Application for Commercial Use Permit - Hawaii

This "Application for Commercial Use Permit" is a part of the paperwork released by the Hawaii Department of Land & Natural Resources specifically for Hawaii residents.

The latest fillable version of the document was released on June 1, 2011 and can be downloaded through the link below or found through the department's forms library.

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APPLICATION FOR
COMMERCIAL USE PERMIT
Division of Boating and Ocean Recreation
Department of Land and Natural Resources, State of Hawai'i
1. PERMIT INFORMATION
Island (
) :
q
Hawaii
q
Kauai q Lanai
q
Maui
q
Molokai q
Oahu
one
4
OFFICE USE ONLY
Mooring Account #:
Location:
Date Received:
Usage Type (
):
q
Ramp
q
Operational Area Use
q
Vessel Moored Elsewhere
q Revocable
one
Received By:
4
q
Inter-Island Passenger vessel
q
Charter Bare Bottom Boat
q Charter Sail
q
Mooring
q
Underwater Film/Photo
2. APPLICANT INFORMATION (Responsible Party)
Name (Last):
(First):
(M.I.):
Suffix:
q
q
Date of Birth:
/
/
Gender:
Female
Male
Occupation:
Employer:
Phone (business):
(mobile):
Email:
Mailing Address:
Apt #:
City:
State:
Zip Code:
Billing Address (if different than as Mailing Address):
Apt #:
City:
State:
Zip Code:
3. BUSINESS INFORMATION
Business Name:
Website:
Business Role of Contact Person:
q
Owner
q
Co-owner
q
Corporate Officer
Contact Name (Last):
(First):
(M.I.):
Suffix:
Date of Birth:
Phone (business):
Phone (mobile):
/
/
Business Address:
Apt #:
Address Line 2:
City:
State:
Zip Code:
4. VESSEL OWNER INFORMATION
check if same as Applicant
q
Owner
's Name (Last):
(First):
(M.I.):
Suffix:
Date of Birth:
/
/
Phone:
Owner Address:
Apt #:
Address Line 2:
City:
State:
Zip Code:
Commercial Use Permit, Revised: 06/2011
Page 1 of
2
APPLICATION FOR
COMMERCIAL USE PERMIT
Division of Boating and Ocean Recreation
Department of Land and Natural Resources, State of Hawai'i
1. PERMIT INFORMATION
Island (
) :
q
Hawaii
q
Kauai q Lanai
q
Maui
q
Molokai q
Oahu
one
4
OFFICE USE ONLY
Mooring Account #:
Location:
Date Received:
Usage Type (
):
q
Ramp
q
Operational Area Use
q
Vessel Moored Elsewhere
q Revocable
one
Received By:
4
q
Inter-Island Passenger vessel
q
Charter Bare Bottom Boat
q Charter Sail
q
Mooring
q
Underwater Film/Photo
2. APPLICANT INFORMATION (Responsible Party)
Name (Last):
(First):
(M.I.):
Suffix:
q
q
Date of Birth:
/
/
Gender:
Female
Male
Occupation:
Employer:
Phone (business):
(mobile):
Email:
Mailing Address:
Apt #:
City:
State:
Zip Code:
Billing Address (if different than as Mailing Address):
Apt #:
City:
State:
Zip Code:
3. BUSINESS INFORMATION
Business Name:
Website:
Business Role of Contact Person:
q
Owner
q
Co-owner
q
Corporate Officer
Contact Name (Last):
(First):
(M.I.):
Suffix:
Date of Birth:
Phone (business):
Phone (mobile):
/
/
Business Address:
Apt #:
Address Line 2:
City:
State:
Zip Code:
4. VESSEL OWNER INFORMATION
check if same as Applicant
q
Owner
's Name (Last):
(First):
(M.I.):
Suffix:
Date of Birth:
/
/
Phone:
Owner Address:
Apt #:
Address Line 2:
City:
State:
Zip Code:
Commercial Use Permit, Revised: 06/2011
Page 1 of
2
Division of Boating and Ocean Recreation
Department of Land and Natural Resources
State of Hawaii
APPLICATION FOR COMMERCIAL USE PERMIT (
)
Continued
5. VESSEL INFORMATION
Vessel Name:
Port of Registry:
Registration
Coast Guard Documentation
q
q
Documentation Type:
Registration / Doc. #:
Expiration Date:
/
/
Hull Manufacturer:
Year Built:
Length Overall:
(feet)
(inches)
Hull ID#:
Number of Hulls:
Length Over Deck:
(feet)
(inches)
Hull Color:
Cabin Color:
Draft of Vessel:
(feet)
(inches)
Top Deck Color:
Trim Color:
Beam of Vessel:
(feet)
(inches)
Master of Vessel:
Tonnage License #:
Passenger Capacity:
Re-Certification Due Date:
/
/
This vessel is currently located ( one and complete):
4
q
In a Berth at (Harbor):
in (Berth Number):
q Moored / Anchored on (Island):
at (Location):
q
On a Trailer on (Island):
at (Location):
6. VESSEL TYPE AND PROPULSION
q
q
q
q
q
Vessel Type ( one):
Open Motorboat
Motor Vessel (more than 65)
Sailing Vessel
Houseboat
Runabout
4
q
q
q
q
Auxilary Powered Sailing Vessel
Cabin Motorboat
Thrillcraft
Dinghy or Skiff
q
q
q
Barge
Platform
Other:
q
q
q
q
q
Principle Use ( one):
Pleasure
Charter Fishing
Commercial Fishing
Commercial Passenger
Charter Bare Boat
4
q
q
q
q
q
Dealer
Manufacturer
Charter Sail
Water Taxi
Other Commercial:
q
q
q
q
Primary Propulsion Type ( one):
Power
Sail
None
Other:
4
q
q
q
q
q
q
If Power: Engine Type(s) ( one):
Outboard
Inboard
Outboard / Inboard
Manual
None
Other:
4
Engine Manufacturer:
Horsepower:
Number of Engines:
If Sail:
Rigging Type:
q
Sloop
q
Schooner
q
Three-Masted Schooner
q
Four-Masted Schooner
q
Ketch
q
Brig
q
q
q
q
q
q
q
q
Brigantine
Barque
Barquentine
Fully Rigged Ship
Snow
Yawl
Cutter
Clipper
Auxiliary Propulsion for Sail:
q
q
q
q
Engine Type(s) ( one):
Outboard
Inboard
Outboard / Inboard
None
4
Engine Manufacturer:
Horsepower:
Number of Engines:
q
q
q
q
Fuel Type ( one):
Gasoline
Diesel
Electric
Other (specify):
4
7. AGREEMENT & SIGNATURE
I agree to comply with the provisions of the Hawaii
Administrative Rules as promulgated by the Division of
/
/
Boating and Ocean Recreation applicable to this permit.
Signature of Applicant
Date
Commercial Use Permit, Revised: 06/2011
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