FORM I APPLICATION FOR SITE PLAN APPROVAL

Transcription

1 " Town of Burlington Planning Board 201:1 J"! 12 Pli 2: 25 Center Street, Burlington MA Phone: Fax Jrlv';'vL";'..,-K ^^rvv.burlington.org/planning/planning.html o^^ur^u t uu, M FORM I APPLICATION FOR SITE PLAN APPROVAL To: Town Clerk j~-. Town of Burlington, Massachusetts Date: ^JU^t 11, s) 0' J The undersigned hereby submits the accompanying Site Plan of property in Burlington, MA for Approval under the requirements of Article IX, Section of the Zoning Bylaw and the Regulation adopted thereunder. (Please Print) 1. Applicant FAX: Name: Changjin Park Tel: Company: d/b/a JEI Learning Center Mailing Address: r\7 Rid?e Street, Winchester, MA f ^7 Signature:, 2. Owner (if same as applicant,write "same") FAX: Name- 13 Adams Street Realty TrustTel: Company: If.Mailing Address: 13 Adams Street, Burlington, MA Signature: t^~~3%&*^*' ^^^^^ ^ ' o V 9 3. Attorney or Legal Representative FAX: Name: Thomas P. Murphy, Jr. Tel: Company:Shea' Mmrphy & Guide, P.C MailingAddress: 35' Ce^ter Street, Burlington, MA 018Q3 4. Engineer, Designer or Architect FAX: _ Name: Paul Fi^occriio Tel: Co mpany : -J-F. an^ Associates Mailing Address: 4 Highland Ave., Wakefield, MA G:\AppHcations, Forms & RuIes_Regs\fml_sp.doc 1 of 3

2 5. Project Location & Description Address: 11 Adams Street, Burlington, MA Map/Parcel No Zoning District (s): T A 10,029 sq. ft. c.,.. Lot Area: ' _ Existing GFA: GFA of Project: Final Site GFA: Brief Description of Project(attach addt'l pages if needed): Applicant seeks to remodel a section of the building for use as an after school learning center. 6. Deed of Property Recorded in Middlesex South Registry. Book 12741, Page 250 Date Acquired: 12/20/ Cost Construction Cost:, Type: DNew DReconstruction nalteration FILING INSTRUCTIONS Upon completion of the application, file the following with the Planning Department: Completed original application (ALL PAGES) Original mylar or reproducible linen, twelve folded paper copies of the plan and any other documentation being submitted A certified abutters (within 300') list obtained from the Town Assessor's Office Application Fee (Check or Money Order made payable to The Town of Burlington) The Planning Department will stamp the application "fee received", issue a receipt for the fee and retain the abutter's list, mylar and four copies of the plan and other documentation submitted. The original application and eight copies of the plan and other documentation will be returned to you for filing with the Town Clerk. This application is considered received on the date stamped by the Town Clerk. The Town Clerk will stamp the application "received" and make 9 copies and return the original to the Planning Department. One copy will be retained for their records, the balance to be transmitted with the plans and documentation packages to the departments specified in the "Request for Recommendation on Site Plan" (pg. 3). G:\Applications, Forms & Rules_Regs\fml_sp.doc 2 of 3

3 Planning Department: Fee Received By (Stamp/Initial): Fee: Receipt^: 1? ^00, on \$ ~s ^ ^^ / ' ^^ J Town Clerk: (Stamp/Initial/Date) / //O //^ Date Received: 1/2 IfX. > O Date Transmitted to Planning Board: C~\^ ral I, V^-^? 1,ir=i u \i/ Li=3 1 h \1 IN, 1 -, 2013 D/ PI AWNlMG BOARD " : ' ' / I / *n / 1 ^^C~xff]/\ ^ 1 t?q ^ '."^ 1 " * - ' " r-.1 - ' ^.'- f " - ** REQUEST FOR RECOMMENDATION ON SITE PLAN C " S tf To: Board of Selectmen - Board of Health - Conservation Commission - Town Engineer^'s ^ Department of Public Works - Fire Department - Police Department 3> -^ Inspector of Buildings (Please consider Street Numbers and Names, among others, in your review of this plan) According to the Site Plan Regulations in the Burlington Zoning Bylaw, your Board has the option to examine and to make recommendations on this plan and to submit your report to the Planning Department on or before ^ ovia \t ( cp-o\.ro (35 days from date of transmittal by the Town Clerk). Recommendation may be indicated directly on the attached plan. G:\Applications, Forms & Rules_Regs\fml_sp.doc 3 of 3

4 Town of Burlington 9 p$ 2: M6 Planning Board wb J' - ' 25 Center Street, Burlington MA ,,, Phone: Fax ^9*7-j;-; JYuri* MA wvvw.burlington.org/plannmg/planning.html To: APPLICATION FOR APPROVAL OF A SPECIAL PERMIT Town Clerk Town of Burlington, Massachusetts Pate: " The undersigned hereby requests a public hearing on this Special Permit Application under the requirements of Article IX, Section of the Zoning Bylaw Please PRINT 1. Applicant Name: Park FAX: Tel: Company: d/b/a.tkt T, Mailing Address: I2 7 St., Winchester, MA Owner (if same as applicant,write "same") FAX: Name: 13 Adams Street Realty Trust Tel: Company: Mailing Address: 13 Adams St., Burlington, I4A Attorney or Legal Representative FAX: Name: Thomas F. Murphy, Jr. Tel: Q90Q Company: Shea, Murphy & Guide r P.C. Mailing Address: 35 Center St., Burlington, MA Engineer, Designer or Architect FAX:^ Name: Paul Finocchio Tel: Company: P.J.F. and Associates Mailing Address: 4 Highland Ave., Wakefield, MA Project Location Address: 11 Adams Street, Burlington, MA _ Map/Parcel No. Zoning District (s): Tr^ G:\Applications, Forms & RuIesMRegs\c 1 of 3

5 6. Special Permit Sought (From Use Designation Table, Section 4.2.0, 4.3.0, 4.4.0) Use # Description: Brief Description of Proposed Use: other than non-profit educational facility 7. Site Plan (Check One) O An approved Site Plan is on file with the Planning Board 0 A Site Plan has been submitted for approval with this Special Permit O I request that the Planning Board consider the attached plot plan sufficient in place of a Site Plan. (Single family residential properties only) 6. Signatures '-- _ : Applicant Owner 3E«Both signatures MUST be present to submit this application. FILING INSTRUCTIONS Upon completion of the application, file the following with the Planning Department: Completed original application (ALL PAGES). Twelve folded paper copies of the current approved plan clearly marked with the proposed changes and twelve copies of any other supporting documentation being submitted. A certified abutters (within 300') list obtained from the Town Assessor's Office. Two complete sets of mailing labels for the abutters shown on the list. Application Fee (Check or Money Order made payable to The Town of Burlington). The Planning Department will stamp the application "fee received", issue a receipt for the fee and retain the abutters list, four copies of the plan and other supporting documentation. The original application and eight copies of the plan and other documentation will be returned to you for filing with the Town Clerk. This application is considered received on the date stamped by the Town Clerk. The Town Clerk will stamp the application "received" and make 9 copies and return the original to the Planning Department. One copy will be retained for their records, the balance to be transmitted with the plans and documentation packages to the departments specified in the "Request for Recommendation on Special Permit" (pg. 3). G:\Applications, Forms & Rules_Regs\fm_spmt.doc 2 of 3

6 Planning Department: Fee Received (Stamp/Initial): Fee: Receipt# PLANNING BOARD Town Clerk: (Stamp/Initial/Date) Date Received: (J) \ j / Date Transmitted to Planning Board: r-o ni o REQUEST FOR RECOMMENDATION ON A SPECIAL PERMIT To: Board of Selectmen Board of Health Conservation Commission Town Engineer Inspector of Buildings Department of Public Works Fire Department Police Department According to the Special Permit Rules & Regulations in the Burlington Zoning Bylaw, your Board has the option to examine and to make recommendations on this plan and to submit your report to the Planning Department on or before OOV^\, o2-o I <J (35 days from date of transmittal by the Town Clerk). If applicable, recommendation may be indicated directly on the attached plan. G:\Applications, Forms & Rules_RegsYfm_spmt.doc 3 of 3