P.O. Box 211

Beverly MA, 0 1915 Fee:______________

Dear Sir:

I herewith make formal application for a mooring in Beverly Harbor, Beverly, Massachusetts, for my own use only.

My signature affixed below will attest that I have read and understood and agree to abide by the Rules and Regulations governing Beverly Harbor.

In making this application, I understand that I have the responsibility for the care and maintenance of the mooring tackle placed in the location assigned to me by the Harbormaster, and that I will not increase or decrease the size of a boat using this tackle without written permission from the Harbormaster. I further agree not to sell, trade, rent, or barter in any way any mooring location assigned to me.

Name______________________________________ Telephone Number ____________________

Address____________________________________

Size and Description of Proposed Vessel ________________________________________________

Vessel Name _____________________________________ Reg/ Doc No. _____________________

Recreational _____ Commercial ____ Preferred ____ location: B___V___R___L___Y___(JYC)____

The following pertains to the waiting list procedure:

I understand that it is my responsibility to confirm my intent to obtain mooring space by April 1^st of each calendar year, pay my $10.00 fee or I will be automatically dropped from the waiting list. The oldest application date has priority and holds that position, even if the applicant declines acceptance of a mooring assignment.

I further agree that I do not wish to be contacted for a mooring assignment for a boat of less than__________ feet.