HomeMy WebLinkAboutMiscellaneous - 104 FOXWOOD DRIVE 4/30/2018NEW ENGLAND CLAIMS SERVICE, INC.
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100 CONIFER HILL DRIVE, SUITE 308 P.O. BOX 578
MANSFIELD, MA 02048 DAN VERS, MA 01923 SHREWSBURY, MA 01545
TEL. (508) 337-8058 TEL. (978) 777-9900 TEL. (508) 842-3995
FAX (508) 339-5835 FAX (978) 774-9296 FAX (508) 842-7510
Form of Notice of Casualty Loss to Building
Under Mass. Geri. Laws. Ch. 139 Sec. 3D
TO: Building Commissioner or
Inspector of Buildings
addresses
Board of Health or
Board of Selectmen
RE: INSUREDfi&),KD HDA _
PROPERTY ADDRESS
POLICY NO..
v
LOSS OF: ---- _LbJ 2- �;J_�_3---
FILE OR CLAIM NO.:.._.._ _ jas 3 310. ------_--
Claim has been made involving loss, damage or destruction of the above -captioned
property which may either exceed $1,000.00 or cause Mass. Gen. Laws, Chapter 143,
Section 6 to be applicable. If any notice under Mass. Gen. Laws, Chapter 139 Section 3D
is appropriate, please direct it to the attenn tioof the writer aril include a reference to the
captioned insured, location, policy number, (late of loss and claim or file number.
On this date, I caused copies of this notice to be sent to the persons named above
at the addresses indicated above by first class mail.
rUN OF NORTH; AAltDO'1-
BOARD OF i _ .
iS
GNA RE AND D__ 4--) =4ATE�c _..
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cc: Fire Dept.