Section 041-25-1 - Application for Establishment License as Defined in 32 M.R.S.§14202(5)The applicant shall submit the information and documentation described below in a format as prescribed by the Director, along with the fee required by chapter 10, section 5(8) of the rules of the Office of Professional and Occupational Regulation, "Establishment of License Fees," and such other information as the Director may require.
1. The trade name or business name under which the establishment will operate2. The physical address, contact address, telephone number and email address of the establishment3. The name of the owner of the establishment, including: A. If a sole proprietor, the name, contact address, social security number, telephone number, fax number and email address of the applicant. B. If a partnership, the name, contact address, employer identification number, telephone number, fax number and email address of the partnership; the name and contact address of each partner; and the name of the partner who will be representing the applicant in matters relating to licensure by the Director.C. If a corporation, the name, contact address, employer identification number, telephone number, fax number and email address of the corporation; the name of the parent company, if any; the name, contact address and title of each corporate officer and Director; the name and contact address of each shareholder owning 10 percent or more of the voting stock of the corporation, including over-the-counter stock, unless the stock is traded on a major stock exchange and not over-the-counter; a certificate of existence from the Maine Secretary of State or, for corporations not organized under Maine law, a certificate of authority from the Maine Secretary of State; and the name of the corporate officer who will be representing the applicant in matters relating to licensure by the Director.D. If a limited liability company, the name, contact address, employer identification number, telephone number, fax number and email address of the limited liability company; a current list of names and mailing addresses of each member and manager described in 31 M.R.S. §655(1)(A); a certificate of existence from the Maine Secretary of State or, for limited liability companies not organized under Maine law, a certificate of authority from the Maine Secretary of State; and the name of the member or manager who will be representing the applicant in matters relating to licensure by the Director.4. A scaled floor plan of the establishment that details the purpose of each area of the facility including entrances, exits, dispensaries, shampoo sinks, utility sinks, work stations and public restroom facilities. Retail and other non-practice areas such as the public reception area, shall be clearly shown and described on the floor plan. If the establishment is part of a commercial building, the applicant shall include an additional scaled drawing and floor plan of the entire premises showing the relative position of the prospective establishment area and the location of all entrances, exits, bathrooms, and storage areas. Issuance of a license will be based on the floor plan submitted with the initial application for licensure. A structural change or alteration made subsequent to initial licensure requires approval prior to construction. A structural change or alteration includes, but is not limited to, changes to the original physical structure of the establishment affecting health and safety such as electrical or plumbing changes.
5. For purposes of initial licensure, the owner of the establishment or independent booth shall complete and attest to compliance with chapter 26 of this Program's rules. A license is issued in reliance on the truthfulness and accuracy of the checklist. The information reported on the checklist is subject to verification upon initial inspection. Sanctions may be imposed, including suspension or revocation of licensure, if the information reported is found to be false6. A current certificate of occupancy where required by local ordinance, or a copy of the plumbing certificate, or a copy of the establishment's internal plumbing permit signed by the local plumbing inspector affirming that the plumbing for the establishment is compliant with the Uniform Plumbing Code as adopted by the Plumbers' Examining Board, and a copy of the certificate affirming that the electrical for the establishment is compliant with the National Electrical Code as adopted by the Electricians' Examining Board7. Establishments not served by a Public Water System, as defined in 22 M.R.S. section2601(8), shall have the water supply tested for Total Coliform bacteria and nitrates by a laboratory certified by the Department of Health and Human Services Drinking Water Program within six (6) months of application for initial licensing. A current list of certified laboratories can be found at www.medwp.com. Water quality must meet the following standards to be considered satisfactory:
A. Total Coliform bacteria - Zero (0) colony forming units of Coliform bacteria per 100 milliliters of sample; andB. Nitrates - A maximum of ten (10) milligrams per Liter. In establishments where water supplies are found to be unsatisfactory, the owner is required to post a sign in the establishment in view of the public stating that the water has been determined to be unsatisfactory. The owner is required to obtain a new test within six (6) months of the date of an unsatisfactory water test, and to submit a copy of the new water test to the Director within ten (10) days of receipt.
02-041 C.M.R. ch. 25, § 1