Work can only be carried out between 7am and 6pm Monday to Friday, and 7am to 2pm on Saturdays.
The decision noted noise and vibration were together the most contentious topic in the application.
"Vibration from driving some 500 or so piles will be a significant effect for properties surrounding the site and some further afield, all in the centre of Dunedin," it stated.
"While the intrusion can be said to be temporary, in the sense that once the piles are installed the vibrations will cease, the duration of pile driving and its effects will be prolonged, enduring for a planned 47 weeks, or longer if the project experiences delays."
The most affected properties were likely to include the Oncology Department at the existing Dunedin Hospital, the printing press at the Otago Daily Times premises, residential locations in nearby hotels and apartments, the Dunedin Central Police Station, the Dunedin Central Fire Station, the Countdown Dunedin Central supermarket and an office block.
Consultation had to be carried out with occupiers of nearby buildings if the vibration from work was predicted to exceed 2.0mm/s peak particle velocity.
There were also noise limits in place, depending on the type of work and nearby buildings.
Meetings had to be held between key stakeholders every three months to review the traffic management plan.
During piling on the inpatient and outpatient sites, one of the footpaths in each of St Andrew, Castle and Cumberland Sts will be closed for periods of up to eight months.
Speed restrictions to 30kmh will be imposed in affected streets and two traffic lanes would be maintained in Cumberland and Castle Sts.
Earthworks on the new outpatient building are expected to begin in February next year and run for four months.
The decision was slightly delayed, after the panel extended its timeframe past the initial reporting back date of December 13.
One factor behind the panel's extension of deliberations was its decision to seek comment from the University of Otago on the proposal.
The panel had already asked a range of businesses and landowners near the inner-city site to comment on the application but initially opted not to include the university, which owns neighbouring land and also operates the Te Rangi Hiroa College residential college, which sits on designated hospital land.
The Government has agreed to a four-storey outpatient building, planned to open in January 2025, and a nine-storey inpatient building which it is hoped will be ready by April 2028. The project has a $1.47 billion budget.
- ODT