CITY OF BRIDGEPORT, CONNECTICUT

45 LYON TERRACE BRIDGEPORT, CONNECTICUT 06604

HARBOR COMMISSION

APPLICATION FOR INDIVIDUAL VESSEL MOORING SPACE AND PERMIT

TO BE COMPLETED AND MAILED OR RETURNED TO: Local Harbormaster, City of Applicant Name: Telephone No:
(Home)

Date Address: /
(Business)

Subject: Request for permission to place a seasonal mooring in

(Please indicate location on copy of chart section and attach - show ranges and bearings to prominent landmarks or sketch showing position relative to nearby buoys, channels, fairways and docks)

for 20

season

New

Renewal Address:

Relocation Request

Vessel Owner (if different) Telephone No: Vessels Name Make of Vessel Length Beam Draft
(Home)

/
Connecticut Registration or Documentation #

(Business)

Type Displacement, lbs. Weight @ ft. ft. of Size Year last inspected

(Cruiser, Sail, etc.)

Mooring Description: Anchor Type Email Address (for general and emergency information) Chain(s) Length(s)

in. Diameter

Pendant(s) Length Year Installed (if applicable)

Dinghy Location or Access (I understand that my vessel must be properly registered in Connecticut or be documented with a Connecticut Certificate of Decal in order to
obtain a mooring space.)
Signature of Mooring Owner

Note: Moorings should have adequate ground tackle, chafing gear and scope for the area and conditions expected. Mooring scope must not allow infringement on other moorings with vessel attached. Under NO conditions are moorings allowed that will permit the vessel to swing into Corps of Engineers maintained navigational channels by action of wind or current or into established fairways, wharfs, docks or floats. Mooring buoys should be identified with boat name. The weight of the anchor should also be clearly painted on the mooring buoy. Vessels MUST comply with the applicable requirements of Inland Navigational Rule 30 (Lights for anchored vessels). Mooring and anchoring is prohibited over submarine cable areas. The owner herein of the above described vessel hereby approves and submits this application and agrees to comply with all appropriate statutes and laws of the state of Connecticut and the City of Bridgeport mooring rules and regulations and will indemnify and save harmless the City of Bridgeport, as permit grantor, for injuries or damages sustained as a result of or arising out of non-compliance with the requirements written herein or of such applicable laws, rules and regulations referred to herein. It is also understood that the Harbormaster may require insurance coverage and evidence of same at the Citys discretion.

------------------------------------------------------------------------------------------------------------------------------------------------------Do not write in this space - For Harbormasters use only Position Assigned Number Assigned Approved
(Harbormaster)

Ground Tackle Inspected

Date

Mooring permits are valid for period of one year and are not transferable to another party.
Make out in Duplicate: (Yellow) Harbormaster; (White) Applicant