Town of Kittery, Maine - Application Form

Town of Kittery, Maine

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Pre Application

Application Form

Application Completion

Instructions

Please submit this form using any of the contact methods provided below.

Instructions

Provider Name

Town of Kittery

Provider Mailing Address

Attn: John Brosnihan
200 Rogers Road
Kittery, ME 03904

Provider Phone

207-451-0829

Provider Email

KPA@KitteryME.org

Application

Application Status

Unknown

Application Type

Facility Use Permit

Category

Application Sticker Number

Applicant

First Name

Last Name

Contact Information

Mailing Street

Mailing City

Mailing State

Mailing Zip

Use Same Address Below

Local Street Number

Local Street Name

Local City

Local State

Local Zip Code

Home Phone (Summer)

Home Phone (Winter)

Mobile Phone

Work Phone

Email Address

Additional Information

Kittery Resident

Vessel

Reg or Doc #

If this is a state registered vessel, enter the registration number, starting with the state prefix. If this is a federally documented vessel, enter "US" followed by the documentation number.

Vessel Name

Vessel Usage

Size

Length

feet

inches

Beam

feet

inches

Characteristics

Year Built

Engine

Engine Horsepower

Mooring

Inspection

Seasonal Status

Acceptance


Terms and Conditions	I have read and understand the Town of Kittery Port Authority’s Rules and Regulations also understand that false information or violation of the Kittery Port Authority Rules and Regulations, Kittery Town Ordinances, State of Maine and Federal Maritime Laws could result in the loss of my mooring permit. The applicant hereby swears that all information submitted above is true to the best of his or her knowledge and that all mooring fees must be paid in full by April 15 annually. I have read and understand the Online Mooring User Terms and Conditions
Signature
Date

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