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TOWN OF BELMONT
BOARD OF HEALTH

Regulation for the Use of Recombinant DNA Molecule Technology and Non-Recombinant Infectious Agents

Section 1: Authority
The Board of Health, Town of Belmont, Massachusetts, acting under the authority of Chapter 111, Section 31 of the General Laws and amendments and additions thereto, and by any other power thereto enabling, has duly made and adopted the following Regulation in the interest of and for the protection of the public health.

Section 2: Applicability
This Regulation shall apply to all activities associated with (a) constructing, propagating, handling, synthesizing, or storing recombinant DNA (rDNA) or RNA (rRNA) molecules [ if these segments are not expressed in vivo as a biologically active polynucleotide or polypeptide product, the synthetic DNA or RNA segments are exempt from this Regulation] b) any plants, animals, bacteria or viruses containing rDNA or rRNA molecules and c) other non-recombinant infectious agents shall be performed in strict accordance with this Regulation and with the National Institutes of Health (NIH) and Centers for Disease
Control and Prevention (CDC) Guidelines as defined below. This Regulation shall apply where it differs from the NIH and CDC Guidelines. This Regulation does not replace nor modify applicable Federal, State and local requirements. This Regulation does supersede the original Belmont DNA Regulation promulgated in May, 1982.

Section 3: Definitions
For the purpose of this Regulation, the following definitions are adopted:

a) Guidelines
Guidelines shall mean the most recent version and any additional and future amendments or approvals of the National Institutes of Health Guidelines for Research Involving Recombinant DNA Molecules as published in the Federal Register and the Centers for Disease Control and Prevention Guidelines, "Biosafety in Microbiological and Biomedical Laboratories." In the event that such Guidelines are discontinued or abolished, those Guidelines in effect and approved by the Board of Health at the time of such discontinuance shall remain in effect.

b) Institution
Institution shall mean any person, natural or otherwise, sole proprietor, corporation, limited liability company, partnership, trust, association, public or private organization, federal, state or local government agency, or any other individual or entity acting in its own or any representative capacity.

c) Recombinant DNA (rDNA) or RNA (rRNA) Molecules
1) molecules constructed outside living cells by joining natural or synthetic DNA or RNA segments to DNA or RNA molecules that can replicate in a living cell or (2) molecules that result from the replication of those described in (1) above. This includes synthetic DNA or RNA segments that are likely to yield a potentially harmful polynucleotide or polypeptide (e.g., a toxin or a pharmacologically active agent); these are considered as equivalent to their natural DNA or RNA counterparts.
Genomic DNA/RNA organisms that have acquired a transposable element, even if the latter was donated from a recombinant vector no longer present, are subject to the NIH and CDC Guidelines and this Regulation only in the case where the transposon itself contains rDNA or rRNA.

d) Significant Deviation
Significant deviation means any deviation from the NIH and CDC Guidelines that might have an adverse effect on personal or public health.

Section 4: Belmont Biosafety Committee
a) A Belmont Biosafety Committee (BBSC) shall be established for the purpose of
overseeing all activities to which this Regulation applies.

b) The BBSC shall:
1) Establish policies, procedures and criteria to aid in the implementation of this Regulation.
2) Inform the Board of Health of significant changes to the Guidelines and other applicable
regulations.
3) Review all applications for permits under this Regulation and recommend action to the
Board of Health.
4) Determine the manner in which Institutions and Institutional Biosafety Committees
(IBCs) make reports, applications or recommendations to the BBSC and the type of information required.
5) Review Institutions' manuals, worker training programs, health and safety programs,
monitoring procedures and reports.
6) Implement site visits to Institutions' facilities and review inspection reports.
7) Advise the Board of Health on the appointment of community members for the IBCs.
8) Develop a procedure for individuals to report alleged violations of this Regulation
to the BBSC.

c) The BBSC shall be composed of no fewer than 5 members, to include the Chairman of the Board of Health or designee, the Director of Health, and a minimum of three community members. These community members shall be appointed by the Board of Health, each to serve three year terms. However, of the first three members appointed to the Committee, one shall serve for a term of one year, one shall serve for a term of two years and one shall serve for a term of three years.

Section 5: Permits
a) Each Institution intending to engage in any activities as defined in Section 2 of this Regulation, shall obtain a permit from the Board of Health prior to commencing such activities.

The permit application shall include the following documentation:
1) A completed Board of Health application form.
2) A plot plan showing the proposed location of the facility and a floor plan showing
the internal layout of the facility.
3) A list of all organisms, recombinant and infectious, the taxonomic groups from which they are obtained, containment levels, and decontamination procedures to be employed.
4) A plan for treatment and disposal of biological waste in accordance with 105
CMR 480.000, Chapter 8, State Sanitary Code, Storage and Disposal of Infectious or Physically Dangerous or Biological Waste.
5) A plan for pest control management in laboratories, contiguous facilities and food service establishments in the same building.
6) A plan for systematic security of the premises.
7) A report summarizing the work subject to the Guidelines performed over the past year.
8) The names of members of the Institutional Biosafety Committee (IBC).
9) The Institution's safety manuals and an employee training program, together with a plan for an appropriate medical oversight program, including a copy of the medical oversight contract, as determined by the IBC, for all persons engaged in the use of rDNA, rRNA and infectious agents.
10) A plan for orientation of the Health, Police and Fire Departments of the Town to the facility and to appropriate emergency procedures.
11) Written agreement to allow inspection of facilities and pertinent records by the BBSC.
12) Every applicant shall submit evidence of, and maintain at all times while conducting activities regulated hereunder, a policy or policies of insurance against liability arising out of activities regulated hereunder, for general liability insurance, and contractual liability insurance covering any indemnification required hereunder or by separate agreement, each in an amount of at least $1,000,000 for personal injury or death to any one person, and at least $5,000,000 for personal injury or death from any one incident, and at least $1,000,000 for property damage, and in addition, the Insitution shall have in full force and effect any other particular or special policy of insurance required by law and the Town of Belmont shall be named as an additional insured in all such policies.
13) Written indemnification agreement fully executed by the Institution which shall be substantially the same as is provided in Section 12 of this Regulation.

b) The BBSC will review the Institution's application for a permit and supporting documents and make its recommendation to the Board of Health within 45 business days of receipt of the application in the Health Department office. The Board of Health shall take final action on the permit application within thirty business days of receipt of the recommendations from the BBSC. The period within which final action
shall be taken may be extended by mutual consent of the Board of Health and the applicant.

c) The fees for permits issued by the Board of Health under this Regulation shall be:
1. Initial Application Fee $200
2. Renewal Application Fee $100

d) Application for permit renewal must be made annually.

Section 6: Institutional Biosafety Committee
a) The Institutional Biosafety Committee (IBC) shall have as members, in addition to the Institution's representatives and the Director of Health or designee, one community representative appointed by the Board of Health..

b) The IBC shall meet at least annually. All minutes of the IBC meetings shall be forwarded to the Board of Health.

c) The community member of the IBC and the Director of Health, or designee, shall have no controlling or substantial financial interest in the Institution or any other Institution in competition therewith. All financial interests shall be disclosed prior to appointment. Such representatives shall be bound to the same
provisions as to non-disclosure and non-use of proprietary information and trade secrets as all other members of the IBC, except to the extent necessary to alleviate any public health hazard. As used in this Regulation, proprietary information and trade secrets shall be defined as set forth under the laws of the
Commonwealth of Massachusetts.

d) The IBC reviews all projects for compliance with the Guidelines. Project protocols must be approved by the IBC and a statement certifying that each project protocol conforms with the Guidelines shall be filed with the Board of Health.

e) Information sent by the IBC to the Board of Health shall not contain proprietary information and trade secrets. Full documentation of IBC reviews and determinations shall remain on file in the records of the Institution for inspection by authorized individuals.

Section 7: Medical Oversight

If the IBC determines that a medical oversight program is necessary, that program shall include, but not be limited to, the following:
a) Prompt reporting to the IBC of illnesses that are potentially related to the use of rDNA, rRNA and infectious agents.
b) Employee medical and health records shall be retained for at least ten years.
c) A training program including illness and injury reporting procedures for all personnel.

Section 8: Inspection and Review
a) All Institutions subject to this Regulation shall allow inspection of its facilities, procedures, practices, and records by the BBSC or Board of Health designee, in order to confirm compliance with this Regulation.

b) The Board of Health, its employees, all members of the BBSC, and any organization employed to perform inspections shall maintain the confidentiality of all proprietary information and trade secrets released to them by reason of this Regulation.

Section 9: Restrictions
a) Use of rDNA, rRNA and infectious agents classified by the Guidelines as requiring BL3 or BL4 containment measures shall not be permitted.

b) Propagation or handling of more than 1,000 liters per vessel of rDNA, rRNA culture or infectious agents shall not be permitted.

c) There shall be no deliberate release into the environment, that is, to sewers, drains, land or air, of any organisms containing viable rDNA, rRNA or infectious agents.

d) The Institution shall report within 24 hours to the Director of Health, followed by a written report within 15 days to the BBSC, any significant deviations, accidents, illnesses or releases related to the use of rDNA, rRNA or infectious agents. An inspection of the facilities, records and procedures may be deemed necessary by the BBSC based upon its judgment of the nature of the incidents.

Section 10: Penalties
a) Violations of this Regulation shall subject the Institution to a fine of five hundred dollars ($500.00) per day. Each day of violation shall constitute a separate and distinct offense.

b) If deemed necessary to protect public health, the Board of Health may close the facility in which the violation occurred.

c) Permits may be revoked by the Board of Health upon determination, after due notice and hearing, that the Institution involved has materially failed to comply with this Regulation, permit conditions, or the Guidelines, or if in the opinion of the Board of Health, activities at the Institution cause a nuisance, or adversely affect the public health, safety and welfare in the Town of Belmont.

Section 11: Assessments
The salaries and expenses incurred by the Town for testing, inspections, reviews, staff and consultants for work directly related to carrying out the requirements of this Regulation shall be assessed to the Institutions holding permits under this Regulation.

Section 12: Indemnification
Each Institution engaging in, or intending to engage in, any activities regulated hereunder agrees to indemnify, defend, protect, and hold harmless the Town of Belmont, its selectmen, officers, agents and employees from and against any and all claims, demands, losses, damages, liabilities, fines, charges, penalties, administrative and judicial proceedings and orders, judgments, remedial actions of any kind, all costs and cleanup actions of any kind, and all costs and expenses incurred in connection therewith, including reasonable attorney's fees and costs of defense (collectively, the "Losses"), directly or proximately resulting from the Institution's negligence with regard to any acts, omissions or conduct in any way related to any activity regulated hereunder, pursuant to its permit, its application therefore, or resulting from the Institution's failure to comply with the terms of the permit, the Regulation or the Guidelines.

Section 13: Severability
Each part of this Regulation is construed as separate to the end, and that if any section, item, sentence, clause or phrase is held invalid for any reason, the remainder of this Regulation shall continue in full force and effect.

Section 14: Variance
The Board of Health may vary the application of any provision of this Regulation. Any variance granted by the Board of Health must be based on written finding of fact and be preceded by a public hearing. A copy of the variance will be made available to the public during business hours in the Offices of the Town Clerk and Board of Health.

This Regulation becomes effective January 1, 2001.

BY ITS BOARD OF HEALTH

APPROVED AS TO FORM:
David B. Alper, D.P.M.

Donna S. David, R.N., M.N. Robert J. Morrissey, Town Counsel

       Public Hearing:
Robert M. Eisendrath, M.D.    Enactment advertised in the Belmont
       Citizen Herald:

BOARD OF HEALTH
TOWN OF BELMONT

BODY ART REGULATIONS

In accordance with the provisions of Chapter 111, Section 31 of the Commonwealth of Massachusetts General Laws, the Belmont Board of Health hereby adopts the following regulations, which become effective July 1, 2001.

1. Purpose

Whereas body art is becoming prevalent and popular throughout the Commonwealth; and whereas knowledge and practice of universal precautions, sanitation, personal hygiene, sterilization and aftercare requirements on the part of the practitioner should be demonstrated to prevent the transmission of disease or injury to the client and/or practitioner; now, therefore the Belmont Board of Health passes these rules and regulations for the practice of body art in the Town of Belmont as part of our mission to protect the health, safety and welfare of the public.

2. Definitions

Aftercare means written instructions given to the client, specific to the body art procedure(s) rendered, about caring for the body art and surrounding area, including information about when to seek medical treatment, if necessary.

Applicant means any person who applies to the Board of Health for either a body art establishment permit or practitioner permit.

Autoclave means an apparatus for sterilization utilizing steam pressure at a specific temperature over a period of time.

Autoclaving means a process that results in the destruction of all forms of microbial life, including highly resistant spores, by the use of an autoclave for a minimum of thirty minutes at 20 pounds of pressure (PSI) at a temperature of 270 degrees Fahrenheit.

Bloodborne Pathogens Standard means OSHA Guidelines contained in 29 CFR 1910.1030, entitled "Occupational Exposure to Bloodborne Pathogens.”

Board of Health or Board means the Board of Health of the Town of Belmont.

Body Art means the practice of physical body adornment by permitted establishments and practitioners using, but not limited to, the following techniques: body piercing, tattoo-ing, cosmetic tattooing, branding, and scarification. This definition does not include practices that are considered medical procedures by the Board of Registration in Medicine, such as implants under the skin, which procedures are prohibited.

Body Art Establishment or Establishment means a location, place, or business that has been granted a permit by the Board, whether public or private, where the practices of body art are performed, whether or not for profit.

Body Art Practitioner or Practitioner means a specifically identified individual who has been granted a permit by the Board to perform body art in an establishment that has been granted a permit by the Board.

Body Piercing means puncturing or penetrating the skin of a client with sterile single-use needles and the insertion of sterile jewelry or other adornment into the opening. This definition excludes piercing of the earlobe with a sterile single-use stud-and-clasp system manufactured exclusively for ear-piercing.

Braiding means the cutting of strips of skin of a person, which strips are then to be intertwined with one another and placed onto such person so as to cause or allow the incised and interwoven strips of skin to heal in such intertwined condition.

Branding means inducing a pattern of scar tissue by use of a heated material (usually metal) to the skin, making a serious burn, which eventually becomes a scar.

Cleaning area means the area in a Body Art Establishment used in the sterilization, sanitation or other cleaning of instruments or other equipment used for the practice of body art.

Client means a member of the public who requests a body art procedure at a body art establishment.

Contaminated Waste means waste as defined in 105 CMR 480.000: Storage and Disposal of Infectious or Physically Dangerous Medical or Biological Waste, State Sanitary Code, Chapter VIII and/or 29 Code of Federal Regulation part 1910.1030. This includes any liquid or semi-liquid blood or other potentially infectious material; contaminated items that would release blood or other potentially infectious material in a liquid or semi-liquid state if compressed; items on which there is dried blood or other potentially infectious material and which are capable of releasing these materials during handling; sharps and any wastes containing blood or other potentially infectious materials.

Cosmetic Tattooing, also known as permanent cosmetics, micro pigment implantation or dermal pigmentation, means the implantation of permanent pigment around the eyes, lips and cheeks of the face and hair imitation.
Disinfectant means a product registered as a disinfectant by the U.S. Environmental Protection Agency (EPA).

Disclosure Statement means a statement of risks and consequences of any body art procedure, read and signed by each client prior to the procedure being done.

Disinfection means the destruction of disease-causing microorganisms on inan-imate objects or surfaces, thereby rendering these objects safe for use or handling.

Ear piercing means the puncturing of the lobe of the ear with a pre-sterilized single-use stud-and-clasp ear-piercing system following the manufacturer's instructions.

Equipment means all machinery, including fixtures, containers, vessels, tools, devices, implements, furniture, display and storage areas, sinks, and all other apparatus and appurtenances used in connection with the operation of a body art establishment.

Exposure means an event whereby there is an eye, mouth or other mucus membrane, non-intact skin or parenteral contact with the blood, bodily fluids or potentially infectious matter of another person.

Hand Sink means a lavatory equipped with hot and cold running water under pressure, used solely for washing hands, arms, or other portions of the body.

Hot water means water that attains and maintains a temperature 110º-130ºF.

Instruments Used for Body Art means hand pieces, needles, needle bars, and other instruments that may come in contact with a client's body or may be exposed to bodily fluids during any body art procedure.

Invasive means entry into the client’s body either by incision or insertion of any instruments into or through the skin or mucosa, or by any other means intended to puncture, break, or otherwise compromise the skin or mucosa.

Jewelry means any ornament inserted into a newly pierced area, which must be made of surgical implant-grade stainless steel; solid 14k or 18k white or yellow gold, niobium, titanium, or platinum; or a dense, low-porosity plastic, which is free of nicks, scratches, or irregular surfaces and has been properly sterilized prior to use.

Light colored means a light reflectance value of 70 percent or greater.

Minor means any person under the age of eighteen (18) years.

Mobile Body Art Establishment means any trailer, truck, car, van, camper or
            other motorized or non-motorized vehicle, a shed, tent, movable structure,
            bar, home or other facility wherein, or concert, fair, party or other event
            whereat one desires to, or actually does, conduct body art procedures.

Operator means any person who individually, or jointly or severally with others, owns, or controls an establishment, but is not a body art practitioner.

Permit means Board of Health approval in writing to either (1) operate a body art establishment or (2) operate as a body art practitioner within a body art establishment. Board approval shall be granted solely for the practice of body art pursuant to these regulations. Said permit is exclusive of the establishment’s compliance with other licensing or permitting requirements that may exist within the Board of Health's jurisdiction.

Person means an individual, any form of business or social organization or any other non-governmental legal entity, including but not limited to corporations, partnerships, limited-liability companies, associations, trusts or unincorporated organizations.

Physician means an individual licensed as a qualified physician by the Board of Registration in Medicine pursuant to M.G.L. c. 112 § 2.

Procedure surface means any surface of an inanimate object that contacts the client's unclothed body during a body art procedure, skin preparation of the area adjacent to and including the body art procedure, or any associated work area that may require sanitizing.

Sanitary means clean and free of agents of infection or disease.

Sanitize means the application of a U.S. EPA registered sanitizer on a cleaned surface in accordance with the label instructions.

Scarification means altering skin texture by cutting the skin and controlling the body’s healing process in order to produce wounds, which result in permanently raised wheals or bumps known as keloids.

Sharps means any object, sterile or contaminated, that may intentionally or accidentally cut or penetrate the skin or mucosa, including, but not limited to, needle devices, lancets, scalpel blades, razor blades, and broken glass.

Sharps Container means a puncture-resistant, leak-proof container that can be closed for handling, storage, transportation, and disposal and that is labeled with the International Biohazard Symbol.

Single Use Items means products or items that are intended for one-time, one-person use and are disposed of after use on each client, including, but not limited to, cotton swabs or balls, tissues or paper products, paper or plastic cups, gauze and sanitary coverings, razors, piercing needles, scalpel blades, stencils, ink cups, and protective gloves.

Sterilize means the use of a physical or chemical procedure to destroy all microbial life including highly resistant bacterial endospores.

Tattoo means the indelible mark, figure or decorative design introduced by insertion of dyes or pigments into or under the subcutaneous portion of the skin.

Tattooing means any method of placing ink or other pigment into or under the skin or mucosa by the aid of needles or any other instrument used to puncture the skin, resulting in permanent coloration of the skin or mucosa. This term includes all forms of cosmetic tattooing.

Temporary Body Art Establishment means the same as Mobile Body Art Establishment.

Three dimensional “3D” Body Art or Beading or Implantation means the form of body art consisting of or requiring the placement, injection or insertion of an object, device or other thing made of matters such as steel, titanium, rubber, latex, plastic, glass or other inert materials, beneath the surface of the skin of a person. This term does not include Body Piercing. This definition does not include practices that are considered medical procedures by the Board of Registration in Medicine.

Ultrasonic Cleaning Unit means a unit approved by the Board, physically large enough to fully submerge instruments in liquid, which removes all foreign matter from the instruments by means of high frequency oscillations transmitted through the contained liquid.

Universal Precautions means a set of guidelines and controls, published by the Centers for Disease Control and Prevention (CDC), as "Guidelines for Prevention of Transmission of Human Immunodeficiency Virus (HIV) and Hepatitis B Virus (HBV) to Health-Care and Public-Safety Workers" in Morbidity and Mortality Weekly Report) (MMWR), June 23, 1989, Vo1.38 No. S-6, and as "Recommendations for Preventing Transmission of Human Immunodeficiency Virus and Hepatitis B Virus to Patients During Exposure-Prone Invasive Procedures" in MMWR, July 12,1991, Vo1.40, No. RR-8. This method of infection control requires the employer and the employee to assume that all human blood and specified human body fluids are infectious for HIV, HBV, and other blood pathogens. Precautions include hand washing; gloving; personal protective equipment; injury prevention; and proper handling and disposal of needles, other sharp instruments, and blood and body fluid-contaminated products.

3. Exemptions

(A) Physicians licensed in accordance with M.G.L. c. 112 § 2 who perform body art procedures as part of patient treatment are exempt from these regulations.

(B) Individuals who pierce only the lobe of the ear with a sterile single-use stud-and-clasp ear-piercing system are exempt from these regulations.

4. Restrictions

(A) No tattooing, piercing of genitalia, branding or scarification shall be performed on a person under the age of 18.

(B) Body piercing, other than piercing the genitalia, may be performed on a person under the age of 18 provided that the person is accompanied by a properly identified parent, legal custodial parent or legal guardian who has signed a form consenting to such procedure. Properly identified shall mean a valid photo identification of the adult and a birth certificate of the minor.

(D) The following body piercings are hereby prohibited: piercing of the uvula; piercing of the tracheal area; piercing of the neck; piercing of the ankle; piercing between the ribs or vertebrae; piercing of the web area of the hand or foot; piercing of the lingual frenulum (tongue web); piercing of the clitoris; any form of chest or deep muscle piercings, excluding the nipple; piercing of the anus; piercing of an eyelid, whether top or bottom; piercing of the gums; piercing or skewering of a testicle; so called “deep” piercing of the penis – meaning piercing through the shaft of the penis, or “trans-penis” piercing in any area from the corona glandis to the pubic bone; so called “deep” piercing of the scrotum – meaning piercing through the scrotum, or “transcrotal” piercing; so called “deep” piercing of the vagina.

(E) The following practices hereby prohibited unless performed by a medical doctor licensed by the Commonwealth of Massachusetts: tongue splitting; braiding; three dimensional/beading/implementation
tooth filing/fracturing/removal/tatooing; cartilage modification; amputation; genital modification; introduction of saline or other liquids.

(F) No person shall establish or operate a Mobile or Temporary Body Art
Establishment.

5. Operation of Body Art Establishments

Unless otherwise ordered or approved by the Board, each body art establishment shall be constructed, operated and maintained to meet the following minimum requirements:

(A) Physical Plant

(1) Walls, floors, ceilings, and procedure surfaces shall be smooth, durable, free of open holes or cracks, light-colored, washable, and in good repair. Walls, floors, and ceilings shall be maintained in a clean condition. All procedure surfaces, including client chairs/benches, shall be of such construction as to be easily cleaned and sanitized after each client.

(2) Solid partitions or walls extending from floor to ceiling shall separate the establishment’s space from any other room used for human habitation, any food establishment or room where food is prepared, any hair salon, any retail sales, or any other such activity that may cause potential contamination of work surfaces.

(3) The establishment shall take all measures necessary to ensure against the presence or breeding of insects, vermin, and rodents within the establishment.

(4) Each operator area shall have a minimum of 45 square feet of floor space for each practitioner. Each establishment shall have an area that may be screened from public view for clients requesting privacy. Multiple body art stations shall be separated by dividers or a partition at a minimum.

(5) The establishment shall be well ventilated and provided with an artificial light source equivalent to at least 20 foot candles 3 feet off the floor, except that at least 100 foot candles shall be provided at the level where the body art procedure is being performed, where instruments and sharps are assembled, and all cleaning areas.

(6) All electrical outlets in operator areas and cleaning areas shall be equipped with approved ground fault (GFCI) protected receptacles.

(7) A separate, readily accessible hand sink with hot and cold running water under pressure, preferably equipped with wrist- or foot-operated controls and supplied with liquid soap, and disposable paper towels stored in fixed dispensers shall be readily accessible within the establishment. Each operator area shall have a hand sink.

(8) There shall be a sharps container in each operator area and each cleaning area.

(9) There shall be a minimum of one toilet room containing a toilet and sink. The toilet room shall be provided with toilet paper, liquid hand soap and paper towels stored in a fixed dispenser.

(10) The public water supply entering a body art establishment shall be protected by a reduced pressure back flow prevention device installed in accordance with 142 Code of Massachusetts Regulation 248, as amended from time to time.

(11) At least one covered, foot operated waste receptacle shall be provided in each operator area and each toilet room. Receptacles in the operator area shall be emptied daily. Solid waste shall be stored in covered, leakproof, rodent-resistant containers and shall be removed from the premises at least weekly.

(12) At least one janitorial sink shall be provided in each body art establishment for use in cleaning the establishment and proper disposal of non-contaminated liquid wastes in accordance with all applicable Federal, state and local laws. Said sink shall be of adequate size equipped with hot and cold running water under pressure and permit the cleaning of the establishment and any equipment used for cleaning.

(13) All instruments and supplies shall be stored in clean, dry, and covered containers. Containers shall be kept in a secure area specifically dedicated to the storage of all instruments and supplies.

(14) The establishment shall have a cleaning area. Every cleaning area shall have an area for the placement of an autoclave or other sterilization unit located or positioned a minimum of 36 inches from the required ultrasonic cleaning unit.

(15) The establishment shall have a customer waiting area, exclusive and separate from any workstation, instrument storage area, cleaning area or any other area in the body art establishment used for body art activity.

(16) No animals of any kind shall be allowed in a body art establishment except service animals used by persons with disabilities (e.g., Seeing Eye dogs). Fish aquariums shall be allowed in waiting rooms and nonprocedural areas.

(17) Smoking, eating, or drinking is prohibited in the area where body art is performed, with the exception of non-alcoholic fluids being offered to a client during or after a body art procedure.

(B) Requirements for Single Use Items Including Inks, Dyes and Pigments

(1) Single-use items shall not be used on more than one client for any reason. After use, all single-use sharps shall be immediately disposed of in approved sharps containers pursuant to 105 CMR 480.000.

(2) All products applied to the skin, such as, but not limited to, body art stencils, applicators, gauze and razors, shall be single use and disposable.

(3) Hollow bore needles or needles with cannula shall not be reused.

(4) All inks, dyes, pigments, solid core needles, and equipment shall be specifically manufactured for performing body art procedures and shall be used according to manufacturer's instructions.

(5) Inks, dyes or pigments may be mixed and may only be diluted with water from an approved potable source. Immediately before a tattoo is applied, the quantity of the dye to be used shall be transferred from the dye bottle and placed into single-use paper cups or plastic cups. Upon completion of the tattoo, these single-use cups or caps and their contents shall be discarded.

(1) All non-disposable instruments used for body art, including all reusable solid core needles, pins and stylets, shall be cleaned thoroughly after each use by scrubbing with an appropriate soap or disinfectant solution and hot water, (to remove blood and tissue residue), and shall be placed in an ultrasonic unit sold for cleaning purposes under approval of the U.S. Food and Drug Administration and operated in accordance with manufacturer's instruc-tions.

(2) After being cleaned, all non-disposable instruments used for body art shall be packed individually in sterilizer packs and subsequently sterilized in a steam autoclave sold for medical sterilization purposes under approval of the U.S. Food and Drug Adminstration. All sterilizer packs shall contain either a sterilizer indicator or internal temperature indicator. Sterilizer packs must be dated with an expiration date not to exceed six (6) months.
(3) The autoclave shall be used, cleaned, and maintained according to manufacturer's instruction. A copy of the manu-facturer's recommended procedures for the operation of the autoclave must be available for inspection by the Board. Autoclaves shall be located away from workstations or areas frequented by the public.

(4) Each holder of a permit to operate a body art establishment shall demonstrate that the autoclave used is capable of attaining sterilization by monthly spore destruction tests. These tests shall be verified through an independent laboratory. The permit shall not be issued or renewed until documentation of the autoclave’s ability to destroy spores is received by the Board. These test records shall be retained by the operator for a period of three (3) years and made available to the Board upon request.

(5) All instruments used for body art procedures shall remain stored in sterile pack-ages until just prior to the performance of a body art procedure. After sterilization, the instruments used in body art procedures shall be stored in a dry, clean cabinet or other tightly covered container reserved for the storage of such instruments.

(6) Sterile instruments may not be used if the package has been breached or after the expiration date without first re-packaging and re-sterilizing.

(7) If the body art establishment uses only single-use, disposable instruments and products, and uses sterile sup-plies, an autoclave shall not be required.

(8) When assembling instruments used for body art procedures, the operator shall wear disposable medical gloves and use med-ically recognized sterile techniques to ensure that the instruments and gloves are not contaminated.

(9) Reusable cloth items shall be mechanically washed with detergent and mechanically dried after each use. The cloth items shall be stored in a dry, clean environment until used. Should such items become contaminated directly or indirectly with bodily fluids, the items shall be washed in accordance with standards applicable to hospitals and medical care facilities, at a temperature of 160?F or a temperature of 120?F with the use of chlorine disinfectant.
(D) Posting Requirements

The following shall be prominently displayed:

(1) A Disclosure Statement, a model of which shall be available from the Board. A Disclosure Statement shall also be given to each client, advising him/her of the risks and possible consequences of body art procedures.

(2) The name, address and phone number of the Belmont Board of Health and the procedure for filing a complaint.

(3) An Emergency Plan, including:
(a) a plan for the purpose of contacting police, fire or emergency medical services in the event of an emergency;
(b) a telephone in good working order shall be easily available and accessible to all employees and clients during all hours of operation; and
(c) a sign at or adjacent to the telephone indicating the correct emergency telephone numbers.

(4) An occupancy and use permit as issued by the Belmont Inspector of Buildings.

(5) A current establishment permit.

(6) Each practitioner’s permit.

(E) Establishment Recordkeeping

The establishment shall maintain the following records in a secure place for a minimum of three (3) years, and such records shall be made available to the Board of Health upon request:

(1) Establishment information, which shall include:
(a) establishment name;
(b) hours of operation;
(c) owner's name and address;
(d) a complete description of all body art procedures performed;
(e) an inventory of all instruments and body jewelry, all sharps, and all inks used for any and all body art procedures, including names of manufacturers and serial or lot numbers, if applicable. Invoices or packing slips shall satisfy this requirement;
(f) A Material Safety Data Sheet, when available, for each ink and dye used by the establishment
(f) copies of waste hauler manifests
(g) copies of commercial biological monitoring tests
(h) Exposure Incident Report (kept permanently); and
(j) a copy of these regulations.

(2) Employee information, which shall include:
(a) full legal names and exact duties;
(b) date of birth;
(c) home address;
(d) home /work phone numbers;
(e) identification photograph;
(f) dates of employment;
(g) Hepatitis B vaccination status ( The establishment shall require that all body art practitioners have either completed, or were offered and declined, in writing, the hepatitis B vaccination series.)
(h) training records

(3) Client Information, which shall include:
(a) name;
(b) age and valid photo identification
(c) address of the client;
(d) date of the procedure;
(e) name of the practitioner who performed the procedure(s);
(f) description of procedure(s) performed and the location on the body;
(g) a signed consent form as specified by 7(D )(2); and,
(h) if the client is a person under the age of 18, proof of parental or guardian identification, presence and consent including a copy of the photographic identification of the parent or guardian.

Client information shall be kept confidential at all times. The Board of Health shall have access to such confidential information in the case of a complaint investigation.

(4) Exposure Control Plan

Each establishment shall create, update, and comply with an Exposure Control Plan. The Plan shall be submitted to the Board for review so as to meet all of the requirements of OSHA regulations, to include, but not limited to, 29 Code of Federal Regulation 1910.1030 OSHA Bloodborne Pathogens Standards et seq, as amended from time to time. A copy of the Plan shall be maintained at the Body Art Establishment at all times and shall be made available to the Board upon request.

6. Standards of Practice

Practitioners are required to comply with the following minimum health standards:

(A) A practitioner shall perform all body art procedures in accordance with Universal Precautions set forth by the U.S Centers for Disease Control and Prevention.

(B) A practitioner shall refuse service to any person whom he/she reasonably believes to be under the influence of alcohol or drugs.

(C) Practitioners who use ear-piercing systems must conform to the manufacturers directions for use, and to applicable U.S. Food and Drug Administration requirements. No practitioner shall use an ear piercing system on any part of the client’s body other than the lobe of the ear.

(D) Health History and Client Informed Consent. Prior to performing a body art procedure on a client, the practitioner shall:

(1) Inform the client, verbally and in writing that the following health conditions may increase health risks associated with receiving a body art procedure:

(a) history of diabetes;
(b) history of hemophilia (bleeding);
(c) history of skin diseases, skin lesions, or skin sensitivities to soaps, disinfectants etc.;
(d) history of allergies or adverse reactions to pigments, dyes, or other sensitivities;
(e) history of epilepsy, seizures, fainting, or narcolepsy;
(f) use of medications such as anticoagulants, which thin the blood and/or interfere with blood clotting; and
(g) any other conditions such as hepatitis or HIV.

(2) Require that the client sign a form confirming that the above information was provided, that the client does not have a condition associated with health risks when receiving body art, that the client consents to the performance of the body art procedure and that the client has been given the aftercare instructions as required by section 7(K).

(E) A practitioner shall maintain the highest degree of personal cleanliness, conform to best standard hygienic practices, and wear clean clothes when performing body art procedures. Before performing body art procedures, the practitioner must thoroughly wash his/her hands in hot running water with liquid soap, then rinse hands and dry with disposable paper towels. This shall be done as often as necessary to remove contaminants.

(F) In performing body art procedures, a practitioner shall wear disposable single-use gloves. Gloves shall be changed if they become pierced, torn, or otherwise contaminated by contact with any unclean surfaces or objects or by contact with a third person. The gloves shall be discarded, at a minimum, after the completion of each procedure on an individual client, and hands shall be washed in accordance with section (E) before the next set of gloves is put on. Under no circumstances shall a single pair of gloves be used on more than one person. The use of disposable single-use gloves does not preclude or substitute for handwashing procedures as part of a good personal hygiene program.

(G) The skin of the practitioner shall be free of rash or infection. No practitioner affected with boils, infected wounds, open sores, abrasions, weeping dermatological lesions or acute respiratory infection shall work in any area of a body art establish-ment in any capacity in which there is a likelihood that that person could contaminate body art equipment, supplies, or working surfaces with body substances or pathogenic organisms.

(H) Any item or instrument used for body art that is contaminated during the procedure shall be discarded and replaced immediately with a new disposable item or a new sterilized instrument or item before the procedure resumes.

(I) Preparation and care of a client’s skin area must comply with the following:

(1) Any skin or mucosa surface to receive a body art procedure shall be free of rash or any visible infection.

(2) Before a body art procedure is performed, the immediate skin area and the areas of skin surrounding where a body art procedure is to be placed shall be washed with soap and water or an approved surgical skin preparation. If shaving is necessary, single-use disposable razors or safety razors with single-service blades shall be used. Blades shall be discarded after each use, and reusable holders shall be cleaned and autoclaved after use. Following shaving, the skin and surrounding area shall be washed with soap and water. The washing pad shall be discarded after a single use.

(3) In the event of bleeding, all products used to stop the bleeding or to absorb blood shall be single use, and discarded immediately after use in appropriate covered con-tainers, and disposed of in accordance with 105 CMR 480.000.

(J) Petroleum jellies, soaps, and other products used in the application of stencils shall be dispensed and applied on the area to receive a body art procedure with sterile gauze or other sterile applicator to prevent contamination of the original container and its contents. The applicator or gauze shall be used once and then discarded.

(K) The practitioner shall provide each client with verbal and written instructions on the aftercare of the body art site. The written instructions shall advise the client:

(1) on the proper cleansing of the area which received the body art;
(2) to consult a health care provider for:
(a) unexpected redness, tenderness or swelling at the site of the body art procedure;
(b) any rash;
(c) unexpected drainage at or from the site of the body art procedure; or
(d) a fever within 24 hours of the body art procedure; and
(3) the address, and phone number of the establishment.

A copy shall be provided to the client. A model set of aftercare instructions shall be made available by the Board.

Contaminated waste shall be stored, treated and disposed of in accordance with 105 CMR 480.000: Storage and Disposal of Infectious or Physically Dangerous Medical or Biological Waster, State Sanitary Code,
Chapter VIII.

7. Exposure Incident Report

An Exposure Incident Report shall be completed by the close of the business day during which an exposure has, or might have taken place, by the involved or knowledgeable body art practitioner for every exposure incident occurring in the conduct of any body art activity.

Each Exposure Incident Report shall contain:

(1) A copy of the application and consent form for body art activity completed by any client or minor client involved in the exposure incident;
(2) A full description of the exposure incident, including the portion of the body involved therein;
(3) A description of the instrument(s) or other equipment implicated;
(4) A copy of body art practitioner license of the involved body art practitioner;
(5) Date and time of exposure;
(6) A copy of any medical history released to the body art establishment or body art practitioner; and
(7) Information regarding any recommendation to refer to a physician or waiver to consult a physician by persons involved.

8. Injury and/or Complication Reports

A written report of any injury, infection, complication or disease as a result of a body art procedure, or complaint of injury, infection, complication or disease, shall be forwarded by the operator to the Board which issued the permit, with a copy to the injured client within five working days of its occurrence or knowledge thereof. The report shall include:

(A) the name of the affected client;
(B) the name and location of the body art establishment involved;
(C) the nature of the injury, infection, complication or disease;
(D) the name and address of the affected client’s health care provider, if any;
(E) any other information considered relevant to the situation.

9. Complaints

(A) The Board shall investigate complaints received about an establishment or practitioner’s practices or acts, which may violate any provision of the Board's regulations.

(B) If the Board finds that an investigation is not required because the alleged act or practice is not in violation of the Board's regulations, then the Board shall notify the complainant of this finding and the reasons on which it is based.

(C) If the Board finds that an investigation is required, because the alleged act or practice may be in violation of the Board's regulations, the Board shall investigate and if a finding is made that the act or practice is in violation of the Board's regulations, then the Board shall apply whatever enforcement action is appropriate to remedy the situation and shall notify the complainant of its action in this manner.

10. Application for Body Art Establishment Permit

(A) No person may operate a body art establishment without a valid permit from the Board.

(B) Applications for a permit shall be made on forms prescribed by and available from the Board. An applicant shall submit all information required by the form and accompanying instructions. The term “application” as used herein shall include the original and renewal applications.

(C) An establishment permit shall be valid from the date of issuance and for no longer than one year unless revoked sooner by the Board.

(D) The Board shall require that the applicant provide, at a minimum, the following information in order to be issued an establishment permit:

(1) Name, address, and telephone number of:
(a) the body art establishment;
(b) the operator of the establishment; and
(c) the body art practitioner(s) working at the establishment;

(2) The manufacturer, model number, model year, and serial number, where applicable, of the autoclave used in the establishment;

(3) A signed and dated acknowledgement that the applicant has received, read and understood the requirements of the Board’s body art regulations;

(3) A drawing of the floor plan of the proposed establishment to scale for a plan review by the Board, as part of the permit application process; and,

(4) Exposure Report Plan

(5) Such additional information as the Board may reasonably require.

(E) The annual fee for the Body Art Establishment Permit shall be $100.

(F) A permit for a body art establishment shall not be transferable from one place or person to another.

11. Application for Body Art Practitioner Permit

(A) No person shall practice body art or perform any body art procedure without first obtaining a practitioner permit from the Board. The Board shall set a reasonable fee for such permits.

(B) A practitioner shall be a minimum of 18 years of age.

(C) A practitioner permit shall be valid from the date of issuance and shall expire no later than one year from the date of issuance unless revoked sooner by the Board.

(D)    Application for a practitioner permit shall include:
(1)   name;
(2)   date of birth;
(3)   residence address;
(4)   mailing address;
(5)   phone number;
(6)   place(s) of employment as a practitioner; and
(7)   training and/or experience as set out in (E) below.

(E) Practitioner Training and Experience

(1) In reviewing an application for a practitioner permit, the Board may consider experience, training and/or certification acquired in other states that regulate body art.

(2) Training for all practitioners shall be approved by the Board and, at a minimum, shall include the following:

(a) bloodborne pathogen training program (or equivalent) which includes infectious disease control; waste disposal; handwashing techniques; sterilization equipment operation and methods; and sanitization, disinfection and sterilization methods and techniques; and
(b) Current certification in First Aid and cardiopulmonary resuscitation (CPR).

Examples of courses approved by the Board include "Preventing Disease Transmission" (American Red Cross) and "Bloodborne Pathogen Training" (U.S. OSHA). Training/courses provided by professional body art organizations or associations or by equipment manufacturers may also be submitted to the Board for approval.

(3) The applicant for a body piercing practitioner permit shall provide documentation, acceptable to the Board, that he/she completed a course on anatomy and physiology with a grade of C or better at a college accredited by the New England Association of Schools and Colleges, or comparable accrediting entity. This course must include instruction on the system of the integumentary system (skin).

(4) The applicant for a tattoo, branding or scarification practitioner permit shall provide documentation, acceptable to the Board, that he/she completed a course on anatomy and physiology with a grade of C or better at a college accredited by the New England Association of Schools and Colleges, or comparable accrediting entity. This course must include instruction on the system of the integumentary system (skin). Such other course or program as the Board shall deem appropriate and acceptable may be substituted for the anatomy course.

(5) The applicant shall submit evidence satisfactory to the Board of at least two years actual experience in the practice of performing body art activities, whether such experience was obtained within or outside of the Commonwealth. This could be in the form of an apprenticeship.

(F) A practitioner’s permit shall be conditioned upon continued compliance with all applicable provisions of these rules and regulations.

(G) The annual fee for the Body Art Practitioner Permit shall be $50.

12. Grounds for Suspension, Denial, Revocation, or Refusal to Renew Permit

(A) The Board may suspend a permit, deny a permit, revoke a permit or refuse to renew a permit on the following grounds, each of which, in and of itself, shall constitute full and adequate grounds for suspension, denial, revocation or refusal to renew:

(1) any actions which would indicate that the health or safety of the public would be at risk;

(2) fraud, deceit or misrepresentation in obtaining a permit, or its renewal;

(3) criminal conduct which the Board determines to be of such a nature as to render the establishment, practitioner or applicant unfit to practice body art as evidenced by criminal proceedings resulting in a conviction, guilty plea, or plea of nolo contendere or an admission of sufficient facts;

(4) any present or past violation of the Board’s regulations governing the practice of body art;

(5) practicing body art while the ability to practice is impaired by alcohol, drugs, physical disability or mental instability;

(6) being habitually drunk or being dependent on, or a habitual user of narcotics, barbiturates, amphetamines, hallucinogens, or other drugs having similar effects;

(7) knowingly permitting, aiding or abetting, an unauthorized person to perform activities requiring a permit;

(8) continuing to practice while his/her permit is lapsed, suspended, or revoked;

(9) having been disciplined in another jurisdiction in any way by the proper permitting authority for reasons substantially the same as those set forth in the Board's regulations:

(10) other just and sufficient cause which the Board may determine would render the establishment, practitioner or applicant unfit to practice body art.

(B) The Board shall notify an applicant, establishment or practitioner in writing of any violation of the Board's regulations, for which the Board intends to deny, revoke, or refuse to renew a permit. The applicant, establishment or practitioner shall have seven (7) days after receipt of such written notice in which to comply with the Board's regulations. The Board may deny, revoke or refuse to renew a permit, if the applicant, establishment or practitioner fails to comply after said seven (7) days subject to the procedure outlined in Section 15.

13. Grounds for Suspension of Permit

The Board may summarily suspend a permit pending a final hearing on the merits on the question of revocation if, based on the evidence before it, the Board determines that an establishment and/or a practitioner is an immediate and serious threat to the public health, safety or welfare. The suspension of a permit shall take effect immediately upon written notice of such suspension by the Board.

14. Procedure for Hearings

The owner of the establishment or practitioner shall be given written notice of the Board’s intent to hold a hearing for the purpose of suspension, revocation, denial or refusal to renew a permit. This written notice shall be served through a certified letter sent return receipt requested or by constable. The notice shall include the date, time and place of the hearing and the owner of the establishment or practitioner’s right to be heard. The Board shall hold the hearing no later than 21 days from the date the written notice is received.
In the case of a suspension of a permit as noted in Section 13, a hearing shall be scheduled no later than 21 days from the date of the suspension.

15. Penalty

(A) Any person found to be in violation of these regulations may be fined the sum of $50.00 under the Non-Criminal disposition By-law of the Town
of Belmont.

(B) Each separate day's failure to comply with an order of the Board of Health
shall constitute a separate violation.

16. Severability

If any provision contained in these regulations is deemed invalid for any reason, it shall be severed and shall not affect the validity of the remaining provisions.

BY ITS BOARD OF HEALTH

David B. Alper, D.P.M. APPROVED AS TO FORM:

Donna S. David, R.N., M.N. Robert J. Morrissey, Town Counsel

       Public Hearing: April 4, 2001
Robert M. Eisendrath, M.D.    Enactment advertised in the Belmont
       Citizen-Herald:

NUISANCE CONTROL REGULATION

In accordance with the provisions of Chapter 111, Sections 31 and 122 of the M.G.L., and for the protection of public health, the Belmont Board of Health hereby adopts the following regulation effective July 1, 1991:

The occupant of any building used for business or habitation
shall be responsible for maintaining in a clean and sanitary
condition free of garbage, rubbish, other filth or health hazards
in that part of the building and outside area which he/she
occupies or control.

The owner of any building, vacant or otherwise, or parcel of
land, shall be responsible for maintaining said building or land
in a clean and sanitary condition, free from garbage, rubbish
overgrowth to a height of 12 inches or more, or other refuse.

All garbage or mixed garbage and rubbish shall be stored
in watertight receptacles with tight fitting covers. Said
receptacles and covers shall be of metal or other durable,
rodent proof material.

"Rubbish" means combustible and non-combustible waste
materials, except garbage, including but not limited to such
material as paper, cartons, wood, packing material, tree
branches, yard trimmings, grass clippings, cans, metals etc.

"Garbage" means the animal, vegetable, or other organic
waste resulting from the handling, preparing, cooking,
consumption or cultivation of food, containers and cans
which have contained food unless said containers and cans
have been cleaned or prepared for recycling.

Any person(s) found to be in violation of this regulation may be fined the sum of $50.00 under the Non-Criminal Disposition By-law of the Town of Belmont. Each separate day's failure to comply with an order of the Board of Health shall constitute a separate violation.
BOARD OF HEALTH

RULES AND REGULATIONS GOVERNING THE PRACTICE OF
MASSAGE/MUSCULAR THERAPY

Under the authority of Section 31 of Chapter III, and Section 51 of Chapter 140, the Board of Health of the Town of Belmont hereby adopts the following:

Rules and Regulations Governing the Practice of Massage/Muscular Therapy

Section I: Definitions

1) Massage or muscular therapy shall mean a method of applying pressure on or friction against, rubbing, kneading, tapping, pounding or stroking the external parts of the body with the hands or arms; with or without the aid of mechanical or electrical apparatus or appliances; and with or without supplementary aids such as rubbing alcohol, liniments, oils, creams, lotions, powders or similar preparations; for the purpose of reducing tension, stimulating circulation and generally providing for an increase in a person's health and well-being.

2) Massage or Muscular Therapist shall mean any person, male or female, who has been trained in and practices the art of massage or muscular therapy.

3) Approved shall mean approved by the Board of Health in accordance with accepted standards in the Commonwealth of Massachusetts.

Section II: Registration

1) No person may practice massage or muscular therapy within the Town of Belmont without a certificate of registration from the Board of Health.

2) An applicant for a certificate must:

a. complete an application form available at the Health Department
b. submit a certified copy of proof of graduation from a school of massage or muscular therapy approved by the American Massage Therapy Association and the Commonwealth of Massachusetts Department of Education.

Section II: Registration - cont'd.
or

proof of graduation from a school of massage or muscular therapy certified by the Board of Education in the State in which the school is located, and which requires at least 500 hours and at least six months of instruction and practicum training.

c. show certification that applicant is free of tuberculosis in communicable form as set forth by the Department of Public Health in the Commonwealth of Massachusetts.

3. The fee for a certificate of registration will be $50 per year.

4. All massage therapy certificates will expire on May 1 of each year.

Section III: Exceptions and Exclusions

1) The provisions of these regulations shall not apply to the following classes of individuals while engaged in the performance of the duties of their respective professions:
a. Physicians, surgeons, chiropractors, osteopaths, podiatrists, physical therapists or occupational therapists who are duly licensed to practice their respective profession in the Commonwealth of Massachusetts.

b. Nurses registered under the laws of the Commonwealth of Massachusetts.

c. Barbers and beauticians who are duly licensed under the laws of the Commonwealth of Massachusetts while engaging in practices within the scope of their licenses, except that this provision shall apply solely to the massaging of the neck, face, and/or scalp of the customer or client.

d. Personnel in hospitals, nursing homes or other health care facilities licensed by the Commonwealth of Massachusetts.

e. Coaches and athletic trainers acting within the scope of their employment at accredited high schools, junior colleges or other educational institutions.
Section III: Exceptions and Exclusions - cont'd.

2) A person registered or licensed to practice massage in any other city or town of the Commonwealth of Massachusetts may, at the request of a physician or other health care professional, attend patients, specified by said person, in Belmont. If requested, he/she shall submit to the Board of Health a copy of his/her registration or license from another community and written confirmation of the request.

Section IV: Massage Therapy Establishment Licensing Requirements

The Board of Health will license establishments for the sole purpose of providing massage therapy if the following requirements are met:

1) All zoning bylaws and requirements of the Town of Belmont are met as specified by the Department of Community Development.

2) All massage therapists practicing on the premises hold current massage therapy registrations from the Town of Belmont.

3) An application supplied by the Health Department has been completed.

4) A fee of $50 is paid to the Town of Belmont at the time the application is submitted.

5) License is non-transferable.

Section V: Massage Therapy Establishment Operating Requirements

1) Massage therapy establishments shall at all times be equipped with an adequate supply of clean sanitary towels, coverings, and linens. Clean towels, coverings and linens shall be stored in enclosed cabinets. Towels and linens shall not be used on more than one patron, unless they have first been laundered and disinfected. Disposable towels and coverings shall not be used on more that one patron. Soiled linens and disposable items shall be deposited in separate, approved receptacles.

2) Instruments utilized in performing massage shall not be used on more than one patron unless they have been sterilized, using approved sterilizing methods.

3) Pads used on massage tables shall be covered with a durable, washable, plastic or other waterproof material, and disinfected between patrons
Section V: Massage Therapy Establishment Operating Requirements - cont'd.

4) Therapists practicing in the establishment must be aware of disease transmission and practice good hand washing between patrons.

5) Walls, ceilings, floors and other physical facilities of the establishment must be maintained in good repair and in a clean and sanitary condition at all times.

6. A list of services and fees shall be clearly posted for the benefit of patrons.

7. The establishment shall be open to the Director of Health, or appointed designee, for the purpose of making reasonable, unscheduled inspections to observe and enforce compliance with applicable regulations. Inspections will be made on at least an annual basis.

Section VI: Penalty

1) Whoever violates any provision of these rules and regulations shall be punished by a fine of not more than one hundred dollars ($100.00).

2) If any clause, section, paragraph, sentence or phrase of these rules and regulations shall be decided invalid for any reason whatsoever, such decision shall not affect the remaining portions of these regulations, which shall remain in full force and effect, and to this end the provisions of these regulations are hereby declared severable.

BOARD OF HEALTH
Town of Belmont

Under the authority of Section 31 of Chapter III, and Section 51 of Chapter 140, the Board of Health of the Town of Belmont herby adopts the following:

Rules and Regulations Governing the
Practice of Massage/Muscular Therapy

Section 1 Definitions

2) Massage or Muscular Therapist shall mean any person, male or female, who has trained in and practices the art of massage or muscular therapy.

3) Approved shall mean approved by the Board of Health in accordance with accepted standards in the Commonwealth of Massachusetts.

Section 2 Registration

1) No person may practice massage or muscular therapy within the Town of Belmont without a certificate of registration from the Board of Health.

2) An applicant for a certificate must:

a. complete an application form available at the Health Department

b. submit a certified copy of proof of graduation from a school of
massage or muscular therapy approved by the American Massage Therapy Association and the Commonwealth of Massachusetts Department of Education.

c. show certification that applicant is free of tuberculosis in communicable form as set forth by the Department of Public Health in the Commonwealth of Massachusetts.

3) The fee for a certificate of registration will be $50 per year.

4) All massage therapy certificates will expire on May 1 of each year.

Section 3 Exceptions and Exclusions

1) The provisions of these regulations shall not apply to the following classes of individuals while engaged in the performance of the duties of their respective professions:

    a. Physicians, surgeons, chiropractors, osteopaths, podiatrists,
   physical therapists or occupational therapists who are duly
   licensed to practice their respective profession in the
   Commonwealth of Massachusetts.

b. Nurses registered under the laws of the Commonwealth of
Massachusetts.

c. Barbers and beauticians who are duly licensed under the laws
of the Commonwealth of Massachusetts while engaging in practices within the scope of their licenses, except that this provision shall apply solely to the massaging of the neck, face, and /or scalp of the customer or client.

d. Personnel in hospitals, nursing home or other health care facilities l licensed by the Commonwealth of Massachusetts.

e. Coaches and athletic trainers acting within the scope of their
employment at accredited high schools, junior colleges or other educational institutions.

Section 4 Massage Therapy Establishment Licensing Requirements

The Board of Health will license establishments for the sole purpose of providing massage therapy if the following requirements are met:

1) All zoning by-laws and requirements of the Town of Belmont are met as specified by the Department of Community Development.

2) All massage therapists practicing on the premises hold current massage therapy registrations from the Town of Belmont.

3) An application supplied by the Health Department has been completed.

4) A fee of $50 is paid to the Town of Belmont at the time the application is submitted.

5) License is non-transferable.

Section 5 Massage Therapy Establishment Operating Requirements

1) Massage therapy establishments shall at all times be equipped with an adequate supply of clean sanitary towels, coverings, and linens. Clean towels, coverings and linens shall be stored in enclosed cabinets. Towels and linens shall not be used on more than one patron, unless they have first been laundered and disinfected. Disposable towels and coverings shall not be used on more than one patron. Soiled linens and disposable items shall be deposited in separate, approved receptacles.

2) Instruments utilized in performing massage shall not be used on more than one patron unless they have been sterilized, using approved sterilizing methods.

3) Pads used on massage tables shall be covered with a durable, washable, plastic or other waterproof material, and disinfected between patrons.

4) Therapists practicing in the establishment must be aware of disease transmission and practice good handwashing between patrons.

5) Walls, ceilings, floors and other physical facilities of the establishment must be maintained in good repair and in a clean and sanitary condition at all times.

6) A list of services and fees shall be clearly posted for the benefit of patrons.

7) The establishment shall be open to the Director of Health, or appointed designee, for the purpose of making reasonable, unscheduled inspections to observe and enforce compliance with applicable regulations. Inspections will be made on at least an annual basis.

Section 6 Penalty

1. Whoever violates any provision of these rules and regulations shall be punished by a fine of nor more than one hundred dollars ($100.00).

Approval as to form:
David B. Alper, D.P.M.

Robert J. Morrissey Donna S. David, R.N.
Town Counsel

Robert M. Eisendrath, M.D.

Advertised in the
Belmont Citizen-Herald
May 11, 1989
BOARD OF HEALTH
Town of Belmont

DUMPSTER/RUBBISH CONTRACTORS REGULATIONS

Section 1 Definitions

1) Board of Health means the appropriate and legally designated
health authority of the Town.

2) Contractor or Rubbish Contractor means any person who, for
compensation, supplies, maintains or services one or more
dumpsters, or removes, transports or disposes of the contents
thereof.

3) Dumpster means any receptacle of 75 gallon capacity or more
which is used for the collections, storage or transportation of
trash, rubbish, garbage, offal, scrap, or other material for
discard, disposal or recycling.

4) Owner means any person, including a lessee or mortgagee in
possession, who alone or severally with others has lawful title
to or lawful possession, care or control of any property on
which a dumpster is located or proposed to be located. Owner
also includes any authorized agent of such person.

5) Person includes any individual, partnership, corporation, firm,
association, or group.

6) Temporary Dumpster is one used for construction purposes that
will occupy a specific location for six months or less. It can be
at a commercial or residential location.

Section 2 Dumpsters - Annual

1) No dumpster shall be used or kept in the Town of Belmont after
December 31, 1983 unless a dumpster permit has been issued to
the Owner by the Board of Health.

2) Dumpster permits shall expire on December 31st in the year they
are issued, but may be renewed on an annual basis.

3) The annual fee for each dumpster permit shall be $25.

4) The Owner shall ensure that each dumpster is so located as to not
interfere with the health, safety, or well-being of any business or
neighbor.

5) Each dumpster shall be of sufficient capacity to contain all accumulated material without overflowing, and shall be emptied
on a regular basis or when full.

6) Each dumpster used in whole or part for the storage or
transportation of garbage, offal or other offensive substances
shall be fitted with a tight-fitting lid or cover, which shall be kept
closed at all times except when being filled, cleaned or emptied.
Said lid shall be kept locked between 11:00 p.m. and 7:00 a.m.

7) No dumpster shall be used for the disposal of liquids or organic
matter unless it is emptied on a daily basis.

8) The Owner shall ensure that each dumpster and the area
immediately surrounding it is kept free of obnoxious odors,
flies, insects, debris, overflow and all other nuisances.

Section 3 Dumpsters - Temporary

1) A permit must be obtained from the Health Department for
each temporary dumpster located in the Town.

2) The fee for a temporary dumpster permit shall be $10.

3) Temporary dumpsters placed on a public or private way shall be
equipped with reflective devices to warn motorists that a dumpster
is present.

4) The Police Department must be notified when a temporary dumpster
is to be located on a public or private way in the Town.

5) Temporary dumpsters must have a covering when full and being
removed from their location.

Section 4 Rubbish Contractor

1) No Person shall do business as a Rubbish Contractor in the Town
of Belmont after December 31, 1983 without first obtaining a
permit from the Board of Health.

2) The annual fee for each Rubbish Contractor permit shall be $50.

3) Rubbish Contractor permits shall expire on December 31st in the
year they are issued, but may be renewed on an annual basis.

4) Each dumpster owned, controlled or serviced by a Rubbish Contractor shall be conspicuously marked with the name and
telephone number of said contractor.

5) The Contractor shall ensure: (1) that the dumpster contents
are not spilled during removal or transportation; and (2)
that each dumpster which it owns, controls or services is
deodorized, washed or sanitized as necessary.

Section 5 Enforcement

1) Anyone violating any portion of these regulations will receive a
citation under the non-criminal disposition by-law of the Town.

2) A new citation will be issued for each new day that the
non-compliance occurs.

3) For continued non-compliance or failure to pay fines, a criminal
complaint will be filed in the District Court.

4) As a result of criminal proceedings, the Board may suspend or
revoke any dumpster or Contractor's permit.

Section 6 Severability

If any provision of this regulation is declared invalid or unenforceable by any court of competent jurisdiction, the other provisions of the regulations shall not be affected thereby, but shall continue in full force and effect.

These regulations were adopted by the Board of Health on June 29, 1983, amended on February 15, 1989 and amended further on August 29, 1990, in accordance with the applicable provisions of Chapter III, Section 31 of the Massachusetts General Laws.

BOARD OF HEALTH

BOARD OF HEALTH
Town of Belmont

RULES AND REGULATIONS FOR CONDUCTING
EXTERIOR ABRASIVE BLASTING

These regulation were adopted by the Board of Health on March 26, 1987 and amended on November 14, 1990 in accordance with Section 31C of Chapter III of the General Laws of the Commonwealth of Massachusetts.

Section 1 General Statement

1) No person shall engage in abrasive blasting of any kind without
a license and a "location-specific" permit from the Town of Belmont.

Section 2 Definitions

1) Abrasive Blasting - shall include both dry, wet and mist abrasive
blasting.

2) Abrasive Material - substance which is used to abrade or clean
a surface.

3) Air Contaminant - any substance in the ambient air space
including, but not limited to dust, fume, mist, odor, smoke,
vapor, heat, any combination thereof, or any reaction product
thereof.

4) Ambient Air Space - all of the air space outside of the shrouded
or contained work area spreading in all directions indefinitely.

5) Atmospheric pollution - the presence in the ambient air space of
one or more air contaminants or combination thereof in such concentration and of such duration as:

a) to be noticeable by sight or smell

b) to be injurious or tend to be injurious to human
or animal life, vegetation, or to property, or

c) to unreasonably interfere with the comfortable
enjoyment of life and property or the conduct of
business.

6) By-products - used abrasive material, paint chips, dust
or any other material resulting from the operation.

7) Contractor - a person who contracts to perform
abrasive blasting work at a certain price or rate.

8) Dangerous Level of Lead - level which materially
endangers the health of children or adults, by
producing a substantial and serious danger of lead
poisoning. When present in paint, a dangerous
level shall be deemed pursuant to M.G.L. Chapter 111
Sections 194 and 196, to be the following:

a) more than 0.5 percent lead by dry weight
   as measured by an atomic absorption
   spectrophotometry test of sample or
   by testing with 6 to 8 percent sodium solution.

b) more than 1.2 milligrams of lead per square
   centimeter of surface as measured on site by
   a mobile x-ray fluorescence analyzer or
   comparable equipment.

9) Department - The Health Department, Town of Belmont

10) Dry Abrasive Blasting - propulsion of a stream of abrasive
material by means of air, steam, or other gas under pressure,
for the purpose of abrading or cleaning a surface.

11) Dust - finely divided solid matter.

12) Electric Sanding - will be considered the use of power tools
to remove paint and consequently the same as dry abrasive
blasting.

13) Emission - discharge or release to the ambient air space of
any air contaminant.

14) Fume - any aerosol resulting from chemical reaction,
distillation, or sublimation.

15) Mist - any liquid aerosol formed by the condensation
of vapor or by the atomization of liquids.

16) Mist Abrasive Blasting - application, for the purpose of
abrading or cleaning a surface, or a water mist together
with an abrasive material which has been propelled by
means of compressed air, steam or other gas.

17) Odor - that property of gaseous, liquid or solid
materials that elicits a physiologic response by the
human sense of smell.

18) Operator - a person who performs abrasive blasting.

19) Particulate Matter - any material that exists in a
finely divided form as a liquid or solid in the ambient
air.

20) Person - an individual, partnership, association, firm,
syndicate, company, trust corporation, city
department, bureau, agency, or any other entity
recognized by law as the subject of rights and
duties.

21) Smoke - visible aerosol, which may contain fly-ash,
resulting from combustion of materials.

22) Vapor - the gaseous state of certain substances
that can exist in equilibrium with their solid or
liquid states under standard conditions.

23) Wet Abrasive Blasting - application, for the purpose
of abrading or cleaning a surface, of a stream of
water under pressure together with an abrasive
material which has been propelled by means of
compressed air, steam or gas.

Section 3 Licenses

1) A license shall be obtained on an annual basis by all
contractors conducting mist or wet abrasive
blasting within the Town of Belmont.

2) All licenses shall expire each year on March 31st.

3) A license may be obtained by filing an application
with the Department on forms provided by said
Department.

4) Fee for annual license shall be ten ($10) dollars.

5) All license holders must comply with the regulations
adopted herein.

Section 4 Permits

1) A permit, specific in location and time, shall be obtained
from the Department by the owner of the property to be
abrasively blasted, before work commences.

2) A permit will be granted only for abrasive blasting
operations done by contractors licensed by the Town
of Belmont.

3) Application for permit shall be made on forms(s)
provided by the Department.

4) The fee shall be determined by the Department based
on the estimated number of days to complete the
project, at a rate of $40.00 per day.

5) Permits must be obtained a minimum of two weeks prior
to the commencement of the abrasive blasting, so as to
allow the Department enough time to give one week's
notice to all abutters. Absolutely no exceptions will be made.

6) Authorized agents of the Department shall conduct on-site
inspections to ensure compliance with all applicable
regulations, particularly during set-up and clean-up
operations.

Section 5 Lead Testing

1) Paint chips, the size of a quarter, one from each different
contiguous surface (i.e. each side of a house) of areas to
be abrasively blasted must be sent to the State Division
of Lead Prevention, State Laboratory, 305 South St.,
Jamaica Plain, 02130, or other State Certified Laboratories to
determine the presence of lead, and results submitted to
the Health Department before obtaining permit.

Section 6 Conditions and Terms

1) Dry Abrasive Blasting

Dry abrasive blasting and machine sanding, except if said
sander is equipped with a HEPA filer vacuum, on exterior
surfaces of any structure within the Town of Belmont is
prohibited.

2) Mist Abrasive Blasting

a) Mist abrasive blasting is allowed on all surfaces if
the licensee is in compliance with Sections 6 and 7.

b) Mist abrasive blasting activities shall be so enclosed
   or curtained off to prevent the escape onto public
   property, rights-of-way, or the property of others,
   any air contaminant, particulate matter, or by-products
   of the operation.

c) Interior as well as the exterior of all windows, within the
shrouded area, are to be taped.

d) All ground area within work area shall be covered
with an impervious ground cloth to prevent any escape
of particulate matter.

e) Abrasive blasting may not commence, and must cease
   once started, if wind velocity or gusting wind is judged
   to be greater than or equal to ten (10) miles per hour.
   Velocity will be determined by the Department and
   permission granted to commence work on a daily
   basis.

f) All enclosures are to be inspected prior to the start of
   each work day by the contractor or operator.
   Enclosures which show excessive wear at any time, i.e.
   large holes or tears are to be adequately repaired or
   discarded. All enclosures which are joined together shall be
   adequately fastened to prevent any escape of particulate
   matter.

g) The following precautions shall be taken at all times
during the blasting operation:

1) Protection of gardens, vegetation or specially
planted areas on-site and adjacent properties.

   2) Protection of permanent play equipment, sandboxes,
    pools, and any other items that may be readily
    removed from possible exposure to particulate
    matter on-site or adjacent properties.

   3) Adequate protection of all areas where the blasting
    operation is in close proximity to playgrounds, parks,
    or any other area where use be the general public
    may pose a potential health problem.

h) The operator shall be responsible for securing the work site,
   and site, and cease operation immediately it if is found that any
   member of the general public is exposed to the abrasive
   material, air contaminants, or any by-product of the operation.

i) Operators shall confine work time to normal daylight working
   hours, to permit proper and adequate clean-up. Any exception
   to this regulation must receive special approval from the Health
   Department.

3) Wet Abrasive Masonry Blasting

a) Wet abrasive blasting on exterior masonry surfaces is permitted
if conditions as outlined in Sections 6 and 7 are met.

b) Plan for containment of abrasive material, water and particulate
matter must be submitted to Department when applying for
permit.

c) Ground cloths will be required to cover all unpaved areas within
the work area.

4) The reuse of abrasive material is prohibited.

5) Abrasive material shall not contain any free silica.

6) Employees or persons engaged in the performance of any aspect of
the blasting operation shall be protected against the inhalation of
particulate matter through the use of all protective devices including,
but not limited to, dust respirators approved by ASHA, or the American National Standards Institute (ANSI), goggles and
protective clothing.

Section 7 Clean-up Procedures

1) A properly filtered industrial vacuum will be used to remove all
particulate matter from all surfaces, including the ground, shrubs,
windows, doorways and ledges inside the shrouded work area
and ten feet beyond work area when the shrouding is removed.
Additional clean-up may be done, but no other method can replace the above procedures.

2) The work site is to be completely cleaned at the end of each
work day. Shrouding may be left in place as long as vacuuming
of the inside has taken place.

3) It shall be the responsibility of the contractor to prevent
ground contamination as a direct result of any abrasive material,
chemical or solvent used during the blasting operation or failure to
recover all material and by-products.

4) The cleaning shall include additional adjacent areas as deemed
necessary by the Department.

5) Disposal of all particulate matter shall be in accordance with DEP
regulations and at a site approved by DEP. Lead contaminated
paint (waste material) removed from homes by either homeowners
or contractors is exempt from the Massachusetts Hazardous Waste Regulations and should be disposed of in accordance with 310 CMR 19.000, Regulations for the Disposal of Solid Wastes by Sanitary Landfills, at an approved DEP Sanitary Landfill. Such waste material, however, removed from any other structure, which is in a quantity greater 20 kilograms and fails the E.P. Toxicity Test (conducted by a Certified Laboratory) is subject to the Massachusetts Hazardous Waste Regulations, 310 CMR 30.000, and should be disposed of accordingly.

Section 8 Evidence of Violation

1) Any of the following conditions shall be prima facie evidence of violations and will result in the immediate cessation of the blasting operation. Work can resume when inspector is satisfied that the violation(s) has/have been corrected.

a) Operating without an abrasive blasting license or
permit.

b) Failure to enclose or curtain off that area of the
building undergoing abrasive blasting.

c) Visible emission of particulate matter or air
contaminants outside of the area enclosed in
accordance with Section 6, Part 2.

d) Failure to ensure adequate precautions against
ground contamination as required by Section 6,
Part 2(d) and Section 6, Part 3(c).

e) Failure to clean property in accordance with Section 7.

2) If work is stopped twice on the same day due to violations,
the permit will automatically be revoked.

3) If a contractor has two successive permits revoked or three in one year within the Town. the contractor's license will be revoked for the remainder of the term of the license.

4) Contractors operating without a license and property owners failing to obtain a permit will receive a citation and fine under the Non- criminal Disposition By-law of the Town. The fine will be fifty ($50) dollars. For continued non-compliance or failure to pay fines, a criminal complaint will be filed in the District Court. For the first offense, a fine of not less than fifty ($50) dollars nor more than one hundred ($100) dollars will be imposed. For subsequent offenses, a fine of not less than two hundred ($200) dollars, nor more than five hundred ($500) dollars will be imposed. Each day or part thereof of violations, whether such violation be continuous or intermittent, shall be construed as a separate and succeeding offense. (M.G.L. Chapter III, Section 31C)

David B. Alper, D.P.M., Chairman
Donna S. David, R.N>