foot above adjacent grade 5
c) Total net area of flood openings in A8.b 2070.00 sq in
d) Engineered flood openings? El Yes Z No
A9. For a building with an attached garage:
a) Square footage of attached garage N/A sq ft
b) Number of permanent flood openings in the attached garage within 1.0 foot above adjacent grade N/A
c) Total net area of flood openings in A9.b N/A sq in
d) Engineered flood openings? E] Yes Z No
SECTION B — FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
Bl. NFIP Community Name & Community Number B2. County Name B3. State
City of Tybee Island 135164 Chatham Georgia
M P
B4. Map/Panel B5. Suffix B6. FIRM Index B7. FIRM Panel B8. Flood B9. Base Flood Elevation(s)
Number Date Effective/ Zone(s) (Zone AO, use Base Flood Depth)
Revised Date
13051 CO213 G 08-16-2018 08-16-2018 AE 10.0
B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item 139:
E] FIS Profile Z FIRM E] Community Determined 0 Other/Source:
B11. Indicate elevation datum used for BFIE in Item 139: E] NGVD 1929 Z NAVD 1988 [] Other/Source:
B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? 0 Yes Z No
Designation Date: E] CBRS [:] OPA
FEMA Form 086-0-33 (12/19) Replaces all previous editions. Form Page 1 of 6
OMB No. 1660-0008
ELEVATION CERTIFICATE Expiration Date: November 30, 2022
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:
608 Miller Avenue
City State ZIP Code Company NAIL Number
Tybee Island Georgia 31328 1
SECTION E - 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 E1 -E4, use natural grade, if available. Check the measurement used. In Puerto Rico only,
enter meters.
El. 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 E] feet E] meters E] above or [:] below the HAG.
b) Top of bottom floor (including basement,
crawlspace, or enclosure) is 0 feet EJ meters E] above or E] below the LAG.
E2. For Building Diagrams 6-9 with permanent flood openings provided in Section A Items 8 and/or 9 (see pages 1-2 of Instructions),
the next higher floor (elevation C2.b in -] EJ meters El above or E] below the HAG.
the diagrams) of the building is E feet
E3. Attached garage (top of slab) is F1 feet 0 meters El above or EJ below the HAG.
E4. Top of platform of machinery and/or equipment
servicing the building is E] feet [] meters [-] above or E] 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 E] No [:] Unknown. The local official must certify this information in Section G.
'S REPRESENTATIVE) CERTIFICATION
SECTION F - PROPERTY OWNER (OR OWNER
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 or Owner's Authorized Representative's Name
Address city State ZIP Eo -de
Signature Date Telephone
Comments
Check here if attachments.
FEMA Form 086-0-33 (12/19) Replaces all previous editions. Form Page 3 of 6
OMB No. 1660-0008
ELEVATION CERTIFICATE Expiration Date: November 30, 2022
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:
608 Miller Avenue
City State ZIP Code Company NAIC Number
Tybee Island Georgia 31328
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 AD) 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 (including type of equipment and location, per C2(e), if applicable)
Check here if attachments.
FEMA Form 086-0-33 (12/19) Replaces all previous editions. Form Page 4 of 6
BUILDING PHOTOGRAPHS OMB No. 1660-0008
ELEVATION CERTIFICATE See Instructions for item A6. Expiration Date: November 30, 2022
FEMA Form 086-0-33 (12/19) Replaces all previous editions. Form Page 5 of 6
BUILDING PHOTOGRAPHS OMB No. 1660-0008
ELEVATION CERTIFICATE Continuation Page Expiration Dater November 30, 2022
FEMA Form 086-0-33 (12/19) Replaces all previous editions. Form Page 6 of 6
Building Permit Number C29 7
Applicant's Name: 5VI Owner's Name:
Site Address, Tax#, Parcel Address: ;
Telephone: 7 'Telephone:
I. All development — Base Flood Elevation Data Provided:
A. The as -built elevation certification from a registered land surveyor or
Professional engineer has been submitted? or NO
B. The lowest floor elevation is at or above the required lowest floor elevation? or (p
C. Electrical, heating, ventilation, plumbing, air conditioning equipment (including
duct work) and other service facilities are located above BFE or flood proofed? YES or NO
U. Development in Zones A, AE, AI -A30 and
A. Solid foundation perimeter walls located below BFE:
1. There are at least two (2) openings?
or NO
2. Square footage of enclosed area subject to flooding
3. Square inches of venting required
g IM
4. Square inches per opening (multiply 1 by w)
TOZ
5. Number of required vents (3 above divided by 4 above)
6. Foundation contains the minimum number of vents?
or NO
7. The bottom of each opening is no higher than one (1) foot above grade?
E or NO
8. Any cover on openings will permit the automatic flow of floodwaters
In both directions?
OR NO
B. Base flood elevation and/or floodway data not available or AO Zones:
1. The lowest floor is at least one (1) foot above the highest adjacent grade? YES or NO
2. The development meets the setback requirements of the ordinance? YES or NO
3. If 2 above was "no", has a No -Rise Certification been submitted? YES or NO
Reviewer's Name: Date reviewed:
B. Floodway data is provided.
1. Did this development encroach in the floodway? YES or NO
2. Do the actual field conditions meet the proposed actions and technical
date requirements? YES or NO
3. If Cl was "yes", has a No -Rise Certification been submitted? YES or NO
Reviewer's Name: Date reviewed
III. Development in Zones V, VE and V! -V30, VO (Coastal High Lazard Areas).
A. Development location complies with all coastal setback requirements? YES or NO
B. Structure is securely anchored to pilings or columns and certification by a
Registered, professional architect or engineer has been submitted? YES or NO
Reviewer's Name: Date reviewed:
C. Walls permitted below the base flood elevation consist of decorative lattice work or,
Where permitted, are breakaway and have been certified by a registered, professional
Architect or Engineer? YES or NO
Reviewer's Name: Date reviewed:
Local Administrator's Signature: Date: JiL �J
City of Tybee Island ry.
4 f�
403 Butler Avenue - P.O. Box 2749
Tybee Island, Ga. 31325-2749 y`