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0 BROOKS STREET - CITY PROP - BUILDING INSPECTION r J t /�,/ ,, �Zjckl CITY OF SALEM - MASSACHUSETTS WILLIAM J.LUNDREGAN Legal Department JOHN D. KEENAN City Solicitor 93 Washington Street Assistant City Solicitor 81 Washington Street Salem, Massachusetts 01970 15 Church Street Tel:978.741-3888 Tel:978-744-8500 Fax:978-741-8110 Fax:978-744-0111 October 22 , 1998 Peter Strout Director of Public Property City of Salem One Salem Green, Second Floor Salem, MA 01970 RE: City of Salem purchase of Lot 192 Brook Street, Salem, MA from the Pelletiers Dear Mr. Strout : With reference to the above purchase of Lot 192 Brook Street, Salem, MA by the City of Salem, please find enclosed for your records original HUD Settlement Statement, original Certification of Title, original tax bill due November 1, 1998 , copy of Quitclaim Deed from the Pelletiers to the City of Salem and a copy of each of the Pelletiers ' licenses . These are important documents and should be kept in a safe place. If you have any questions with reference to this matter, please do not hesitate to call me. /Veryly youJ. LUND GAN CI Y SOLICITOR WJL/amc Enclosures HUD-1 UNIFORM SETTLEMENT STATEMENT m EASY SOFT,Inc. A. U.S.DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT SETTLEMENT STATEMENT B. TYPE OF LOAN 6.File Number: 7.Loan Number: 1. FHA 2. FmHA 3. Conv.Unins. 4. VA 5. Conv.Ins. 8. Mortgage Insurance Case Number C. NOTE: This farm is famished to give you a statement of actual settlement casts. Amounts paid to and by the settlement agent are shown. Items marked '(p.o.a)" were paid outside the closing; they are shown here for informational purposes and are not included in the totals. NOTE: TIN=Tax a er's Identification Number D. NAME AND ADDRESS OF NWER: E. NAME,ADDRESS AND TIN OF SELLER: F. NAME AND ADDRESS OF LENDER: BUYER Wilfred & Theresa PelletierN/A City of Salem Lionel & Mary Pelletier 93 Washington Street Anita M. Pelletier Salem, MA 01970 G. PROPERTY LOCATION: H. SETTLEMENT AGENT NAME,ADDRESS AND TIN Lot 192 Brook Street William J. Lundregan, Esq. , City Solicitor, City of Salem Salem, MA 01970 81 Washin ton Street Salem MA 01970 PLACE OF SETTLEMENT 1. SETTLEMENT DATE Wm. Lundregan, City Solicitor 10/14/1998 81 Washington St. Salem MA J. SUMMARY OF BORROWER'S TRANSACTION V- SUMMARY OF SELLER'S TRANSACTION 100.GROSS AMOUNT DUE FROM BORROWER: 400.GROSS AMOUNT DUE TO SELLER: 101.Contract sales price 10 000.00 401.Contract sales price 1 10 000.00 102.Personal property 402.Personal oroperty 103.Settlement charges to borrower Line 1400 190.00 403. 104. 404. 105. 405. Adjustments for items paid by seller in advance Adjustments for items paid by seller in advance 106.Ci /town taxes 406.Ci /town taxes 107.Coumv taxes 1 407.Countv taxes 108.Assessments 408.Assessments 109. 409. 110. 410. Ill 411. 112. 412. 120.GROSS AMOUNT DUE FROM BORROWER 10 190.00 420.GROSS AMOUNT DUE TO SELLER 10 000.00 200.AMOUNTS PAID BY OR IN BEHALF OF BORROWER: 500.REDUCTIONS IN AMOUNT DUE TO SELLER: 201.Deposit or earnest money 501.Excess deposit 202.Principal amount of new Ioan s) 502.Settlement charges to seller Line 1400 55.60 203.Existing Ioan s taken sub'ect to 503.Existing loans taken sub ecl to 204. 504.Payoff of first mortgage loan 205. 505.Pa off of second mortgage loan 206. 506. 207. 507. 208. 508. 209. 509. Ad'ustments for items unpaid by seller Adiustments for items unpaid by seller 210.Ci /town taxes 09/30/1998-10/14/1998 3.92 510.Ci /town taxes 09/3 0 1998-09/30/1998 3.92 211.County taxes 511.Countv taxes 212.Assessments 512.Assessments 213. 513. 214. 514. 215. 515. 216. 516. 217. 517. 218. 518. 219. 1 519. 220.TOTAL PAID BYIFOR BORROWER 3.92 520.TOTAL REDUCTION AMOUNT DUE SELLER 59.52 300.CASH AT SETTLEMENT FROM/TO BORROWER 600.CASH AT SETTLEMENT FROM/TO SELLER 301.Grass amount due from borrower Line 120 10 190.00 601.Gross amount due to seller Line 420 10 000.00 302.Less amount Paid by/for borrower Line 220 3.92 1 602.Less reduction in amount due seller Line 520 59.52 303.CASH FROM BORROWER 1 10 186.08 1 603.CASH TO SELLER 9,940.48 SUBSTITUTE FORM 1099 SELLER STATEMENT The information contained in Blocks E,G,H,and I and on line 401 (or,if line 401 is asterisked,line 403 and 404)is important tax information and is being furnished to the Internal Revenue Service. If you are required to file a return,a negligence penalty or other sanction will be imposed on you if this item is required to be reported and the IRS determines that it has of been reported.If this real estate is your principal residence,file Form 2119,Sale or Exchange of Principal Residence,for any gain,with your income tax return;for other transactions,complete the applicable parts of Form 4797,Form 6252 and/or Schedule D(Fomi 1040).You are required to provide the Settlement Agent (named above)with your correct taxpayer identification number.If you do not provide the Settlement Agent with your correct taxpayer identification number,you may be subject to pivtl r crimin posed by law.Under penalties of perjury,I certify that the number shown on this statement is my correct taxpayer identification number. -�nl. /'J1 11Ln� � I � (Seller's IS ed Si aturo rte• L. SETTLEMENT CHARGES m EASY SOFT,Inc. 700.TOTAL SALES/BROKER's COMMISSION based on price 10 000.00 ® PAID FROM PAID FROM Division of Commission(line 700 as follows: BORROWER'S SELLER'S 701. FUNDS AT FUNDS AT 702. SETTLEMENT SETTLEMENT 703.Commission vaid at Settlement 704. 800.ITEMS PAYABLE IN CONNECTION WITH LOAN 801.Loan Origination Fee 802.Loan Discount 803.Appraisal Fee to 804.Credit report to 805.Lender's Inspection Fee 806.Mortgage Insurance Atrolication Fee to 807.Assumption Fee 808. 809. 810, 811. 900.ITEMS REQUIRED BY LENDER TO BE PAID IN ADVANCE 901.Interest from 902.Mortgage Insurance Premium for 903.Hazard insurance Premium for 904. 905. 1000.RESERVES DEPOSITED WITH LENDER 1001.Hazard insurance 1002.Mortgage insurance 1003.City Property Taxes 1004.County Property Taxes + 1005.Annual assessments 1006. 1007. 1008.Aggregate Accountin Ad'ustmentrrF 1100.TITLE CHARGES 1101.Settlement or closing fee to 1102.Abstract or title search to 1103.Title Examination to John Kriegel 165.00 1104.Title insurance binder to 1105.Document oney.ration to 1106.Notary fees to 1107.Attorney's fees to includes above line numbers: 1108.Title Insurance to includes above line numbers: taste FE r r ..,utr"r+�, �1 1109.Lenders coverage $ 0.00ON I I 10.Owner's cover. e $ 0.00 y i4r _ ' �7is ir9.'r a; 1111. ....._._ _._._. 1112. 1113. 1200.GOVERNMENT RECORDING AND TRANSFER CHARGES 1201.Recording fees: Deed 25.00 Mortgage$ Release$ 25.00 1202.Ci /cn tax/stam s: Deed Mortgage 1203.State tax/stamps: Deed$ 45.60 Mortgaize 45.60 1204. Record Death Certificate 10.00 1205. 1300.ADDITIONAL SETTLEMENT CHARGES 1301.Survey to 1302.Pest inspection to 1303. 1304. 1305. 1306. 1307. 1308. 1400.TOTAL SETTLEMENT CHARGES enter on lines 103 Section J and 502 Section 190.00 55.60 CERTIFICATION I have carefully reviewed the HUD-I Settlement Statement and to the best of my knowledge and belief,it is a true and accurate statement of all receipts and disbursements on my count o�Jb An this; c hon. I further certify that I received a cc y of the HUD-1 S ttlement Statement. Seller g ty 9 lem y Seller ""��, Bo er To the best of my knowledge Hup�r settlement Statement which I have prepared is a true an accurate account o e hfunds which were received and have been or will be dish ed b the under ' to art of t ettlement of this transaction. �� �o�%-• 10/14/1998 ettlement Ag William J. undregan, Esq. ADa IV WARNING: s a crime to knowingly a false statements to the United States on this or any other similar form. Penalties upon conviction can include a fine and imprisonment. For details see: Tide 1 .S.Code Section 1001 and Section 1010. QUITCLAIM DEED We, Wilfred J. Pelletier and Theresa C. Pelletier, husband and wife as tenants by the entirety and Lionel R. Pelletier and Mary G. Pelletier, husband and wife as tenants by the entirety and Anita M. Pelletier, Individually all of Salem, Essex County, Massachusetts, for consideration paid, and in ✓ full consideration of Ten Thousand and 00/100 ($10, 000 . 00) Dollars grant all our right, title and interest to City of Salem, a public body, politic and corporate having a usual place of business at 93 Washington Street, Salem, Essex County, Massachusetts, with QUITCLAIM COVENANTS : The land in said Salem, bounded and described as follows : Beginning on the Southerly side of Brook Street at a point one hundred seventy-five (175) feet Westerly from the Southwesterly corner of Lawrence Street and Brook; thence running Westerly by Brook Street about two hundred twenty- five (225) feet to land now or formerly of Joseph G. Begin; thence turning and running Southerly by land now or formerly of Begin, ninety (90) feet; thence turning and running Easterly by Lots 107, 108, 109, 110, and 111 as shown on a plan of part of the Derby Estate, which plan is recorded with Essex South District Registry of Deeds, Book 1001, Page 300, about two hundred sixteen and 5/10 (216 . 5) feet to land now or formerly of Camille C. Blanchette et ux. ; thence turning and running Northerly by land now or formerly of Blanchette et ux. , ninety (90) feet to the point of beginning. Be all of said measurements more or less . For our title see deed dated June 30, 1987 and recorded with the Essex South District Registry of Deeds in Book 9063 , Page 555 . WITNESS our hands seal this 14rthnday (�of October1998 .1998 . i tples 6 all 7tures Wi eA J.V Pel t..C.� Th a C. ier ignel R. Pe 1 t er `-� Mary G. 'Pletier Anita M. Pelletier COMMONWEALTH OF MASSACHUSETTS ESSEX, SS . October 14 , 1998 Then personally appeared the above-named Wilfred J. Pelletier, Theresa C. Pelletier, Lionel R. Pelletier, Mary G. Pelletier and Anita M. Pelletier and acknowledge the foregoing instrument to be their fre act and ee before me . otary b c My C ission Expi es : >v/3 ahe Tommonweukq of Massut$usetis A STANDARD CERTIFICATE OF DEATH REGISTRY OF VITAL RECORDS ANO STATIST= REGISTERED NUMBER STATE USE ONLY DECEDENT-NAME FIRST MIDDLE LAST I SEX I"TE OF DEATH(Aft.,DF,W.) I Real Louis Pelletier 2Male 3December 15, 19(75 PLADEOFDEATH(Cdy?own) COUNTY OFDEATH HOSPITALOR OTHER INSTRUTION N�ma(nroIMNtMr,Phe abrxandnwNwJ Salem an Esser. k Salem Hospital PIACEOFDEATHIChookonA.): SO(NMLSECURRYNUMBER IF US WAR VETERAN P5WARSPITAL: Ip�{,HER: SPECIFY In,aden, C1ERXHdw'ml O DOA LJ Murai,Hone ❑RaWlence O aMrrS{N'+YYJ 0 026-26-4507 , Korean WASDECEDENTOFHISPANICORIGINi RACE Al P.WNIa.Bock Ana"wa,HrWN,ft.) DECEDENT'S EDUCATION(HpnaR Grad Own,W1) 1 1 In M,SpaaY PVlVR,Rha,DwNnten.Gnaw.Ma,I rpecAV: EbMSac(D12) LWM1p fly.5.) eNO ❑VES S14--W i Bo White 3 12 -0- AGE-LNI Blnnda, UNDER YEAR UNDER;DAY DATE OF BIRTH(Mo,Dry,Yr.) BIRTHPLACE(Gly aMShre wFft"A Count) (yft) MOS ; DAYS HOURS; MINS ton 6201 Jul 20, 1933 ,I Salem, Massachusetts MARRIED.NEVER MARRIED LAST SPOUSE fn wae.Phe menden n—) USUAL OCCUPATION HIND OF BUSINESS OR INDUSTRY WIDOWED OR DIVORCED (Anw-npNy) 12 Married 13 Anita M. Ouellette Iu machinist Iahmanufacturing RESIDENCE-NO.,ST.,CRY?CWN,COUNTY.STATEICOUWRY =IPODDE ,,, 5 Wheatland Street Salem, Essex County, Massachusetts 150 01970 FATHER FULLNAME STATEOFSIRTH(nnpfb US MOTHER NAME (GIVEN) (MAIDEN) STATE OF BIRTH(nrolb U$ ,,David Pelletier „Canada ,B Clara Gagnon B Zranada INFORMANTSMAME MAILINDMdiESs-N0.A ST.,CITYROWN,STATE,LPCODE RELATIONSHIP m Anita M. Pelletier 21 5 Wheatland Street Salem, MA 01970 ,2 Wife MLIHQU OF DISPOSITION(a BURIAL ❑CREMATION , 0 ENTOMBMENT ❑REMOVAL FROM STATE I FV 23❑DONATION ❑OTH.SPEC: 2e Paul P. Levesque 25 5178 PLACE OF DISPOSITION(Naw WCemaM1ry,Cranlaawftov N) LOCATION(CUyrown.SlaM1l 25e Greenlawn Cemetery2m Salem, Massachusetts DATE OF DISPOSITION NAME PND ADDRESS OF FACILITY 27becember 20, 1995 2 Levesque Funeral Home, Inc . 163 Lafayette St . Salem, MA R PARTI-EnlerbedlNawn.Inada.wcomplWlbne Bu,caufed ftl0non.DoM uaeca UlanadaWdyaW.swana IaiAwnRRwMw amM,NdawnaaR laYws. AftlRaimabinlervM batorllyana cwaa Neacn llN(e,nrpuph 0).PRIMOR TYPELEGISLY. Ba ween Draw and Death MMMn CAUSE(Final 1 d1NNe Cr Cmbl� a. lei✓." �((A. �. a e-S In dwB r � SNNnIMDy IMIOMIa1bnLBA anyMtllnpbbulWlW a. a aop.EAwa UNDERLYING !�1 .� fc' S CAUSE(GaewwblW,lul C. InIUMN a\enD mMbq in aNln)LAST. 0. PART U-One,0Hfidm CMddlons Wind,bdelh eul rol.01,In undrlyin,uumpi\en in Pan L WASAUTOPSY 1WEREAUTOPSYNNICINGS ( /� PERFOBMEOi AVAILABLE PRIOR TO SO t.C �/W'\I�V�/�.� Z �Y� 3 N "L/ )h OF DEA Ilp uwMOBE WASCASEREFERREO 3lM�N NEROFDEATH DATEOF IWURY TIMEOFINALAY IWURYATWORX TOME.? ®'FATURAL C3 HOMICIDE ❑COULD NOTBE OEfERMINEO (Nd pY.W.J (YeawW) 33 wNa) N� ❑ACCIDENT ❑SUICIDE ❑PENDING INVESTIGATION 35e BSa M 3X DESCRIBE HOW INJURY OCCURRED PLACEOFIWURY-Alhone. LOCATIONlAa&S!.,CUyyl.,SNft) INm,aUNI/aCNY.dfloe M.lG.. Mc.SpeWry: 350 ppyM 95e 351 ]N io lM ban W/pr�YApPM1Opa dea ox I ft Ann.daft.aadpla enOON b IM 37a DatlNOWa WeaaMruLM aMW bwatlpafM MmygVNon deb oCowMal lM Ome. ISMne a)neI(`/�li�./� dft,.dpeu arca.bbeuPeN'gmM _ /Squmn i WDd) [[ p� and Tata) d' DAATESI E�`�t'W.J�� I l HOUR DEATH 8 DATE SIGNED(W.,Day Yr.) HOUR OF DEATHW.)�� I l HOUR DEATH �8 DATE SIGNED(W.,Gey,Yr.) HOUR OF DEATH tt77 \\UU 3 M 3]E 3Tc M NAME OF ATTENDING PHYSICIAN IF NAME OF ATTENDING CLW IF NDTCERTIFIER a� PRONOUNCED DEAD(W.,DFG W✓ PRONOUNCEDDEAD(H,Ju� PRONOUNCED DEAD(W.,Da,W..) PRONOUNCEDDEAD(Hr) 3BU N 3)d 3Ta M S. NN1)Vz CES INGPHYSICINIORMED EIXAMINP ryaw M0 I� ��`� ��� LICENSE NO. CERTIFIER WASTHER5ANA.N. IFYES.DATES 'C✓' C^ I ES,TWE CDd NAM OF PRONOUNCING GISTERED NURSE L /J PRONOUNCE PRONOUNCED PRONOUNCED Y.wlb NAME CDa ave CDc M )NLY DATEBUR PERMITISSU / C RECEIVED IN THE CRIYTOWN OF: DATE OF RECORD n :�. s ✓, 5.41 F— SIGNAT E BD.OF CL RK'S ,;,,,,�� DEC ] R lggj HEALTH AGENT TORE at A3 I, Deborah E. Burkinshaw, hereby certify that I hold the office of City Clerk of the City of Salem, County of Essex and Commonwealth of Massachusetts;that the records of Deaths in said City are in my custody, and that the above is a true extract from the Records of Deaths in said City as certified by me. WITNESS my n haand the SEAL of the said CITYOF SALEM on DEC 2 7 IqQq ATTEST.• , Z&G G e � w CITY OF SALEM - MASSACHUSETTS WILLIAM J.LUNDREGAN Legal Department JOHN D. KEENAN City Solicitor 93Washington Street Assistant City Solicitor 81 Washington Street Salem, Massachusetts 01970 15 Church Street Tel:978-741-3888 Tel:978-744-8500 Fax:978-741-8110 Fax:978-744-0111 CERTIFICATION OF TITLE PAGE ONE DATE OF CERTIFICATION: October 14, 1998 BUYER(S) : City of Salem PROPERTY ADDRESS : Lot 192 , Brook Street Salem, MA 01970 AMOUNT OF TRANSACTION ( "Amount" ) : $10, 000 . 00 ATTORNEY' S CERTIFICATE OF TITLE Pursuant to General Laws, Chapter 93 , Section 70 , as amended, we hereby certify that upon recording of the Mortgage referenced on Page One of this Certification, the Mortgagee is the holder of and the Mortgagee is named in a good and sufficient first mortgage of record given by the Mortgagor covering the Property set forth on Page One of this Certificate, and certify also to said Mortgagor that at the time of recording the mortgage, the Mortgagor held good and sufficient title of record to the property free from all encumbrances which would materially affect the title, except said mortgage, matters expressly enumerated therein, and except the following: 1 . Those encumbrances referred to in General Laws, Chapter 185, Section 46, whether or not title to the Property is registered, if record notice of such encumbrance is not recorded or filed with the Registry; 2 . Real estate taxes and other municipal liens, including, but not limited to, liens as established under Chapter 551 of the acts of 1980 ; but not limited to, liens as established under Chapter 551 of the acts of 1980; 3 . Any encroachments, overlaps, boundary line disputes or other state of physical facts which may be revealed by a personal inspection or accurate survey of the Property; 4 . Rights or claims of parties in possession not shown by the public records; 5 . Easements or claims of easements not shown by the public records; 6 . Any lien or right to a lien for services, labor or materials heretofore or hereafter furnished, imposed by law or not shown by the public records; 7 . Any law, ordinance, by-law or other governmental regulation affecting, restricting, prohibiting or otherwise regulating the occupancy, use or enjoyment of the Property, the character, dimensions, or location of any present or future improvement now existing or hereafter planned for the Property, or a separation in ownership or change in the dimensions or area of the property (including, without limiting the generality of the foregoing, Zoning Laws, State Building Codes, Wetlands Protection Act, Subdivision Control Laws, Lead Paint Laws, health laws, sewage disposal laws, historic districts, and pollution control laws and Massachusetts Oil and Hazardous Materials Release Prevention and Response Act of 1983) ; and 8 . Encumbrances as listed as "Exhibit All attached hereto and made a part hereof . Provision has been made for discharge or satisfaction of other existing mortgages, liens or encumbrances of record. The title examination covers a period of fifty years to present . The period of title search and the Certification is further based upon and consistent with that set forth in "Title Standards adopted by the Massachusetts Conveyancers Association" as presently constituted. Our liability shall be limited to the amount of consideration shown on the Deed. Further, our liability shall otherwise be limited as provided in Massachusetts General Laws, Chapter 93 , Section 70, as presently constituted. Very truly yours, LUNDREGAN LAW OFFICES By: �6 WILLIAM UNDREG The undersigned acknowledges receipt of a copy of the within certificate . City of Salem By: ATTORNEY' S CERTIFICATE OF TITLE PAGE FOUR EXHIBIT A 1 . Subject to City of Salem, flood control system easement recorded with the Essex South District Registry of Deeds in Book 5762 , Page 379 . 2 . Subject to Order of conditions recorded with the Essex South District Registry of Deeds in Book 10647, Page 576 .