Private Shellfish Aquaculture Application Form Home » Massachusetts » Private Shellfish Aquaculture Application Form Division of Marine Fisheries Private Shellfish Aquaculture Application Form A brief description of the form or Application to be filled out here. Name First Middle Last Mailing Address Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Home PhoneCell PhoneEmail Business Name (dba)State Commercial Shellfish Permit #Location of aquaculture license site(s) (grants)Town issued license #Waterbody where the site is located (DSGA)Species Cultured on SiteType of Gear Utilized# of Acres Seed Purchases and Grow out ActivitiesDo you intend to purchase seed shellfish? Yes No ListSpeciesAmountHatchery/Individual where Seed will be ObtainedSize of Seed Intermediate GrowoutDo you intend to use upweller or other similar device off your growout site? Yes No My device is Floating Land-based What size will the seed be when it is moved to the primary growout site?Where is the nursery site located (town site number, DSGA, physical address)CullingDo you intend to cull shellfish at a location other than your licensed site? Yes No What is the address of culling location (s) (no PO Boxes)Sale of ShellfishDo you intend to sell seed? Yes No What speciesWill you only sell seed your same DSGA? Yes No Then whereOff Site Over-winteringDo you intend to over-winter shellfish off your license site? Yes No Describe method of over-wintering (in-water pit, walk-in, cooler)Location of over-wintering activities; (if land based an address is required, No P.O. Boxes)Spat CollectionDo you intend to collect seed by spat collection methods? Yes No What kind of gear will you use?Spat collection activities be conducted On-site Off-site Where?Other InformationDo you also harvest shellfish for commercial purposes from public beds? Yes No If you will utilize floating gear, do you take measures to deter birds? Yes No What are your mesures to deter birdsWill you be using ice produced from a machine that you own? Yes No What is the source of water used to produce the ice? Town Private Well Other Have you been convicted of any violation of the laws or regulations relating to marine fisheries within one (1) calendar year preceding the date of the application? Yes No Contact InformationName First Last Email* Enter Email Confirm Email Phone*Application Fee Price: RENEWAL ADVANCED PAYMENT OPTION No Additional Years 2 year renewal 3 year renewal 4 year renewal 5 year renewal Total $0.00 Consent*I CERTIFY THAT THE RECITATIONS CONCERNING THE VESSEL: NAME, TONNAGE, DIMENSIONS, PROPULSION, OWNERSHIP, HAILING PORT, RESTRICTIONS, ENTITLEMENTS, REMARKS AND ENDORSEMENTS CONTAINED IN THE CERTIFICATE OF DOCUMENTATION REMAIN ABSOLUTELY THE SAME. I agreeNAME:*Type your full name to sign this secure webformSignature*CAPACITY OF PERSON SIGNING (E.G., OWNER, AGENT, TRUSTEE, GENERAL PARTNER, CORPORATE OFFICER, MEMBER)Date MM slash DD slash YYYY Authorization*I agree to pay the above total amount according to the card issuer agreement and hereby authorize the charge for the total amount above for the processing of selected permits. I understand that my application will be processed in the order in which it is received by Commercial Fishing Permits Center, a private fee-for-service documentation company, not owned or operated by any governmental agency. I understand that application and processing fees are non-refundable as per Commercial Fishing Permits Center's no refund policy. I understand that submitting another application for a license or permit will supersede the current/pending application for that license or permit. I understand that Commercial Fishing Permits Center does not issue or sell any licenses or permits. I agreeCredit CardCard Details Cardholder Name Having Trouble with your card?Check this box to move forward without your Credit Card. 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