SCV1 Application form

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					                                YDSA Certifying Authority
                                    (Authorised by the Maritime and Coastguard Agency)

                              The Glass Works, Penns Road, Petersfield, Hampshire, GU32 2EW
                                        Tel: (01730) 710490 Fax: (01730) 710423

                            THE SAFETY OF SMALL COMMERCIAL MOTOR AND SAILING VESSELS
                                                  Codes of Practice




SCV1 APPLICATION FOR EXAMINATION
(This form may also be used to notify change of Owner/Managing Agent for a vessel with a previously
valid Certificate, in which case this should be clearly stated on the form. The extent of examination
required on change of Owner/Managing Agent will be at the discretion of the Certifying Authority.)

OWNERSHIP DETAILS
                              Owner/Managing Agent (1)                    Owner if different from (1)
Name:
Address:




Postcode:
Telephone No:
Fax No:
Correspondence to be sent to:
Details to be shown on certificate:

VESSEL DETAILS
Name:
Port of Registry:
Official No (or SSR):
Hull Identification Number (HIN):
Call sign:
Builder:
Year Built:
Model or Design Class:
Overall Length (m):
Beam (m):
Load line length if over 24m (m):
Motor, RIB, or Sail:                                          Motor
Certifying Authority Unique No (if known):




SCV1 Application for Examination Sept 05                                                                Page 1
CODING
Category applied for:                                                         Category 2
Maximum number of persons on board:
Base port (Categories 0 to 4):
Nominated Departure Point(s) (Cats 5 & 6):
Will the vessel be used for carrying 16 or more persons, over 1000kg cargo,                                                Tick if yes
towing or lifting?
Was the vessel ‘Coded’ prior to 1st December 2004 as a Small Commercial                                                    Tick if yes
Vessel?
If you have ever applied to certify the above or any
other vessel with any other Certifying Authority,
state the name of the Certifying Authority and the
name of the vessel:
Name of chosen YDSA Nominated Surveyor:                                       Richard O.J. Naylor


DECLARATION BY OWNERS/MANAGING AGENT
I, the Owner/Managing Agent of the vessel described above, apply to have the vessel examined and
accepted under the Code of Practice for Small Commercial Vessels and agree to pay all charges in
respect of the Certification of the vessel to the YDSA Certifying Authority and for the survey of the
vessel.


Signature of Owner/Managing Agent: ..............................................................................................

Date: .............................................................................................................................................




SCV1 Application for Examination Sept 05                                                                                                  Page 2

				
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