Section Pda 511.01 - General Use Mooring Permit Application Form(a) Each person seeking a general use mooring permit or temporary seasonal general use mooring permit as provided in Pda 506.11(e)(1) shall complete a general use mooring application form provided by the division and hand deliver or mail the completed application to: Pease Development Authority
Division of Ports and Harbors
555 Market Street
Portsmouth, NH 03801
(b) The applicant shall provide the division the following information utilizing the "General Use Mooring Permit Application Form":(1) The applicant's full legal name;(2) The applicant's permanent address, including:(3) The applicant's mailing address, if different from the permanent address;(4) Which address the applicant requests be used as the correspondence address by the division, if different from the permanent address;(5) The applicant's telephone number(s) including: a. Permanent telephone number;b. Emergency telephone number;c. Cell telephone number, if different from permanent telephone number;(6) The applicant's e-mail address, if the applicant has an e-mail address; and(7) The following information pertaining to the vessel:b. New Hampshire state registration number, unless the vessel is not required to be registered under New Hampshire law;(c) The applicant shall attach: (1) A copy of the current New Hampshire state registration for the vessel listed on the mooring permit application, unless the vessel is not required to be registered under New Hampshire law;(2) If the vessel is not required to be registered under New Hampshire law, a photograph of the vessel; and(3) The mooring permit fee, provided that fees paid in the form of a check or a money order shall be made payable to "Pease Development Authority, Division of Ports and Harbors" or "PDA-DPH."(d) By signing the form, the applicant shall certify the following: (1) "I hereby certify that I am an owner in full or in part of the vessel described in this application;"(2) If no New Hampshire state registration number is provided for the vessel: "I hereby certify that the vessel described in this application is not required to be registered under New Hampshire law;"(3) "I hereby certify that I have read the mooring rules in Pda 500 applicable to the type of mooring for which I am applying and that I will comply with such rules;"(4) "I hereby certify that I release and indemnify Pease Development Authority and hold Pease Development Authority harmless from any and all claims or liability which may arise on account of the use of the mooring;"(5) If the application is for a temporary seasonal mooring permit: "I hereby certify that if I enter into an agreement with the mooring permit holder to use the mooring equipment presently located at the mooring site, I acknowledge that the mooring equipment is not owned or maintained by the Pease Development Authority and that the Pease Development Authority makes no representation as to the condition of the mooring equipment or its suitability for my intended use;" and(6) "I hereby certify that the statements and information in the enclosed documents are to the best of my knowledge and belief true, accurate and complete. I am aware that my mooring permit or placement on a mooring wait list may be withdrawn by the Pease Development Authority for submitting false statements or information or omitting required statements or information."(e) The applicant shall sign and date the application.N.H. Admin. Code § Pda 511.01
#7940, eff 8-23-03; amd by #8184, eff 10-1-04; amd by #8775, eff 12-16-06; ss by #9975, eff 8-20-11 (See Revision Note at chapter heading for Pda 500)
Amended by Volume XL Number 2, Filed January 9, 2020, Proposed by #12958, Effective 12/24/2019, Expires 12/24/2029.