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Port of Palm Beach logohome > Operations > Berth ApplicationRight Corner
Berth Application
** Form cannot be submitted until all spaces are filled. Items must be filled in order for form to submit.**
where an item is not applicable to your vessel, insert "NA"
* required

* Vessel Name: * Call Sign:
* Official Vessel Number: Vessel Flag:
* Berth Requested: * Length:
ETA: Gross Tons:
ETD: Beam:
Agent: Draft:
Stevedore: Vessel Phone:
ISPS Certificate #: Cargo: Inbound Outbound
Current Vessel MARSEC Level 1 2 3 Description of Cargo:
Hazardous Materials on Board: Tonnage:
  Select One: RO/RO LO/LO BARGE/TUG
  * Agent E-mail Address:
Cranes Ordered: Agent Contact (24HR) #:
    Stevedore Contact #:
For the Above Listed Vessel: 72-hour notice of arrival Hot Work Permit Requested: Yes No
  36-hour notice of arrival Water Service Requested: Yes No
  24-hour notice of arrival Line Handlers Requested: yes no
    Last Port:
    Next Port:



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