039-041elevation certificate Building Atwood DrU.S. DEPARTMENT OF HOMELAND SECURITY
Federal Emergency Management Agency
National Flood Insurance Program
A1. Building Owner's Name Atwood Drive LLC
ELEVATION CERTIFICATE
Important: Read the instructions on pages 1-9.
SECTION A-PROPERTY INFORMATION
A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P .0. Route and Box No.
Atwood Drive
City Northampton State MA ZIP Code 01060
A3. Property Description (Lot and Block Numbers, Tax Paree! Number, Legal Description, etc.)
Assessor's Map-Lots: 39-060, 39-061, 39-062, 39-063, 46-014
A4. Building Use (e.g., Residential, Non-Residential. Addition, Accessory, etc.) Non-Residential I Office
OMB No. 1660-0008
Expires March 31, 2012
AS. Latitude/Longitude: Lat. 42"18'11.2" Long. -072"37'22.0" Horizontal Datum: D NAD 1927 IZI NAD 1983
AS. Attach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance.
A7. Building Diagram Number fA
AS; For a building with a crawlspace or enclosure(s): A9. For a building with an attached garage:
a) Square footage of crawlspace or enclosure(s) N/A sq ft a) Square footage of attached garage J:ll8 sq ft
b) No. of permanent flood openings in the crawispace or b) No. of pennanent flood openings in the attached garage
enclosure(s) within 1.0 foot above adjacent grade Q within 1.0 foot above adjacent grade Q
c) Total net area of flood openings in AB.b N/A sq in c) Total net area of flood openings in A9.b .t:![8 sq in
d) Engineered flood openings? D Yes 181 No d) Engineered flood openings? D Yes IZI No
SECTION B • FLOOD INSURANCE RATE MAP (FIRM) INFORMATION
81. NFIP Community Name & Community Number
City of Northampton 250167
82. County Name
Hampshire
83. State
MA
84. Map/Panel Number 85. Suffix 86. FIRM Index 87. FIRM Panel 88. Flood 89. Base Flood Elevation(s) (Zone
250167 0002 A Date Effective/Revised Date Zone(s) AO, use base flood depth)
04-03-1978 04-03-1978 A13 123'
810. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item 89.
181 FIS Profile D FIRM D Community Determined D Other (Describe) __
811. lndlcateelevationdatumusedforBFEinltemB9: 181 NGVD1929. D NAV01988 0 Other(Describe) __
812. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? D Yes
Designation Date __ D CBRS D OPA
1Z1 No
SECTION C -BUILDING ELEVATION INFORMATION (SURVEY REQUIRED)
C1. Building elevations are based on: IZI Construction Drawings" D Building Under Construction* D Finished Construction
*A new Elevation Certificate will be required when construction of the building is complete.
C2. Elevations -Zones A 1-A30, AE, AH, A (with BFE), VE, V1-V30, V (with BFE), AR, ARIA, AR/AE, AR/A1-A30, AR/AH, AR/AO. Complete Items C2.a-h
below according to the building diagram specified in Item A7. Use the same datum as the BFE.
Benchmark. Utilized RM9 Vertical Datum NGVD 1929.
Conversion/Comments
a) Top of bottom floor (including basement, crawlspace, or enclosure floor) ___in.L_
b) Top of the next higher floor ~._9 _
c) Bottom of the lowest horizontal structural member (V Zones only) NIA . __
d) Attached garage (top of slab) NIA . __
e) Lowest elevation of machinery or equipment servicing the building ___in._3_· _
(Describe type of equipment and location in Comments)
f) Lowest adjacent (finished) grade next to building (LAG) __ill._5 _
g) Highest adjacent (finished) grade next to building (HAG) ~._5 _
h) Lowest adjacent grade at lowest elevation of deck or stairs, including ___.111._o _
structural support
Check the measurement used.
181 feet D meters (Puerto Rico only)
181 feet D meters (Puerto Rico only)
D feet D meters (Puerto Rico only)
D feet · D meters. (Puerto Rico only)
181 feet D meters (Puerto Rico only)
181 feet
181 feet
181 feet
D meters (Puerto Rico only)
D meters (Puerto Rico only)
D meters (Puerto Rico only)
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
infonnation. 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 by1ine or imprisonment under 18 U.S. Code, Section 1001.IZI
Check here if comments are provided on back of form. Were latitude and longitude in Section A provided by a
licensed land surveyor? 181 Yes · D No
Certifier's Name Daniel F. Stasz License Number 47160
Title Licenced Land Surveyor I Owner Company Name Northeast Survey Consultants, PC
City Easthampton State MA ZIP Code 01027
Signature Telephone (413) 203-5144
FEMA Form 81-31, Mar 09 See reverse side for continuation. Replaces all previous editions
IMPORTANT: In these spaces, copy U,e corresponding Information from Section A.
Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.} or P.O. Route and Box No.
Atwood Drive
City Northampton State MA ZIP Code 01060
SECTION D -SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED).
Copy both sides of this Elevation Certificate for (1) community official, (2) insurance agent/company, and (3) building owner.
9/9~,,
ate
O Check here if attachments
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.
E1. Provide elevation information for the following and check the appropriate boxes to show whether the elevation is above or below the highest 1:1djacent
grade (HAG) and the lowest adjacent grade (LAG}.
a} Top of bottom floor (including basement, crawlspace, or enclosure} is __ .__ D feet D meters D above or D below the HAG.
b) Top of bottom floor (including basement, crawlspace, or enclosure} is --·--D feet O meters O above or D below the LAG.
E2. For Building Diagrams 6-9 with permanent flood openings provided in Section A Items B and/or 9 (see pages 8-9 of Instructions), the next higher floor
(elevation C2.b in the diagrams} of the building is __ .__ D feet D meters D above or D below the HAG.
E3. Attached garage (top of slab} is __ .__ D feet D meters D above or D below the HAG.
E4. Top of platform of machinery and/or equipment servicing the building is --·--D feet D meters O above or O below the HAG.
ES. 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? 0 Yes O No O Unknown. The local official must certify this infomiation in Section G.
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's or Owner's Authorized Representative's Name
Daniel F. Stasz
Address P.O. B City Easthampton State MA ZIP Code 01027
Signature Date Telephone (413) 203-5144
Comments
D Check here if attachments
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 GB and G9.
G1. ·D The infomiation 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. D 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. D The following infom,ation (Items G4-G9~ is provided for community floodplain management purposes.
G4. Permit Number GS. Date Pemiit Issued G6. Date Certificate Of Compliance/Occupancy Issued
· G7. This permit has been issued for: D New Construction O Substantial Improvement
GB. Elevation of as-built lowest floor (including basement) of the building: --·--0 feet O meters (PR) Datum __
G9. BFE or (in Zone AO) depth of flooding at the building site: __ __ D feet D meters (PR) Datum __
GtO. Cory1munity's design flood elevation ____ 0 feet D meters (PR) Datum _. __
Local Official's Name Title
Community Name Telephone
Signature Date
Comments
------------------------------------------0 Check here if attachments
FEMA Form 81-31, Mar 09 Replaces all previous editions