APPLICATION FOR APPROVAL OF A SPECIAL PERMIT

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' ' Town of Burlington i ~.. C ~:! 'v ~~ ~) Planning Board 25 Center Street, Burlington MA 018Qa lo ;JG 2 2 p ~ : oq Phone: 781-270-1645 http://www.burlington.org/community devclopment/plarl.fiil\i.php'. ~i To: APPLICATION FOR APPROVAL OF A SPECIAL PERMIT Town Clerk Town of Burlington, Massachusetts Date: August 6, 2018 The undersigned hereby requests a public hearing on this Special Permit Application under the requirements of Article IX, Section 9.2.0 of the Zoning Bylaw (Please Print) 1. Applicant EMAIL dcaron@tmcrowley.com Name: Mr. Don Caron Tel: 508-801-0356 Company: T_M_C N_e_w_E_n~g~la_n_d~, _L_L_C_c_/o T_.M_._C_r_o_w_le~y_& A_ss_o_c_ia_te_s Mailing Address: 501 Pennsylvania Parkway; Suite 160; Indianapolis, IN 46280 Signature: ~ (}.~ 2. Property Owner (if same as applicant, write "same") EMAIL khague@edens.com Name: Mr. Keith Hague Tel: 617-369-6609 Company: Burlington Crossroads (E&A) LLC 3. Attorney EMAIL mvaughan@riemerlaw.com Name: Mr. Mark Vaughan Tel: 617-880-3457 Company: Riemer Braunstein Mailing Address: 700 District Ave; Burlington, MA 01803 4. Engineer, Designer or Architect EMAIL brian.dundon@rjoconnell.com Name: Brian Dundon Tel: 781-279-0180 x103 Company: RJ O'Connell & Associates, Inc. Mailing Address: 80 Montvale Ave.; Stoneham, MA; 02180 Special Permit Page 1 of3

5. Project Location Address: Burlington Crossroads Shopping Center- 34 Cambridge St. Map/Parcel No. Map 48; Lot 38 Zoning District (s): General Business (BG) 6. Special Permit Sought (From Use Designation Table, Section 4.2.0, 4.3.0, 4.4.0) Sec: 4.3.2.22 - Drive Thrqugh Use# Description: Sec: 6.1.2.2- Request for finding. Consideration of alteration, improvement or no change to pre-existing non-conformities: Parking Brief Description of Proposed Use: Construct a Pharmacy pick up/drop off window associated with the redevelopment of the former Busa Wine store to accommodate CVS. Additional renovations planned 7. Site Plan (Check One) by CVS will result in a loss of six (6) parking spaces (min. 801 spaces required 0 758 spaces provided, 764 parking spaces currently exists) An approved Site Plan is on file with the Planning Board 129 A Site Plan has been submitted for approval with this Special Permit 0 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 FILING INSTRUCTIONS It is recommended that you call 781-270-1645 prior to filing an application to arrange a submission appointment with the Senior Planner Upon completion of the application, file the following with the Plarining Department: Completed original application (ALL PAGES). Twelve folded paper copies of the current approved plan clearly markedwith the proposed changes and twelve copies of any other supporting documentation being submitted. One set of submittal material and plans must also be in electronic pdf format A certified abutters (within 300') list obtained from the ToWJ:l 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 abutter's list, four copies of the plan and other supporting documentation. The original application and eight copies cifthe 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. Special Permit Page2 ef3

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) Planning Department: Fee Received (Stamp/Initial): RECEIVED Fee:.$fo.:J.CT) AUG 22 2018 Receipt# \l.\3850 PLANNING DEPART Town Clerk: (Stamp/Initial/Date) Date Received: --------------------- Date Transmitted to Planning Board:.. ~ ~- ),,... "1.....,. -\', ~ REQUEST FOR RECOMMENDATION ON A SPECIAL PERMIT 1 ~ ;, ---..,... 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 ~ ~~, 'do\ b (35 days from date of transmittal by the Town Clerk).REQUEST FOR RECOMMENDATION ON A SPECIAL PERMIT To: Board of Selectmen Board ofhealth Conservation Commission Town Engineer Inspector of Buildings Department of Public Works Fire Department Police Department According tolm~~~...l!.endit Rules & Regulations in the Burlington Zoning Bylaw, our Board has the option to p=~~~:""'rvu a. your report to the Planning Department on or u a '"""UJ.. J&!ae!_l by the Town Clerk) Special Permit Page 3 of3

Town of Burlington,.. ~ t~, L:: :\t::;;.. Planning Board 25 Center Street, Burlington MA 0180~ l S WS 22 P tf: OC) Phone: 781-270-1645 http://www.burlington.org/community development/planniu'g.ptip. -....,, ;. f ' l,... J : FORMV APPLICATION FOR A MINOR ENGINEERING CHANGE To: The Planning Board Town of Burlington, Massachusetts Date: August 6, 2018 The undersigned hereby respectfully requests, pursuant to Section 3 of the Burlington Planning Board's Rules & Regulations, that the Planning Board approve as a "Minor Engineering Change" the following modifications to the property located at: Address: 34 Cambridge St- Burlington Crossroads Shopping Center- CVS Relocation Map and Parcel: Map 48; Lot 38 for which there is an approved Site Plan on file with the Planning Board which is: Entitled: Site Plan (Sheet 4 of 10) Submitted By: _E_de_n_s Prepared By: Bohler Engineering Dated October 19, 2012, and Revised to March 3, 2015 ---~-------------- Endorsed by the Planning Board on~m~a=-:.7..:..,~20.::..:1::.::5 Proposed Change(s) Please list proposed change(s) below. Include a statement supporting the basis for a "Minor Engineering Change". Attach additional pages as needed as well as redlined plans illustrating the proposed change(s). All pages of the plan that are affected must be redlined with proposed change(s). See Attached Narrative for Description of Plan Changes Minor Engineering Change 1 of3

Please Print Applicant Name:_M_r_D_o_n_C_ar_o_n Company: TMC New England, LLC c/o T.M. Crowley & Associates Mailing Address: 501 Pennsylvania Parkway; Suite 160; Indianapolis, IN; 46280 Phone: 508-801-0356 EMAIL: dcaron@tmcrowley.com Property Owner (if same as applicant,write "same") Name : Mr Keith Hague Company: Burlington Crossroads (E&A) LLC Mailing Address: 21 Custom House, Suite 450; Boston, MA 02110 Designer/ Architect/ Engine Company: R J O'Connell & Associates, Inc. Mailing Address: 80 Montvale Ave; Suite 201; Stoneham, MA 02180 Phone: 781-279-0180 x103 EMAIL: brian.dundon@rjoconnell.com Attorney I Legal Representative Name: :M~r.:..:M~a::.rk::...:V-=a:.::u~:>:gh:::an=------------------- Company: Riemer & Braunstein Mailing Address: 700 District Ave; Burlington, MA 01803 Phone: 617-880-3457 EMAIL: mvaughan@riemerlaw.com I, the applicant, am fully aware that if the Planning Board grants approval for said minor engineering change(s), I will be responsible for updating the record mylar on file with the Planning Board to show all approved minor engineering change(s) and submitting the revised mylar and CAD file(s) to the Planning Board with the required number of prints of said plan as is specified in the Board's decision. Applicant (Signature)_~----=~:..:...::..-=C=~=-=,.,. _ Minor Engineering Change 2 of3

FILING INSTRUCTIONS It is recommended that you call 781-270-1645 prior to filing an application to arrange a submission appointment with the Senior Planner Upon completion of the application, file the following with the Planning Department: Completed original application (ALL PAGES). Six folded paper copies of the current approved plan of record (no larger than 24 x 36}, redlined on all affected pages to show proposed change(s), and any other supporting documentation required. One set of submittal material and plans must also be in electronic pdf format. All electronic plans must be stamped by the Engineer. Application Fee (Check or Money Order made payable to The Town of Burlington) The Planning Department will stamp the application "received", issue a receipt for the fee and assign a meeting date at which time this matter will be scheduled to be discussed by the Planning Board. Planning Department: Application & Fee Received By (Stamp/Initial): Receipt# \ ~1::>-ckiD Amount:~ (::(]) m Rcv'd By: cxe RECEIVED AUG 22 2018 PLANNING OEPAR Minor Engineering Change 3 of3