New Hampshire Code of Administrative Rules
Pda - Pease Development Authority
Chapter Pda 300 - PORT CAPTAINS, PILOTS AND PILOTAGE
Part Pda 306 - FORMS
Section Pda 306.01 - Application Form for Initial Pilot Appointment

Universal Citation: NH Admin Rules Pda 306.01

Current through Register No. 12, March 21, 2024

(a) Each person seeking an initial appointment as a pilot shall complete an application form for initial appointment provided by the division and deliver or mail the completed application to:

Pease Development Authority

Division of Ports and Harbors

555 Market Street

Portsmouth, NH 03801

(b) The applicant shall provide the following on the application form for initial appointment:

(1) The applicant's full legal name;

(2) The applicant's maiden name or other names used by the applicant, if applicable;

(3) The applicant's date and place of birth;

(4) The address of the applicant's residence, including:
a. Street and number;

b. City or town;

c. State; and

d. Zip code;

(5) Mailing address, if different from residence address;

(6) The applicant's home telephone number;

(7) The applicant's mobile/cell telephone number, if the applicant has a mobile/cell telephone;

(8) The applicant's fax number, if the applicant has a fax machine;

(9) The applicant's e-mail address, if the applicant has an e-mail address;

(10) The name of and information required under (4) - (9) relating to the applicant's business, if applicable;

(11) The class of pilot licensure for which the applicant is applying;

(12) The applicant's employment history relating to piloting or operation of vessels within the past 5 years, including:
a. The name and address of any previous employer;

b. Where and when the applicant was employed;

c. The type and gross tonnage of vessels on which the applicant was employed; and

d. The positions held and the dates when the positions were held under previous employers;

(13) A list of harbor areas where the applicant has served as pilot, including a description of any special navigational features associated with each harbor area, including, but not limited to:
a. Exceptional currents or tides; or

b. Difficult navigational obstructions; and

(14) A description of the training the applicant has received pertaining to pilotage skills.

(c) The applicant shall indicate on the application whether the applicant:

(1) Was ever convicted of violating a controlled drug law of the United States, District of Columbia, or any state, or territory of the United States, including NH RSA 318-B, Controlled Drug Act, and laws relating to possession, use or sale of marijuana, which conviction has not been annulled;

(2) Has ever tested positive for a controlled drug, including marijuana, within the past 180 days, or has ever refused a test for a controlled drug;

(3) Was ever convicted by any court, including a military court, for an offense other than a minor traffic violation, which conviction has not been annulled;

(4) Was ever convicted of a traffic violation, which conviction has not been annulled, arising in connection with a fatal traffic accident, reckless driving, racing on the highway, or operating a motor vehicle while under the influence of or impaired by alcohol or a controlled drug;

(5) Has ever had his or her driver's license revoked or suspended for refusing to submit to an alcohol or drug test;

(6) Was ever given a Coast Guard Letter of Warning or assessed a civil or administrative penalty by a federal or state agency or a court of competent jurisdiction for violation of maritime or environmental laws; and

(7) Has ever had any Coast Guard license or document voluntarily surrendered, revoked, or suspended.

(d) If there is an affirmative response to any of the items listed in subparagraphs (c)(1) - (7) above, the applicant shall attach an explanatory statement(s) to the application. If the applicant responds affirmatively to:

(1) Subparagraph (c)(1), the applicant shall attach a statement describing the violation and sentence;

(2) Subparagraph (c)(2), the applicant shall attach a statement explaining the circumstances of such refusal or positive drug test result;

(3) Subparagraph (c)(3) or (4), the applicant shall attach copies of any court order or judgment rendered;

(4) Subparagraph (c)(5), the applicant shall attach a statement describing the grounds for the revocation and conviction, and supply the name of the state issuing the license;

(5) Subparagraph (c)(6), the applicant shall attach a copy of the Letter of Warning and/or penalty assessment; and

(6) Subparagraph (c)(7), the applicant shall attach a statement describing the action taken by the Coast Guard and the reasons for the action;

(e) The applicant shall sign and date the application form, indicating agreement to the following statement relating to (d) above:

"I have attached a statement of explanation for all areas marked "yes" above. I have signed this section with full understanding that a false statement is a basis for denial of the application as well as criminal prosecution. I understand that failure to answer every question may delay my application."

(f) The applicant shall include, as part of the application:

(1) A copy of a government-issued photo identification card of the applicant, such as a:
a. State-issued driver's license;

b. Merchant Marine identification document; or

c. Valid United States passport;

(2) A certified copy of the applicant's current license issued by the Coast Guard as master or mate, for ocean, near coastal, or inland, for vessels over 1,600 gross tons that includes the applicant's:
a. Coast Guard pilotage endorsement for Portsmouth Harbor and the Piscataqua River up to and including Dover Point, New Hampshire;

b. Valid Coast Guard radar-observer endorsement; and

c. Bridge resource management certificate from a course approved by the Coast Guard;

(3) A copy of the record of any appointment granted to the applicant by the Pease development authority or the former New Hampshire port authority;

(4) A copy of the applicant's military record, if the applicant has such a record;

(5) At least 2 letters attesting to applicant's professional character from persons who hold a valid Coast Guard master or mate's license;

(6) At least one letter of recommendation prepared in accordance with Pda 305.06(b)(7) from a pilot appointed by the Pease development authority or the former New Hampshire port authority; and

(7) Documentation that the applicant has met the passage requirements of Pda 305.07, including:
a. Description of the pilotage route for each passage;

b. The name, gross tonnage and official number, if applicable, of the vessel on which each passage was made;

c. The inbound or outbound beginning and ending times for each passage; and

d. Certifying signatures of the master of the vessel and the pilot for each passage.

(g) The applicant shall certify whether or not the applicant:

(1) Is a citizen of the United States of America;

(2) Was ever refused an authorization to pilot a vessel;

(3) Was ever convicted of a felony or misdemeanor, which has not been annulled;

(4) Was ever treated by a physician for drug or alcohol addiction or abuse;

(5) Was ever hospitalized for any mental or emotional illness within the past year;

(6) Has ever had a mental or physical illness or disability that restricted the applicant's ability to operate as a pilot for more than 30 days;

(7) Has ever held an authorization to pilot vessels in New Hampshire or any other state or jurisdiction that has been suspended or revoked; and

(8) Holds a valid license issued by the Coast Guard as master or mate, for ocean, near coastal, or inland, for vessels over 1,600 gross tons that includes a:
a. Valid Coast Guard pilotage endorsement for Portsmouth Harbor and the Piscataqua River up to and including Dover Point, New Hampshire;

b. Valid Coast Guard radar-observer endorsement; and

c. Bridge resource management certificate from a course approved by the Coast Guard.

(h) An applicant unable to certify a true answer for any item in subparagraphs (g)(1) - (8) shall submit an explanatory report that includes:

(1) A complete explanation of the circumstances which cause any statement in subparagraphs (g)(1) - (8) to be untrue; and

(2) For each circumstance which causes a statement in subparagraphs (g)(1) - (8) to be untrue, an explanation as to why the authority should not find it to be grounds for denying the applicant's appointment as a pilot.

(i) The form shall then be signed and dated. By signing the application form, the applicant shall certify that the information provided in the application is true, to the best of the applicant's knowledge.

(j) The form shall contain the following certification language:

"I certify that the statements and information in the enclosed documents are to the best of my knowledge and belief true, accurate and complete. I am aware that my appointment as a pilot may be withdrawn or suspended by the Pease Development Authority for submitting false statements and information or omitting required statements and information."

(k) The application shall require the applicant to separately sign and date a release authorization for a background investigation, as follows:

"To all courts, probation departments, Selective Service boards, employers, physicians, health care facilities, health care providers, educational institutions, and government, including all agencies and departments thereof:

I, ___________________, as an applicant for appointment by the Pease Development Authority as a pilot of vessels, have hereby authorized the Pease Development Authority to conduct an investigation into my background for the purpose of determining my suitability and eligibility for such appointment. You are hereby authorized to release any and all information pertaining to me, documentary or otherwise, as requested by an appropriate employee, agent or representative of the Pease Development Authority. This authorization shall supersede and countermand any prior request or authorization to the contrary."

#7870, eff 4-12-03; ss by 9891-B, eff 4-1-11

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