Town of Westerly, RI
 
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Instructions

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

Instructions
Mooring permit applications are due by March 1st.
Provider Name
Town of Westerly
Provider Mailing Address
Tax Collector's Office -
45 Broad Street
Westerly, RI 02891
Provider Phone
(401) 714-4114
Provider FAX
Provider Email
krayner@westerlypolice.org

Application

Application Status
Unknown

Applicant

Mobile Phone
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
Primary Phone
Work Phone
Email Address
Emergency Contact
Emergency Contact Name
Emergency Contact Home Phone
Emergency Contact Email
Additional Information
Resident?
Please circle one of the following:

No

Yes

Vessel

Vessel Type
Please circle one of the following:

Bow Rider

Cabin Cruiser

Catboat

Center Console

Cuddy

Daysailor

Deck Boat

Express

Fiberglass

Fiberglass Outboard

fish boat

Hard bottom inflatable

Inboard

Inboard Gasoline

Inboard/Outboard

inflatible

Ketch

Marshall Cat Sandpiper

Montauk

Motor

Motorboat

Open

Open cockpit Fisherman

Open Runabout

Out board

outboard

Overnighter

Picnic boat

Pleasure

Pleasurecraft

Pontoon

Power

Power Boat

Propulsion

RIB

Runabout

Sail

sailboat

Single Hull

Skiff

Small sail or pedal

Small sail, pedal or row

Sportfish

Trawler

Walk Around

Whitehall-Design Pulling Boat
Size
Length
  feet     inches

Wait List

Wait List Selection
Select up to 1 list(s):
List Name
Colonel Willie Cove
Haversham East
Haversham West
Point Dock at Shelter Harbor
Riparian Permit (Waterfront Property Owner)
The Groves at Shelter Harbor
Watch Hill Cove
Weekapaug Cove

Attachments

Attach a paper copy of each attachment listed below:
Proof Of Insurance
Expiration Date
 

Acceptance

Terms and Conditions
Mooring Permit Application:

I certify that the information on this application is correct and that fees must be paid by credit card or Electronic Check. Fees associated with this application are non-refundable. I further understand that I must comply with all town mooring ordinances, or this permit may be revoked. Moorings must be occupied as the primary berth for the vessel.

By checking this box and typing my name, I intend to electronically affix my signature, indicating that I have read, understand and affirm this attestation. *

Waiting List Application:

I certify that the information on this application is correct. I further understand that this is an application to be placed on a waiting list for a mooring and that this application is required to be renewed annually.


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