HomeMy Public PortalAbout2022 Renewal letter and Low Risk BioSafety FillTOWN OF WATERTOWN
Board of Health
Administration Building
149 Main Street
Watertown, MA 02472
Phone: 617-972-6446
Fax: 617-972-6499
www.watertown-ma.gov
Larry Ramdin, MPH, REHS, CHO, CP-FS
Director of Public Health
2022 RENEWAL BIOSAFETY
APPLICATION FOR PERMIT OR REGISTRATION TO OPERATE BIOSCIENCE
LABORATORY
Dear Applicant:
Please find an enclosed 2022 Renewal Application for Permit or Registration to Operate a BioScience Laboratory.
It is required that you complete the attached application and return to the Watertown Health Department with the
following documentation to be reviewed by Watertown BioSafety Committee:
• Completed Application for Permit or Registration to Operate a BioScience Laboratory (a. or b.)
a. Recombinant DNA (rDNA) and/or Biologic Agents Permit BLS1, BLS2 - $500.00
b. Recombinant DNA (rDNA) use by Low -Risk Facilities BLS1 - $100.00
• Provide all the supplemental documents listed on the application with your submission of this application
• Provide an electronic copy of the application and supplemental documents
• Submit correct Permit or Registration Fee(s), checks payable to "Town of Watertown", see application.
• Must submit the most recent IBC meeting minutes. (All applicants must have had at least one IBC
meeting since January 1, 2021)
Watertown Health has established guidelines and regulations regarding permitting laboratories within the
community. The biosafety renewal applications must be received by December 31, 2021 with your payments and
completed applications.
The permit fee for Recombinant DNA (rDNA) and/or Biologic Agents Permit BLS 1, BLS2 is $500.00 and the
fee for Recombinant DNA (rDNA) use by Low -Risk Facilities BLS1 is $100.00 make your payments payable to
"Town of Watertown".
Completed applications and all supporting documentation must be received prior to December 31,
2021. Late fee of fifty dollars ($50.00) will be assessed for non -submittal of all applications and/or
incomplete application packets received after December 31, 2021. Please note that any missing
information may cause a delay in the permit renewal process.
Thank you for your attention to this matter and your anticipated compliance. Should you have any questions
please contact this office at (617) 972-6446.
Sincerely,
Director of Public Health
TOWN OF WATERTOWN
Board of Health
Administration Building
149 Main Street
Watertown, MA 02472
Phone: 617-972-6446
Fax: 617-972-6499
www.watertown-ma.gov
2022 Renewal Registration of Recombinant DNA (rDNA) use by Low -Risk Facilities
Please provide electronic version of your application and supporting documents
To the Watertown Board of Health:
The undersigned seek to register our use of rDNA pursuant to the Town of Watertown's Board of
Health regulation: Biotechnology and the use of Recombinant DNA Molecule Technology.
Biosafety Containment Level (check all that apply): ❑ BSL-1 ❑ BSL-2
Institution / Company Information:
Name of the Institution:
Address:
Mailing Address (If Different):
Phone:
Email:
Fax:
Date of Occupancy:
Institutional Official / Responsible Official / Chief Executive Officer (CEO):
Name:
Work Address:
Phone (Office):
Email:
Phone (cell):
❑Check if contact person for permit -related communication
Contact Person (if not selected above):
Name:
Work Address:
Phone (Office):
Email:
Phone (cell):
Please provide for the RENEWAL the following documentation:
❑ Completed and signed use of rDNA registration form.
❑ Check or money order payable to the Town of Watertown for $100.00.
Name and curriculum vitae of a person in the organization familiar with the proposed
rDNA Work and with the NIH Guidelines.
❑ This signed form with up-to-date company contact information.
A one -page summary of work performed over the past year. Including:
a. name and type of organisms (host/donor [foreign DNA]/vector) being used.
b. reference to the section of the NIH Guidelines where the work falls.
c. approximate percentage of viral genome present, if rDNA containing eukaryotic viruses are
propagated in cells.
d. scale (in liters) on which the organisms will be grown.
Any initial documents that have changed significantly (ex. new waste management company, new
pest control company, etc.)
II
Agreement and Signature
1. We, the undersigned, do hereby certify and affirm that all the information provided in this
application, including all attached documents, is true and accurate to the best of our
knowledge and belief.
2. We certify that we shall conduct work specified in this application in compliance with the Town
of Watertown's Board of Health regulation entitled Biotechnology and the use of Recombinant
DNA Molecule Technology.
3. We understand that, under the above -mentioned regulation, only facilities that have a biosafety
contentment level no higher than BSL-1, and are defined as a Low -Risk Facility, are allowed to
register in place of seeking a permit.
4. We understand that an amendment to this registration must be sought prior to annual renewal
in the following instances: move to a new location within the Town of Watertown, physical
expansion of lab space within current facilities, creation of additional lab space at another
location in the Town of Watertown, and/or the addition of Large -Scale activities as defined in
Appendix K of the NIH Guidelines. Amendments to the registration must be approved before
the above -mentioned changes can proceed.
5. We are aware that an increase in containment level above BSL-1 requires us to seek a permit
prior to the commencement of work.
6. We agree and consent to inspection of our facilities, procedures, and practices in order to
confirm compliance with the above -mentioned regulation and all applicable federal, state and
local laws by the Board or Health or its Agents at reasonable times. Inspections may be
conducted annually or with greater frequency if deemed necessary by the Board of Health.
Institutional Official / Responsible Official / CEO Date
(Signature)
Institutional Official / Responsible Official / CEO (Printed) Date