The fast-food establishment, which will be the city's fourth, won't be allowed to open 24-hours for the first six months but passed unanimously on Tuesday night.

Instead, it will be limited to 5am to 11pm opening hours, with a slight amendment for a noise validation assessment to be completed at the end of six months.

Councillor Phil Betts said the obesity concerns need to be dealt with through further community education.

"I do agree Dr Allen [who made representations in community consultation] has a valid point that some of the figures coming out show Tamworth is in some terms obese," he said.

"I have received quite a number of concerns but with 90 plus conditions and some of them are quite thorough and onerous, the people who had the concerns should be given the best level of comfort they possibly can."

"The council has no option but to approve this development because if they don't it will go to the NSW Land and Environment Court, cost the council $500,000 and it will still go ahead."

The $3.3 million project will be built at 114-122 Peel Street which neighbours an aged-care facility and houses on Marius Street.

Noise impacts were the main concerns raised in 22 submissions to the council against the project.

Developer of the McDonald's North store Adrian Sippel started at the store when he was younger and is now a franchisee.

A Tamworth local he spent his first 26 years here before he became a franchisee.

"I'd like to acknowledge the work that council have done in recommending this for approval and addressing the concerns of neighbours and the broader community," he said.

"I appreciate the feedback provided so far and am committed to liaising with and addressing the concerns of neighbours."

Mr Sippel said Mcdonald's Tamworth employs 420 locals and would provide jobs and further economic development if the new store is approved.

In recent times McDonald's Tamworth has supported local sports including golf and Little Athletics, Mr Sippel said.

"I am committed to being a good neighbour and community contributor and making sure this has a positive impact on Tamworth," he said.

McDonald's will need to provide a noise validation assessment to gain approval to open all the time after the six-month restriction.

Councillor Helen Tickle said in six months there will be time to assess the time restrictions and the owners of McDonald's can assess how much traffic they get through there.

"I can fully understand the concerns of the residents and hopefully the conditions will address that," she said.

"Healthy communities are strong communities, in Tamworth we have shocking figures for obesity and overweight, shocking figures for dental decay.

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"It is up to big companies like McDonald's to make a difference and McDonald's can make a difference to our community - they have massive marketing power ... so why not market healthy options as trendy ... why not instead of asking if they want a coke with that, ask if they want a water with that?

"Unfortunately we're known as the fattest town in Australia and that's a terrible statistic."

Lights will need to be dimmed or turned off by 11pm for the neighbours.

The restaurant will be able to seat 82 patrons and includes a McCafe, play area, two-lane drive-thru and two waiting bays.

The exit and entry points will be on Marius Street with 41 carparks on-site, one disabled park and a bike rack.

Retired doctor Lyn Allen took a stand against the development application for a fourth McDonald's during community consultation.

Dr Lyn Allen has worked as a GP in Tamworth since 1980 and back then the fast food options were limited to milk bars and corner shops.

"My scales then were 120kg ... they then made 150kg scales, 180kg scales and by the time I retired 200kg scales," she said.

"A change of diet and lack of cooking skills and exercise have made Tamworth one of the most obese cities in Australia.

"McDonald's North is a commercial development in a residential zone, the allowance for food and drink was initially designed for corner stores and neighbourhood stores of which there are very few left - it will not make a positive impact on the area."