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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
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WASCASEREFERREO 3lM�N NEROFDEATH DATEOF IWURY TIMEOFINALAY IWURYATWORX
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33 wNa) N� ❑ACCIDENT ❑SUICIDE ❑PENDING INVESTIGATION 35e BSa M 3X
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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 .