Form Dsss 19 - Application For A Congregate Mooring Field Permit Page 3

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THE FOLLOWING DOCUMENTATION MUST ACCOMPANY YOUR APPLICATION:
NOTE: If the documentation requested does not apply please indicate so.
1. Copy of the recorded deed or lease to the shore front property.
2. A listing of all members, including addresses.
3. A copy of all rules of the applicant pertaining to waterfront use. Include rules pertaining to docks,
beaches and swim rafts.
4. A copy of all by-laws of the applicant pertaining to waterfront use. Include by-laws pertaining to
docks, beaches and swim rafts.
5. Five copies of a scaled map on 11” x 17” paper of the proposed mooring field. See the attached
sample map for the required specifications and information.
6. A copy of the certificate of insurance for comprehensive general liability insurance against all claims
of bodily injury, death, or property damage resulting from the maintenance, management, or
operation of a mooring field and the amounts of coverage. If members are insured individually please
submit copies of each individual’s certificate of insurance.
7. A copy of the current boat registration for all boats used at the property. This includes the boats kept
at the dock.
8. A statement that no other viable alternative exists for securing the boats. (If docks exist which are
under the applicant’s control, the applicant must show that they are not sufficient for the user’s current
need or there are more boats than dock slips available. The applicant should respond to the present
need for moorings. The number of moorings applied for will not exceed the number of boats now in
possession within the applicant’s group. Unless there are extenuating circumstances, permits will not
be issued for small boats which can be easily removed from the water such as sunfish, jetskies, pwcs,
canoes, etc.)
9. A statement explaining what circumstances exist that would warrant the moorings to be located more
than 150 feet from the shore.
10. Land and water directions to the shore front property.
11. Signed, certified returned receipts from each abutter.

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