262 BAYSIDE DR•
U.S. DEPARTMENT OF HOMELAND SECURITY
Federal Emergency Management Agency
National Flood Insurance Program
ELEVATION CERTIFICATE
OMB No. 1660-0008
Expiration Date: November 30, 2018
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
Helen Furfari
Policy Number:
A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and
Box No.
262 Bayside Drive
Company NAIC Number:
City State ZIP Code
Clearwater Florida 33767
A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.)
Lot L, Block 1, Unit A Bayside Subdivision Parcel ID #08-29-15-04986-001-0120
A4. Building Use (e.g.,
A5. Latitude/Longitude:
A6. Attach at least
A7. Building Diagram
A8. For a building
a) Square footage
b) Number of permanent
c) Total net area
d) Engineered
A9. For a building with
a) Square footage
b) Number of permanent
c) Total net area
d) Engineered
Residential, Non -Residential, Addition, Accessory, etc.)
Lat. 27°58'10.7" N Long. 82°49'14.6" W
Residential
Horizontal
Datum:
insurance.
above
❑ NAD 1927
adjacent grade
grade N/A
x NAD 1983
10
2 photographs
Number
with a crawlspace
of crawtspace
flood
of flood openings
flood openings?
an attached
of attached
flood
of flood openings
flood openings?
of the building if the
7
Certificate is being used to obtain flood
3550.00 sq ft
or endosure(s):
or enclosure(s)
openings in the crawlspace
in A8.b
or endosure(s)
2304.00 sq in
within 1.0 foot
foot above adjacent
in
N/A sq ft
x Yes ❑ No
garage:
garage
openings in the attached garage within 1.0
in A9.b N/A sq
D Yes x No
SECTION B — FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
B1. NFIP Community Name & Community Number
City of Clearwater 125096
B2. County Name
Pinellas (Independent City)
B3. State
Florida
84. Map/Panel
Number
12103C102
B5. Suffix
G
86. FIRM Index
Date
08-18-2009
B7, FIRM Panel
Effective!
Revised Date
09-03-2003
B8. Flood
Zone(s)
AE
B9. Base Flood E evation(s)
(Zone AO, use Base Flood Depth)
11
B10. Indicate the source
❑ FIS Profile
B11. Indicate elevation
812. Is the building
Designation
of the
Base Flood Elevation
❑ Community Determined
for BFE in Item B9:
Coastal Barrier Resources
❑
(BFE) data
or base flood
❑ Other/Source:
1929
:'CBRS)
---"�
depth entered in Item B9:
x FIRM
datum used
located in a
Date
Other/Source
Protected
r NGVD
x NAVD 1988
System
CBRS
area or Otherwise
Area (WA)?
0 Yes X No
FEMA Form 086-0-33
Replaces ali s editions.
Form Page 1 of 6
2,2a /s'- 067-7 'Fgd
fsi -J kyc,d,
R,E10E VE [1 9Y- B
MAY 9 2O1
CITY OF
SNERgl
ELEVATION CERTIFICATE
OMB No. 1660-0008
IMPORTANT: In
--.,-.•�...... vaaw. ..v. cn II., I JV, cv IU
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.
262 Bayside Drive
Policy Number:
City State ZIP Code
Clearwater Florida 33767
Company NAIC Number
SECTION C — BUILDING ELEVATION INFORMATION (SURVEY REQUIRED)
Cl. 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, A (with BFE), VE, V1 V30, V (with BFE), AR, AR/A, ARAE, AR/A1—A30,
Complete Items C2.a—h below according to the building diagram specified in Item A7. In Puerto Rico only,
Benchmark Utilized: "AURAL A" PID AG0298 Vertical Datum: NAVD 1988
x
Finished Construction
AR/AH, AR/AO.
enter meters.
Indicate elevation datum
❑ NGVD 1929
used
x
for the elevations in items a) through h) below.
NAVD 1988 ❑ Other/Source:
Datum used for building elevations must be the same as that used for the BFE.
Check
a) Top of bottom floor (induding basement, crawispace, or enclosure floor) 5.9
x
the measurement used.
feet ❑ meters
b) Top of the next higher floor 16.1
x
feet ❑ meters
c) Bottom of the lowest horizontal structural member (V Zones only) N/A
❑
feet ❑ meters
d) Attached garage (top of slab) N/A
❑
feet ❑ meters
e) Lowest elevation of machinery or equipment servicing the building
(Describe type of equipment and location in Comments) 4.6
x
feet ❑ meters
f) Lowest adjacent (finished) grade next to building (LAG) 5.3
x
feet ❑ meters
g) Highest adjacent (finished) grade next to building (HAG) 5.8
x
feet ❑ meters
h) Lowest adjacent grade at lowest elevation of deck or stairs, including
structural support 5.2
x
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.
I 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 /8 U.S. Code, Section 1001.
Were latitude and longitude in Section A provided by a licensed land surveyor? 0 Yes ❑ No ❑ Check here -if attachments.
Certifier's Name License Number
Dennis J. Eyre 2865
Title
Professional Surveyor and Mapper
_
Company Name
Geodata Services, Inc.
Address
1166 Kapp Drive
City
Clearwater
State ZIP Code
Florida 33765
Signature
Date Telephone Ext.
..4�/111. 05-25-2018 (727) 447-1763
Copy all p• rs levationA ficaa . d all attachments for (1) community official, (2) insurance agent/company, and (3) building owner.
Comments (including type o ...up (art and location, per C2(e), if applicable)
A5. Determined with GIS program "Google Earth".
A8.d) 10 total engineered flood vents. "Smart Vents", 8 model number 1540-521, each providing 400 square feet of coverage, and 2
model number 1540-520, each providing 200 square feet of coverage, for a total of 3600 square feet of coverage.
C2.e) Bottom of elevator pit elevation, located in ground floor enclosure.
The air conditioning platforms <&ievations are: Right side of house = 13,0 €_et ;ide of house = 12.9.
The bottom of electric meter': _ x. _eft side of house, elevation = 12.1.
FEMA Form 086-0-33 (7/151
Replaces all previous., ,,a
s
Page 2 of 6
ELEVATION CERTIFICATE
OMB No. 1660-0008
Expiration Date: November 30. 2018
IMPORTANT: In these spaces, copy the corresponding information from Section A.
FOR INSURANCE COMPANY USE
Building Street Address (induding Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No.
262 Bayside Drive
Policy Number.
City State ZIP Code
Clearwater Florida 33767
Company NAIC Number
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
complete Sections A, B,and C. For Items E1—E4, use natural grade, if available. Check the measurement
enter meters.
El. Provide elevation information for the following and check the appropriate boxes to show whether
the highest adjacent grade (HAG) and the lowest adjacent grade (LAG).
a) Top of bottom floor (induding basement,
crawlspace, or enclosure) is ❑ feet ❑ meters
LOMA or LOMR-F request,
used. In Puerto Rico only,
the elevation is above or below
❑ above or ❑ below the HAG.
or
❑ below the LAG.
9 (see pages 1-2 of Instructions),
❑ above or ❑below the HAG.
❑above or ❑below the HAG.
❑ above or ❑below the HAG.
with the community's
certify this information in Section G.
b) Top of bottom floor (induding basement,
crawlspace, or enclosure) is ❑ feet ❑ metersabove
E2. For Building Diagrams 6-9 with permanent flood openings provided in Section A Items 8 and/or
the next higher floor (elevation C2.b in
the diagrams) of the building is ❑ feet ■ meters
E3. Attached garage (top of slab) is ❑ feetmeters
❑
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 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 or Owner's Authorized Representative's Name
Address City State ZIP Code
Signature Date Telephone
Comments
❑ Check here if attach;
Form 086-0-33 (7/15)
Reolaces all previous editions
Form
ELEVATION CERTIFICATE
OMB No. 1660-0008
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.
262 Bayside Drive
Policy Number:
City State ZIP Code
Clearwater Florida 33767
Company NAIC Number
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 04—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: ❑
G8. Elevation of as -built lowest floor (including
of the building:
G9. BFE or (in Zone AO) depth of flooding at the
G10. Community's design flood elevation:
New Construction ❑ Substantial Improvement
basement)
❑ feet
❑ feet
❑ feet
❑ meters Datum
building site:
❑ meters Datum
❑ meters Datum
Local Official's Name Title
Community Name Telephone
Signature Date
Comments (including type of equipment and location, per C2(e), if applicable)
FEMA
h..33 (7/151
aces all previous editions.
Check here d attachments.
Form Page 4 of e.
ELEVATION CERTIFICATE
BUILDING PHOTOGRAPHS
See Instructions for Item A6.
OMB No. 1660-0008
Expiration Date: N
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.
262 Bayside Drive
Policy Number:
City State ZIP Code
Clearwater Florida 33767
Company NAIC Number
If using the Elevation Certificate to obtain NFIP flood insurance, affix at least 2 budding 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.
10* -vr - ;RR,
Photo One
Photo One Caption Front View 05/24/2018 Clear Photo One
e �[' lel
�'.gS-b
I
Clear Photo Two
Pnotu Two
_
Photo Two Caption Rear View 05/24/2018
FEMA Form 086-0-' > 7(15)
Replaces all r re;vious editions.
Form Page 5 of 6
ELEVATION CERTIFICATE
BUILDING PHOTOGRAPHS
Continuation Page
OMB No. 1660-0008
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.
262 Bayside Drive
Policy Number:
City State ZIP Code
Clearwater Florida 33767
Company NAIC Number
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.
. f
{
Photo Three
Photo Three Caption Left Side View 05/24/2018 Clear Photo Three
i fir/
_ y .-<._‘-_,
Photo Fax
Photo Four Caption Right Side View and Typical Flood Vent 05/24/2018 Ciear Photo Four
Pate Pram tlRfLfLRA 17t1F,1
Reniacrac ail nrt?vini Mitinns
Form Pane 6 of 6
.. . �
2fi2 BAYSfQE DR
BCP2015-0C7$8
E/C
FURFARI, HELEN
Zoning: Low Medium Density Atlas #: 2766
0
„, .,
U.S. DEPARTMENT OF HOMELAND SECURITY
Federal Emergency Management Agency
National Flood Insurance Program
ELEVATION CERTIFICATE
Important: Follow the instructions on pages 1-9.
OMB No. 1660-0008
Expiration Date: November 30, 2018
Copy all pages of this Elevation Certificate and all attachments for (1) community official, (2) insurance agenUcompany, and (3) building ownec
SECTION A— PROPERTY INFORMATION FOR INSURANCE COMPANY USE
A1. Building Owner's Name Policy Number:
HELEN and MARIO FUFARI
A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Company NAIC Number:
Box No.
262 BAYSIDE DRIVE
Ci� State ZIP Code
CLEARWATER Florida 33767
A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.)
LOT L, BLOCK 1, UNIT A OF BAYSIDE SUBDIVISION (PLAT BOOK 36, PAGES 57 & 58)
A4. Building Use (e.g., Residential, Non-Residential, Addition, Accessory, etc.) RESIDENTIAL
A5. Latitude/Longitude: Lat.27°58'10.4” Long.82°49'15.5" Horizontal Datum: ❑ NAD 1927 ❑x 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 �
A8. For a building with a crawlspace or enclosure(s):
a) Square footage of crawlspace or enclosure(s) 4,905 sq ft
b) Number of permanent flood openings in the crawlspace or enclosure(s) within 1.0 foot above adjacent grade 16
c) Total net area of flood openings in A8.b 2,247 sq in
d) Engineered flood openings? ❑ Yes 0 No
A9. For a building with an attached garage:
a) Square footage of attached garage Sq �
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 sq in
d) Engineered flood openings? ❑ Yes ❑ No
SECTION B— FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
61. NFIP Community Name & Community Number B2. County Name B3. State
CITY OF CLEARWATER 125096 PINELLAS Florida
84. Map/Panel B5. Suffix B6. FIRM Index B7. FIRM Panel 68. Flood Zone(s) B9. Base Flood Elevation(s)
Number Date Effective/ (Zone AO, use Base
Revised Date Flood Depth)
12103C0102 G 08/18/2009 09/03/2003 AE 11'
B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item B9:
� FIS Profile ❑x FIRM ❑ Community Determined ❑ Other/Source:
B11. Indicate elevation datum used for BFE in Item B9: ❑ NGVD 1929 ❑x NAVD 1988 ❑ Other/Source:
612. 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
.._
� -- _ -- —
� �
ELEVATION CERTIFICATE OMB No. 1660-0008
FYnirafinn 1'l�tc• Hln..e.,,�,s� �n �n� n
_"r.._..._.. � ...... .......���..v� ., �v
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.
262 BAYSIDE DRIVE
��h' State ZIP Code Company NAIC Number
C�EARWATER Florida 33767
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 A1—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: AURAL "A" Vertical Datum:
Indicate elevation datum used for the elevations in items a) through h) below.
❑ NGVD 1929 Ox 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) 5. 85 0 feet ❑ meters
b) Top of the next higher floor 14. 81 � feet � meters
c) Bottom of the lowest horizontal structural member (V Zones only) N�A. �x feet � meters
d) Attached garage (top of slab) 5. 85 ��et � meters
e) Lowest elevation of machinery or equipment servicing the building ❑x feet ❑ meters
(Describe type of equipment and location in Comments)
� Lowest adjacent (finished) grade next to building (LAG) 5 � �X feet � meters
g) Highest adjacent (finished) grade next to building (HAG) 5 4 � feet ❑ meters
h) Lowest adjacent grade at lowest elevation of deck or stairs, including 5� �x 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.
I cerfify that the information on this Certificafe represents my best efforts to interpret the data available. I understand that any fa/se
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 ^�
EDWARD C. ELLIOTT 3g$3 4���9 ;�` p� ��3 �j`� f` ,� ;
Title R ,<'3 .• '
PROFESSIONAL SURVEYOR AND MAPPER � ¢"�, � • (. t'•• ,
;a ��•• � ' �4 {%" �•/l
Company Name �° • � �g � . -� -
ARCTURUS GROUP, LLC �° � : — : c''
t�� .
ix � � .
Address �= � � e ' • =
2328 U.S. HIGHWAY 19 �
� t� � .' c�� ,
. t��".'�
City State ZIP Code o ,••' • � ' � � �'
HOLIDAY Florida 34691 �'r�� ,� �� Q� f:g�`, .'
Signature �/�� Date Telephone � � ,
08/17/2016 (727) 940-8888
Copy all ages of this Elevation Certificate and all attachments for (1) communiry official, (2) insurance agenUcompany, and (3) building owner.
Comments (inGuding type of equipment and location, per C2(e), if applicable)
1. THERE IS NO MACHINERY OR EQUIPMENT SERVICING THE BUILDING AS OF THE DATE OF THIS CERTIFICATE
2. THE GARAGE IS NOT AN ATTACHED GARAGE BECAUSE IT IS LOCATED BENEATH THE ELEVATED FLOOR
OF A SECOND STORY.
r��v�H rvrm �ao-u-o3 �rna� Keplaces all previous editions. �- Form Page 2 of 6