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HomeMy Public PortalAboutBAY ST_1308.pdfFEMA check list Building Permit Number G 30 1 (oO Applicant's Name: 4,' ,S „v fit2(4 Owner's Name: aut i iQ,,, e , Site Address, Tax#, Parcel#: /3 as' Bay Address: 7?L,L. 1-3 / _''v6,, ' Telephone: f p ne:gip-- 3,3 s`- Telephone: p I. All development — Base Flood Elevation Data Provided: A. The as -built elevation certificate from a registered land surveyor or Professional engineer has been submitted? B. The lowest floor elevation is at or above the required lowest floor elevation? C. Electrical, heating, ventilation, plumbing, air conditioning equipment (including Duct work) and other service facilities are located above BFE or flood proofed? II. Development in Zone AE: or No (Ye br No Y or No A. Solid foundation perimeter walls located below BFE: 1. There are at least two (2) openings? (yig or No 2. Square footage of enclosed area subject to flooding 3. Square inches of venting required 4. Square inches per opening (multiply 1 by w) 5. Number of required vents (3 above divided by 4 above) 6. Foundation contains the minimum number of vents? 7. The bottom of each opening is no higher than one (1) foot above grade? 8. Any cover on openings will permit the automatic flow of floodwaters in both directions? (Ye$ or No III. Development in Zones V, VE and V! -V30, VO (Coastal High Hazard Areas). A. Development location complies with all coastal setback requirements? B. Structure is securely anchored to pilings or columns and certification by a Registered, professional architect or engineer has been submitted? -e or No 63 or No Yes or No Yes or No Reviewer's Name: C_Theov9e_ SC-\cuki Date reviewed: 34261,)76 Local Administrator's Signature: Date: City of Tybee Island 403 Butler Avenue-P.O. Box 2749 Tybee Island, Ga. 31328-2749 3(4 -(pi/ ELEVATION CERTIFICATE IMPORTANT: MUST FOLLOW THE INSTRUCTIONS ON PAGES 9-19 BUILDING PHOTOGRAPHS Continuation Page Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No.: 1308 BAY STREET City: TYBEE ISLAND State: GA ZIP Code: 31328 FOR INSURANCE COMPANY USE Policy Number: Company NAIC Number. Insert the third and fourth photographs below. Identify all photographs with the date taken and "Front View," "Rear View," "Right Side View," or "Left Side View." When flood openings are present, include at least one close-up photograph of representative flood openings or vents, as indicated in Sections A8 and A9. Photo Three Photo Three Caption: REAR VIEW 11/06/2023 Photo Four Caption: RIGHT SIDE VIEW 11/06/2023 Clear Photo Four Photo Four Clear Photo Three FEMA Form FF-206-FY-22-152 (formerly 086-0-33) (10/22) Page 8 of 19 ELEVATION CERTIFICATE IMPORTANT: MUST FOLLOW THE INSTRUCTIONS ON PAGES 9-19 BUILDING PHOTOGRAPHS See Instructions for Item A6. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No.: 1308 BAY STREET City: TYBEE ISLAND State: GA ZIP Code: 31328 FOR INSURANCE COMPANY USE Policy Number: Company NAIC Number Instructions: Insert below at least two and when possible four photographs showing each side of the building (for example, may only be able to take front and back pictures of townhouses/rowhouses). Identify all photographs with the date taken and "Front View," "Rear View," "Right Side View," or "Left Side View." Photographs must show the foundation. When flood openings are present, include at least one close-up photograph of representative flood openings or vents, as indicated in Sections A8 and A9. Photo One FEMA Form FF-206-FY-22-152 (formerly 086-0-33) (10/22) Page 7 of 19 ELEVATION CERTIFICATE IMPORTANT: MUST FOLLOW THE INSTRUCTIONS ON PAGES 9-19 Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No.: 1308 BAY STREET FOR INSURANCE COMPANY USE Policy Number: City: TYBEE ISLAND State: GA ZIP Code: 31328 Company NAIC Number. SECTION H — BUILDING'S FIRST FLOOR HEIGHT INFORMATION FOR ALL ZONES (SURVEY NOT REQUIRED) (FOR INSURANCE PURPOSES ONLY) The property owner, owner's authorized representative, or local floodplain management official may to determine the building's first floor height for insurance purposes. Sections A, B, and I must also be nearest tenth of a foot (nearest tenth of a meter in Puerto Rico). Reference the Foundation Type Instructions) and the appropriate Building Diagrams (at the end of Section !Instructions) to complete 1-11. Provide the height of the top of the floor (as indicated in Foundation Type Diagrams) above the a) For Building Diagrams IA, IB, 3, and 5-9. Top of bottom ❑ feet ❑ complete Section H for all flood zones completed. Enter heights to the Diagrams (at the end of Section H this section. Lowest Adjacent Grade (LAG): meters ❑ above the LAG floor (include above -grade floors only for buildings with subgrade crawlspaces or enclosure floors) is: b) For Building Diagrams 2A, 2B, 4, and 6-9. Top of next 1 feet ❑ meters • above the LAG to or above the floor indicated by the Building Diagram? higher floor (i.e., the floor above basement, crawlspace, or enclosure floor) is: H2. Is all Machinery and Equipment servicing the building (as listed in Item H2 instructions) elevated H2 arrow (shown in the Foundation Type Diagrams at end of Section H instructions) for the appropriate j♦ Yes ❑ No SECTION I — PROPERTY OWNER (OR OWNER'S AUTHORIZED REPRESENTATIVE) CERTIFICATION The property owner or owner's authorized representative who completes Sections A, B, and H must sign here. The statements in Sections A, B, and H are correct to the best of my knowledge. Note: if the local floodplain management official completed Section H, they should indicate in Item G2.b and sign Section G. ® Check here if attachments are provided (including required photos) and describe each attachment in the Comments area. Property Owner or Owner's Authorized Representative Name: Address: City: State: ZIP Code: Signature: Date: Telephone: Ext.: Email: Comments: FEMA Form FF-206-FY-22-152 (formerly 086-0-33) (10/22) Page 6 of 19 ELEVATION CERTIFICATE IMPORTANT: MUST FOLLOW THE INSTRUCTIONS ON PAGES 9-19 Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No.: 1308 BAY STREET FOR INSURANCE COMPANY USE Policy Number: City: TYBEE ISLAND State: GA ZIP Code: 31328 Company NAIC Number. SECTION G - COMMUNITY INFORMATION (RECOMMENDED FOR COMMUNITY OFFICIAL COMPLETION) The local official who is authorized by law or ordinance to administer the community's floodplain management ordinance can complete Section A, B, C, E, G, or H of this Elevation Certificate. Complete the applicable item(s) and sign below when: 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 state law to certify elevation information. (Indicate the source and date of the elevation data in the Comments area below.) G2.a. ❑ A local official completed Section E for a building located in Zone A (without a BFE), Zone AO, or Zone AR/AO, or when item E5 is completed for a building located in Zone AO. G2.b. ❑ A local official completed Section H for insurance purposes. G3. ❑ In the Comments area of Section G, the local official describes specific corrections to the information in Sections A, B, E and H. G4. ❑: The following information (Items G5 —G11) is provided for community floodplain management purposes. G5. Permit Number. G6. Date Permit Issued: G7. Date Certificate of Compliance/Occupancy Issued: ❑ meters Datum: G8. This permit has been issued for. 0 New Construction ❑ Substantial Improvement G9.a. Elevation of as -built lowest floor (including basement) of the building: ❑ feet G9.b. Elevation of bottom of as -built lowest horizontal structural member: ❑ feet ❑ meters Datum: G10.a. BFE (or depth in Zone AO) of flooding at the building site: ❑ feet ❑ meters Datum: G10.b. Community's minimum elevation (or depth in Zone AO) requirement for the lowest floor or lowest horizontal structural member: ❑ feet 0 meters Datum: G11. Variance issued? ❑ Yes ❑ No If yes, attach documentation and describe in the Comments area. The local official who provides information in Section G must sign here. / have completed the information in Sect/on G and certify that it is correct to the best of my knowledge. If applicable, 1 have also provided specific corrections in the Comments area of this section, Local Official's Name: Title: NFIP Community Name: Telephone: Ext.: Email: Address: City: State: ZIP Code: Signature: Date: Comments (including type of equipment and location, per C2.e; description of any attachments, and corrections to specific information in Sections A, B, D, E, or H): FEMA Form FF-206-FY-22-152 (formerly 086-0-33) (10/22) Page 5 of 19 ELEVATION CERTIFICATE IMPORTANT: MUST FOLLOW THE INSTRUCTIONS ON PAGES 9-19 Building Street Address (including Apt, Unit, Suite, and/or Bldg. No,) or P.O. Route and Box No.: 1308 BAY STREET FOR INSURANCE COMPANY USE Policy Number: City: TYBEE ISLAND State: GA ZIP Code: 31328 Company NAIC Number: SECTION E — BUILDING MEASUREMENT INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO, ZONE AR/AO, AND ZONE A (WITHOUT BFE) For Zones AO, AR/AO, and A (without BFE), complete Items E1 —E5. For Items El —E4, use natural intended to support a Letter of Map Change request, complete Sections A, B, and C. Check the measurement enter meters. Building measurements are based on: Construction Drawings* Building Under Construction* *A new Elevation Certificate will be required when construction of the building is complete. El. Provide measurements (C.2.a in applicable Building Diagram) for the following and check the appropriate measurement is above or below the natural HAG and the LAG. a) Top of bottom floor (including basement, crawlspace, or enclosure) is: ❑ feet ❑ meters grade, if available. If the Certificate is used. In Puerto Rico only, ❑ Finished Construction boxes to show whether the ❑ above or [] below the HAG. b) Top of bottom floor (including basement, crawlspace, or enclosure) is: ❑ feet ❑ meters [] above or • below the LAG. 9 (see pages 1-2 of Instructions), the E2. For Building Diagrams 6-9 with permanent flood openings provided in Section A Items 8 and/or next higher floor (C2.b in applicable Building Diagram) of the building is: t feet [ meters above or ■ below the HAG. 1❑ above or ❑ below the HAG. ❑ above or D below the HAG. with the community's certify this information in Section G. E3. Attached garage (top of slab) is: 0 feet • meters E4. Top of platform of machinery and/or equipment servicing the building is: ❑ feet ❑ meters E5. Zone AO only: If no flood depth number is available, is the top of the bottom floor elevated in accordance floodplain management ordinance? ■', Yes ❑ No ❑' Unknown The local official must SECTION F — PROPERTY OWNER (OR OWNER'S AUTHORIZED REPRESENTATIVE) CERTIFICATION The property owner or owner's authorized representative who completes Sections A, B, and E for Zone A (without BFE) or Zone AO must sign here. The statements in Sections A, 6, and E are correct to the best of my knowledge ❑ Check here if attachments and describe in the Comments area. Property Owner or Owner's Authorized Representative Name: Address: City: State: ZIP Code: Signature: Date: Telephone: Ext.: Email: Comments: FEMA Form FF-206-FY-22-152 (formerly 086-0-33) (10/22) Page 4 of 19 ELEVATION CERTIFICATE IMPORTANT: MUST FOLLOW THE INSTRUCTIONS ON PAGES 9-19 Building Street Address (including Apt, Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No.: 1308 BAY STREET FOR INSURANCE COMPANY USE Policy Number: City: TYBEE ISLAND State: GA ZIP Code: 31328 Company NAIC Number: SECTION C — BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) 01. Building elevations are based on: ❑ Construction Drawings* ❑ Building Under Construction` *A new Elevation Certificate will be required when construction of the building is complete. C2. Elevations — Zones A1 —A30, AE, AH, AO, A (with BFE), VE, V1 —V30, V (with BFE), AR, AR/A, AR/AE, A99. Complete Items C2.a—h below according to the Building Diagram specified in Item A7. In Puerto Benchmark Utilized: RTK-GPS W/EGPS SOLUTIONS Vertical Datum: NAVD-88 /`./: Rico Finished Construction AR/A1—A30, AR/AH, AR/AO, only, enter meters. Indicate elevation datum ❑ NGVD 1929 r used for the elevations in items a) through h) below. NAVD 1988 ❑ Other. Datum used for building elevations must be the same as that used for the BFE. Conversion factor used? If Yes, describe the source of the conversion factor in the Section D Comments area. a) Top of bottom floor (including basement, crawlspace, or enclosure floor): 7.30 ❑ Check ►, Yes the feet measurement ❑ No used: meters b) Top of the next higher floor (see Instructions): 16.90 ►, feet ❑ meters c) Bottom of the lowest horizontal structural member (see Instructions): N/A ❑ feet ❑ meters d) Attached garage (top of slab): N/A ❑ feet ❑ meters e) Lowest elevation of Machinery and Equipment (M&E) servicing the building (describe type of M&E and location in Section D Comments area): 15.30 ,1 feet ❑ meters f) Lowest Adjacent Grade (LAG) next to building: ❑ Natural ►i Finished 6.60 h/ feet ❑ meters g) Highest Adjacent Grade (HAG) next to building: [] Natural Finished 7.10 ►/ feet ❑ meters h) Finished LAG at lowest elevation of attached deck or stairs, including structural support 7.10 ►1 feet ❑ meters SECTION D — SURVEYOR, ENGINEER,, OR ARCHITECT CERTIFICATION This certification is to be signed and sealed by a land surveyor, engineer, or architect information. 1 certify that the information on this Certificate represents my best efforts false statement may be punishable by fine or imprisonment under 18 U.S. Code, Were latitude and longitude in Section A provided by a licensed land surveyor? ❑ Check here if attachments and describe in the Comments area. Certifier's Name: THOMAS G. GAMMON License Number GA Section Iii authorized to interpret 1001. Yes PLS NO. ■ by state law to certify elevation the data available. I understand that any No 3005 Title: LAND SURVEYOR �0 R Cry c, IarFR Company Name: SHUPE SURVEYING COMPANY, P.C. �O Address: 3837 DARIEN HVVY. * P320FEseStL * City: BRUNSWICK State: GA ZIP Code: 31525 �so'� Sup\is& 42� �QS . GP,- Thomas G. Gammon Digitally signed by Thomas G. Gammon Signature: Date: 2023.11.0913:12:24-05'0© Date: 11/06/2023 Telephone: (912) 265-0562 Ext.: Email: ggammon@shupesurvey.com I Place Seal Here Copy all pages of this Elevation Certificate and all attachments for (1) community official, (2) insurance agent/company, and (3) building owner. Comments (including source of conversion factor in C2; type of equipment and location per 02.e; and description of any attachments): ITEM C2e IS A/C LOCATED OUTSIDE ON THE SIDE OF THE STRUCTURE. FEMA Form FF-206-FY-22-152 (formerly 086-0-33) (10/22) Page 3 of 19 U.S. DEPARTMENT OF HOMELAND SECURITY Federal Emergency Management Agency National Flood Insurance Program OMB Control No. 1660-0008 Expiration Dale: 06130/2026 ELEVATION CERTIFICATE IMPORTANT: MUST FOLLOW THE INSTRUCTIONS ON PAGES 9-19 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 Owners Name: AMERICA'S HOME PLACE Policy Number: A2. Building Street Address (including Apt.,, Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No.: 1308 BAY STREET Company NAIC Number. ZIP Code: 31328 City: TYBEE ISLAND State: GA A3. Property Description (e.g., Lot and Block Numbers or Legal Description) and/or Tax Parcel Number. LOT 8, BLOCK 3, A MAP OF THE TOWN OF TYBEE, BAY WARD A4. Building Use (e.g., Residential, Non -Residential, Addition, Accessory, etc.): RESDIENTIAL A5. Latitude/Longitude: Lat. 32.02134°N Long. 080.85856°W Horizontal Datum: ■ NAD 1927 1/ NAD 1983 ❑ WGS 84 (see Form pages 7 and 8). A6. Attach at least two and when possible four clear photographs (one for each side) of the building A7. Building Diagram Number. 6 A8. For a building with a crawlspace or enclosure(s): a) Square footage of crawlspace or enclosure(s): 986.00 sq. ft. b) Is there at least one permanent flood opening on two different sides of each enclosed area? c) Enter number of permanent flood openings in the crawlspace or enclosure(s) within 1.0 foot Non -engineered flood openings: 14 Engineered flood openings: 0 ►I Yes ■ No ■ N/A above adjacent grade: 0.00 sq. ft. d) Total net open area of non -engineered flood openings in A8.c: 17,605.00 sq. in. e) Total rated area of engineered flood openings in A8.c (attach documentation - see Instructions): f) Sum of A8.d and A8.e rated area (if applicable - see Instructions): 17,605.00 sq. ft. ❑ Yes ❑ No I N/A grade: N/A sq ft A9. For a building with an attached garage: a) Square footage of attached garage: N/A sq. ft. b) Is there at least one permanent flood opening on two different sides of the attached garage? c) Enter number of permanent flood openings in the attached garage within 1.0 foot above adjacent Non -engineered flood openings: N/A Engineered flood openings: N/A d) Total net open area of non -engineered flood openings in A9.c: N/A sq. in. e) Total rated area of engineered flood openings in A9.c (attach documentation - see Instructions): f) Sum ofA9.d and A9.e rated area (if applicable - see Instructions): N/A sq. ft. SECTION B - FLOOD' INSURANCE RATE MAP (FIRM) INFORMATION B1.a. NFIP Community Name: CITY OF TYBEE ISLAND B1.b. NFIP Community Identification Number. 135164 B2. County Name: CHATHAM B3. State: GA B4. Map/Panel No.: 13051 C 0213 95. Suffix: G B6. FIRM Index Date: 08/16/2018 B7. FIRM Panel Effective/Revised Date: 08/16/2018 88. Flood Zone(s): AE 89. Base Flood Elevation(s) (BFE) (Zone AO, use Base Flood Depth): 10 B10, Indicate the source of the BFE data or Base Flood Depth entered in Item B9: o FIS FIRM ■ Community Determined ❑ Other. B11. Indicate elevation datum used for BFE in Item B9: ❑ NGVD 1929 1:• NAVD 1988 • Other/Source: B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Designation Date: ❑ CBRS ❑ OPA Area (OPA)? I■ Yes No No 913, Is the building located seaward of the Limit of Moderate Wave Acton (LiMWA,)? i• Yes ► I FEMA Form. FF-206-FY-22-152 (formerly 086-0-33) (10/22) Page 2 of 19