The flood insurance is in no way limited to coastal areas (or in particular to NC). Ever hear of flooding along the Mississippi? And every year, when the snows melt, flooding in places up north? And earlier last year in Colorado? It's always interesting how people living in other places (other than the coast) seem to think that insurance rates should go up for those living at the coast. But they are just fine with tornado damage, forest fires etc. being covered and with the costs spread across the country, including to those living on the coast. And those of you who think you are on high ground and have nothing to worry about, nor any need for flood insurance, you just haven't gotten the right weather conditions. And when you do, you'll find that suddenly, flood zones have been re-designated and you are in one That's what happened here in NC in my area. Anywhere in the country, drainage systems are based on previous experience, but if you have an unusual situation in amount of water from rain, hurricanes, snow melt, etc. and the drainage in your area is limited by development, or systems coming plugged with fallen trees, growth, or mud slides, etc., you will have flooding.
Also, I would say that the Pamlico Sound and Pamlico River are both quite suitable for 40 ft. boats, as long as you don't have deep draft. Boats, drawing 5ft. or less, do just fine as long as they pay attention to the charts. The area is largely undeveloped however, so if you are looking for big city lights nearby, you won't find them. Washington has a number of marinas and several boat yards. Also, several nice waterfront developments (Pamlico Plantation, Cypress Landing). Greenville, 20 miles to the west has excellent medical facilities, air service, and a good sized university (East Carolina University).