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Home My WebLink AboutElevation Certificate 2022-9-5 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(includin Apt.,Unit,Suite,and/or Bldg.No.)or P.O. Route and Box No. Policy Number. City State ZIP Code Company NAIC Number 1/ y /05-73 SECTION C—BUILDING ELEVATION INFORMATION(SURVEY REQUIRED) C1. 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. Elevations—Zones Al—A30,AE,AH,A(with BFE),VE,V1—V30,V(with BFE),AR,AR/A,AR/AE, AO. Compiete Items C2.a—h below according to the building dia ram specified in Item A7.In Puerto Ri Benchmark Utilized: ,li'j/3 9 A/ /lnk�s ;y l/;rtical Datum: 20, v Indicate elevation datum used for the elevations in items a)through h)below. IEfr ❑ NGVD 1929 X NAVD 1988 ❑ Other/Source: _ 2022 Datum used for building elevations must be the same as that used for the BFE. 1C Vl O a) Top of bottom floor(including basement,crawlspace,or enclosure floor) 7¢ 34 AMEN b) Top of the next higher floor 8 3 , 72 feet ❑ meters c) Bottom of the lowest horizontal structural member(V Zones only) ❑ feet ❑meters d) Attached garage(top of slab) 7.3 . 96 feet ❑ meters e) Lowest elevation of machinery or equipment servicing the building feet meters 7:3 (Describe type of equipment and location in Comments) - ❑ f) Lowest adjacent(finished)grade next to building(LAG) 7 SI ,�;] feet C] meters g) Highest adjacent(finished)grade next to building(HAG) 7¢,,n 5-- E§ feet ❑ meters h) Lowest adjacent grade at lowest elevation of deck or stairs,including 73 �"� feet ❑ meters 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. l certify that the information on this Certificate represents my best efforts to interpret the data available.l understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001. Were latitude and longitude in Section A provided by a licensed land surveyor? ❑Yes RNo ❑Check here if attachments. Certifier's Name License Number MICHAEL MASTROGIACOMO,P.E.,L.S. NYS PE 083853 of Nay Title �P� tAASTR�yO,p PRESIDENT Ua - Company Name MASTROGIACOMO ENGINEERING PC LU Ckf Address �2 ? 10 MIDLAND AVE,SUITE 204A s 083853 F. City State ZIP Code pRCFESS1OrA PORT CHESTER New York 10573 Signature Data Telephone EA. � f SZt-,Zz- 914.920.6372 Copy all pages of this Elevation Certificate and all attachments for(1)community official,(2)insurance agent/company,and(3)building owner. Comments(including type of equipment and location,per C2(e),if applicable) ele(,-,c/; ate, 7 FEMA Form 086-0-33(12/19) Replaces all previous editions. Form Page 2 of 6 BUILDING PHOTOGRAPHS OMB No. 1660-0008 ELEVATION CERTIFICATE See Instructions for Item A6. Expiration Date: November 30,2022 IMPORTANT:In these spaces,copy the corresponding information from Section A. FOR INSURANCE COMPANY USE Building Stre Address(including Apt, Unit Suite,and/or Bldg.No.)or P.O.Route and Box No. Policy Number. City � � // St to ZIP e Company NAIC Number lDo 0 73 If using the Elevation Certificate to obtain NFIP flood insurance, affix at least 2 building photographs below according to the instrudons for Item A6.Identify all photographs with date taken;'Front View"and"Rear Yew';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 ftt on this page,use the Continuation Pegs. PhobD One Caption " Clear Photo One H1+x } 11�,yq:�•1 i,-L. w' tv�,d-,rt -ar •`' far •+'Y�d�1,z,.h,�+rc `..ry,:9►4• `7i.'a�.4 - '...' _ - 6 Cp�t.�+'r,�nlnr :.t �r i'F.,�g car1"�C�?.t,r••� ^ i.. �`' . ys�'j�. ;.7 •.,�'� 1 �1 L=^i:.-�1�P"'r�.ayl�'�+,_��is `� '+ ,�-,t,�#' + �i7�y�;'i � �.. rk ♦`^ .�: Photo Two Caption �� Clear Photo Two FEMA Form 086-0-33(12/19) Replaces all previous editions. Form Page 5 of 6 U.S. DEPARTMENT OF HOMELAND SECURITY OMB No. 1660-0008 Federal Emergency Management Agency Expiration Date:November 30,2022 National Flood Insurance Program - 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: A2. Building Street Address(including Apt.,Unit,Suite,and/or Bldg. No.)or P.O. Route and Company NAIC Number. Box No.�� '2 l�6'DO :� City State ZIP Code /U' /a5"73 A3. Propertf Description(Lot and Block Numbers,Tax Parcel Number,Legal Description,etc.) A4. Building Use(e.g.,Residential, Non-Residential,Addition,Accessory,etc.) A5. Latitude/Longitude: Lat.fl,0/02 6( Long.-73., 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. AT Building Diagram Number LA A8. For a building with a crawlspace or enclosure(s): a) Square footage of crawlspace or enclosure(s) �j/,¢ . sq ft b) Number of permanent flood openings in the crawlspace or enclosure(s)within 1.0 foot above adjacent grade c) Total net area of flood openings in AB.b sq in d) Engineered flood openings? ❑Yes ❑ No A9.For a building with an attached garage: a) Square footage of attached garage so ( .0 sq ft b) Number of permanent flood openings in the attached garage within 1.0 foot above adjacent grade c) Total net area of flood openings in A9.b O sq in d) Engineered flood openings? ❑Yes IS-No SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION B1.NFIP Community Name&Community Number B2.County Name B3. State Y T, i 1CC e_ J 2 ��t C1� 360930 \AJC,_S eS�r 0, 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) � �Uo Revised Date '36i15u2_s,t F B10. Indicate the source of the Base Fkxxi Elevation(BFE)data or base flood depth entered in Item 139: ❑ FIS Profile ZJ FIRM ❑Community Determined ❑ Other/Source: 1311. Indicate elevation datum used for BFE in Item B9: ❑ NGVD 1929 0 NAVD 1988 ❑ Other/Source: B12. Is the building located in a Coastal Barrier Resources System(CBRS)area or Otherwise Protected Area(OPA)? ❑Yes K No Designation Date: ❑ CBRS ❑ OPA FEMA Form 086-0-33(12119) Replaces all previous editions. Form Page 1 of 6