Fishing Permit Application

Fishing Permits are required for fishing on any Mattituck Park District property. Permits are issued gratis to residents of Mattituck and Laurel, who provide proof of having a NYS Marine Permit.

You may apply online, but must come in with your NYS Marine Permit to collect the permit.

Do you own property within the Mattituck Park District or reside there as a year-round renter? *

YesNo

Do you have a current NYS DEC Marine Permit?*

YesNo

Property Owner/Year-Round Renter Name*

First NameSurname

Hamlet:

Hamlet & ZIP:*

Street Address

City

Hamlet

Zip Code

Email:*

example@example.com

Phone Number (Including Area Code):*

Fishing Permit Usage Rules:

a) The permit must be carried by the person fishing at all times while fishing.

b) It must be produced, along with a government-issued photo ID upon request by MPD Security or personnel.

c) No other use is granted to the permitee.

d) Permitee must comply with all maritime rules for safe fishing.

e) Any violation in connection with this permit will terminate the validation immediately.The permit may not be transferred or assigned to any other person other than then named applicant.

Security, Loss, Damage

f) The Permitee is governed by all rules and regulations of the Mattituck Park District.
Permitee indemnifies and holds harmless the Park District from all claims, damages, expenses, suits and losses including but not limited to attorney’s fees arising from Permitee’s use of the Park District property and activity in connection with this permit.

g) MPD accepts no liability for damage to, or security of, permitee’s property.

h) Loss of this permit will require a $10 replacement fee.

I certify that the facts contained in this application are true and complete to the best of my knowledge and understand that falsified statements on the application shall be grounds for termination. I have read, understand, and agree to the above rules governing the acceptance of entering into a rental agreement with the MPD and accept the disclaimer and liability waiver and sign it of my own free will.

Signature

Resident-Only Fishing Permit

Permit Rules