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Town of Lyme, Connecticut
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Application Completion
Instructions
Please submit this form using any of the contact methods provided below.
Instructions
Provider Name
Town of Lyme
Provider Mailing Address
Lyme Town Hall
480 Hamburg Road
Lyme, CT 06371
Provider Phone
860-304-0660 cell
Provider FAX
Provider Email
thomas@reynolds1859.com
Application
Application Type
Mooring Permit
Applicant
Mobile Phone
First Name
Middle Name
Last Name
Contact Information
Mailing Street
Mailing City
Mailing State
Mailing Zip
Use Same Address Below
Second Address Street Number
Second Address Street
Second Address City
Second Address State
Second Address Zip Code
Primary Phone
Email Address
Vessel
Reg or Doc #
Vessel Name
Size
Length
feet
inches
Beam
feet
inches
Draft
feet
inches
Other
Vessel Photo(s)
(Maximum file size=10MB)
Acceptance
Terms and Conditions
I , the undersigned applicant, agree that all information provided in this application is true and complete to the best of my knowledge and belief. I understand that any false or incorrect statement of mine may be grounds for [dismissal] rejection of this application or the revocation of an existing mooring permit at the sole discretion of the Harbor Master. I will only use this mooring site for the vessel designated in this application. I agree to comply to all rules and regulations as defined in section 157-20 through 157-24 in the Town of Lyme regulations I understand that I am completely responsible for the safe ownership, operation and maintenance of my vessel and my mooring hardware and tackle and any consequential damages caused by my vessel or the failure of my mooring hardware or tackle. I also understand that I hold harmless and will defend any claim for damages against the Town of Lyme caused by the conduct of my vessel or my mooring hardware and tackle.
I have read and understand the Online Mooring
User Terms and Conditions
Signature
Date
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