The property owner must fill out and sign a Board of Health application form ($100.00 made payable to the Town of Pembroke) and a separate Department of Public Works application form ($35.00 made payable to the Town of Pembroke / Department of Public Works).

Only State licensed well drillers may install a well. A copy of the well driller’s current State license must accompany the application form.

A plan of the property showing lot lines, buildings, the septic system and the proposed well location must be submitted with the 2 aforementioned applications and fees. (Be sure to be very exact in measuring the distances from the proposed well site to any of the septic components as the DPW Director and / or the Health Agent will reject any applications that are not accurate. Wells cannot be installed within 100 feet of any component of the property owner’s septic system or of any component of any abutters’ septic systems.)

Upon receipt of all the required paperwork, the entire package is then forwarded to the DPW Director for approval.

Once signed off by the DPW Director, the forms are returned to the Board of Health office for the Health Agent’s approval.

At the Health Agent’s approval, the well installer that is listed on the application form will be sent the permit for drilling the well along with a letter stating other requirements that are needed to be completed before a well number will be issued. A copy of the letter will be sent to the property owner listed on the application.

A well completion form from the well installer.

An “as-built” drawing showing the exact location of the well from the well installer. Wells cannot be installed within 100 feet of any component of the property owner’s septic system or of any component of any abutters’ septic systems

A copy of the electrical permit.

Water testing results. (All wells must be tested for portability (drinkability) whether or not it will be used for irrigation or drinking water.)

Notification from the DPW that the cross-connection check has been completed. (The property owner is responsible for notifying the DPW that the well has been completed and needs to be inspected for cross-connection and backflow situations.)

A well number is issued to the property along with a letter stating such. The property owner is required to post the well number in a location that is visible from the street. The property owner may now use the well legally.