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Home My WebLink AboutMiscellaneous - 49 ELMWOOD STREET 4/30/2018 (3) Conservation 49 Elmwood Street 4XVEPARTMENT OF HOMELAND SECURITY OMB No. 1660-0008 Federal Emergency Management Agency ,Expiration Date: November 30 2018 9 National Flood Insurance Program P 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: Susan Hennessey A2. Building Street Address(including Apt., Unit,Suite,and/or Bldg. No.)or P.O. Route and Company NAIC Number: Box No. 49 Elmwood Street City State ZIP Code North Andover Massachusetts 01845 A3. Property Description(Lot and Block Numbers,Tax Parcel Number, Legal Description,etc.) Tax Parcel Map 3 Lot 12 A4. Building Use(e.g., Residential, Non-Residential,Addition,Accessory,etc.) Residential by observation at time of survey A5. Latitude/Longitude: Lat.42-41-42.5 Long,71-08-28.7 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 7 A8. For a building with a crawlspace or enclosure(s): a) Square footage of crawlspace or enclosure(s) 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 A8.b sq in d) Engineered flood openings? ❑Yes ❑ No A9. For a building with an attached garage: a) Square footage of attached garage 287 sq ft b) Number of permanent flood openings in the attached garage within 1.0 foot above adjacent grade 0 c) Total net area of flood openings in A9.b 0 sq in d) Engineered flood openings? ❑Yes ❑ No SECTION B—FLOOD INSURANCE RATE MAP(FIRM) INFORMATION B1. NFIP Community Name&Community Number B2.County Name B3. State North Andover-250098 Essex Massachusetts B4. Map/Panel B5.Suffix B6. FIRM Index B7. FIRM Panel B8.Flood Zone(s) B9. Base Flood Elevation(s) Number Date Effective/ (Zone AO,use Base Revised Date Flood Depth) 0209 F 07/03/2012 07/03/2012 AE 34' 1310. 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 ❑ NAVD 1988 ❑ Other/Source: B12. Is the building located in a Coastal Barrier Resources System(CBRS)area or Otherwise Protected Area(OPA)? ❑Yes ❑ No Designation Date: ❑ CBRS ❑ OPA FEMA Form 086-0-33(7/15) Replaces all previous editions. Form Page 1 of 6 OMB No. 1660-0008 ELEVATION CERTIFICATE Expiration Date: November 30,2018 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: 49 Elmwood Street City State ZIP Code Company NAIC Number North Andover Massachusetts 01845 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,AR/A1—A30,AR/AH,AR/AO. Complete Items C2.a—h below according to the building diagram specified in Item A7. In Puerto Rico only,enter meters. Benchmark Utilized: RTK multiple observations average 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. Check the measurement used. a) Top of bottom floor(including basement,crawlspace,or enclosure floor) 33 7 ❑ feet ❑ meters b) Top of the next higher floor 42. 2 ❑ feet ❑ meters c) Bottom of the lowest horizontal structural member(V Zones only) ❑ feet ❑ meters d) Attached garage(top of slab) 33 7 ❑ feet ❑ meters e) Lowest elevation of machinery or equipment servicing the building 38. 3 ❑ feet ❑ meters (Describe type of equipment and location in Comments) f) Lowest adjacent(finished)grade next to building(LAG) 33 5 ❑ feet ❑ meters g) Highest adjacent(finished)grade next to building(HAG) 39 1 ❑ feet ❑ meters h) Lowest adjacent grade at lowest elevation of deck or stairs, including 38 2 ❑ 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. 1 certify that the information on this Certificate represents my best efforts to interpret the data available. /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 ❑No ❑Check here if attachments. Certifier's Name License Number Michael J.Sergi 33191 t�V11 AOFk`sd' Title y Professional Land Surveyor 2� MICHAEL Oy Company Name 3 Rt Christiansen&Sergi Inc. O SERGI M Address v No.33191 co 160 Summer Street A,QO �Qv FESSo City State ZIP Code l9ND SURN Haverhill Massachusetts 01830 Signature Date Telephone Michael J. Sergi 11/15/2017 (978)373-0310 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) Lowest machinery is breaker panel. FEMA Form 086-0-33(7/15) 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 30,2018 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: 49 Elmwood Street City State ZIP Code Company NAIC Number North Andover Massachusetts 01845 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. 1 Photo One Photo One Caption Front 11/9/17 f . [11N t r _ Photo Two Photo Two Caption Right 11/9/17 FEMA Form 086-0-33(7/15) Replaces all previous editions. Form Page 5 of 6 BUILDING PHOTOGRAPHS OMB No. 1660-0008 ELEVATION CERTIFICATE Continuation Page Expiration Date: November 30,2018 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: 49 Elmwood Street City State ZIP Code Company NAIC Number North Andover Massachusetts 01845 If submitting more photographs than will fit on the preceding page, affix the additional photographs below. 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. i I . ..e Photo One Photo One Caption Rear 11/9/17 Photo Two Photo Two Caption Left 11/9/17 FEMA Form 086-0-33(7/15) Replaces all previous editions. Form Page 6 of 6