OFFICE USE ONLY
Conservation ID (if known)
First Name Last NameMI
Hair ColorEye Color
Vessel Permit Application
Drivers License Information
Daytime Phone Number Evening Phone Number
City State Zip Code
Mailing Address (if different than residence)
New License Renewal
For License Year
Mail to: Department of Energy and Environmental Protection
License and Revenue Unit, 79 Elm St., Hartford, CT 06106
Continue on reverse side
Primary Vessel Owner Information
Passenger CapacityCrew Size
Net TonnageGross Tonnage
Vessel Secondary ColorVessel Primary Color
(Inches)Depth (feet)(Inches)Beam (feet)
Propulsion Type (ex: Gas, Diesel)Connecticut Landing Port
Home PortHome Port State
Year BuiltVessel Type (ex: Party, Charter, Lobster, Trawler, Open, Cabin)
Federal Permit NumberUSCG Doc Number
State Registration NumberVessel Name
Vessel Identification Information
Vessel Purchase Date
Commercial Fishing Vessel Permit............................$100.00
For use of a vessel for activities authorized under any commercial fishing,
finfish, lobster or landing license.
What is your home port town?
Marina name (or) exact location?
Date of issue?
Coast Guard Reference Number?
Who is the principal operator?
Party / Charter Vessel Registration...........................$315.00
To operate a party / charter boat or for-hire recreational vessel to take marine
species in Connecticut waters or land marine species at Connecticut ports,
regardless of where those species are taken. A separate party / charter
registration is required for each vessel operated for this purpose.