Town of Provincetown, MA
 
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Instructions

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

Instructions
Provider Name
Town of Provincetown
Provider Mailing Address
260 Commercial Street

Provincetown, MA 02657
Provider Phone
(508) 487-7030
Provider FAX
Provider Email
PWhinn@provincetown-ma.gov

Application

Reference Number
DVGMSHHD
Application Status
Unknown
Application Phase
Other Public Access
Application Type
Mooring Permit
Application Subtype
Permit Number
Is this a Holding Mooring (No Boat)?
Please circle one of the following:

No

Yes

PLEASE NOTE: There are required fields on this application about your boat. If you choose the "no boat" option here, you'll still need to enter information in those required fields which will be ignored. You can enter "NA" in non-numeric fields, and can enter a "1" in numeric fields.

Applicant

Mobile Phone
First Name
Middle Name
Last Name
Contact Information
Local Street Name
Local City
Local State
Local Zip Code
Use Same Address Below
Preferred Mailing Street Number
Preferred Mailing Street Name
Preferred Mailing City
Preferred Mailing State
Preferred Mailing Zip Code
Primary Phone
Email Address
Emergency Contact
Emergency Contact Name
Emergency Contact Home Phone
Additional Information
Are You A Provincetown Resident Or Voter?
Please circle one of the following:

Non-Resident

Resident
Senior (65+)?
Please circle one of the following:

No

Yes

Vessel

Reg or Doc #
Attach insurance docs for all boats 20'+, or 30+ HP engine, or inboard or inboard/outboard, or houseboats.
Vessel Name
Hull ID
Primary Use Of Vessel
Please circle one of the following:

Commercial

Pleasure
Vessel Type
Please circle one of the following:

Commercial

Dinghy

Float

Houseboat

Kayak

Power

Sail
Size
Length
  feet     inches
Draft
  feet     inches
Characteristics
Year Built
Builder?
Vessel Color
Trim Color
Engine
Engine Type
Engine Horsepower
Engine #2
Engine #2 Type
Engine #3
Engine #3 Type
Fuel
Fuel Type
Insurance
Insurer Name
Accessories
MSD
Other
Holding Tank Size

Mooring

Mooring Number
Mooring Type
Please circle one of the following:

Concrete Block

Danforth

Helix
Location
Application Latitude/Longitude
  
Inspection
Service Provider
Please circle one of the following:

Flyer's Boat Yard

Pilots Point Marina

Provincetown Harbormaster

Self

Other (Please Specify)

When inspecting underwater mooring gear, it is critical to check for wear of the loop in the top of the mooring block, rust and/or wear on turn buckles, shackles and chains, and the fittings under and atop of the mooring ball.
Inspection Status
Not applicable
Inspection Date
 
Overall Status
Please circle one of the following:

Fail

Pass
Depth MHW (Ft.)
  feet     inches
Indicating the Mean Hi Water (tide level) is a way to assure your mooring chain is long enough to withstand Provincetown weather at all tide levels.
Swivel to Shackles Appropriate Size and Seized?
Please circle one of the following:

N/A

No

Yes

Enter additional comments for the inspection
Primary Tackle
Mooring Weight (Lbs.)
Swivel Size
Shackle Size
Chain And Shackle Diameter
Float
Pennant Diameter
Pennant Length
  feet     inches
Secondary Tackle
Light Chain Size (ft)
Light Chain Size
  feet     inches
Heavy Chain Length
  feet     inches
Heavy Chain Size (in)
Other
Expected Date To Arrive On Your Mooring?
Please circle one of the following:

Before Memorial Weekend

I Will Have No Boat On My Mooring This Season

In July

In June
Chain, Swivel & Shackles Showing Wear Patterns?
Please circle one of the following:

N/A

No

Yes
Warp (Rope), Eye Splices, Hooks or Clips Worn?
Please circle one of the following:

N/A

No

Yes
Mooring Notes

Attachments

Attach a paper copy of each attachment listed below:
Insurance Documents
Attach insurance docs for all boats 20'+, or 30+ HP engine, or inboard or inboard/outboard, or houseboats.
Expiration Date
 
Copy Of Registration Or Document
Expiration Date
 

Acceptance

Terms and Conditions
BY SIGNING ABOVE, THE PERMIT HOLDER ACKNOWLEDGES THAT ALL INFORMATION IN THE APPLICATION IS CORRECT. A LATE FEE OF $50 WILL BE ASSESSED JULY 1st AND AN ADDITIONAL $50 WILL BE ASSESSED AUGUST 1st. AS OF SEPTEMBER 1st, THE MOORING REVERTS TO THE TOWN OF PROVINCETOWN FOR POSSIBLE REASSIGNMENT.

I have read and understand the Online Mooring User Terms and Conditions
Signature
Date
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