HomeMy WebLinkAboutMiscellaneous - 109 BRENTWOOD CIRCLE 4/30/2018 �p C1ROlE `� - ----- -. �-
/ 109 BREN�p35-0�0 0 � -�---- -- _ --
2101
Safety Insurance
AUTO•HOME •BUSINESS
P.O. Box 55098
Boston MA 02205
617-951-0600
November 13, 2017
Building Commissioner or Inspector of Buildings
Fire Department or Arson Squad
Board of Health or Board of Selectman
City Hall
NORTH ANDOVER, MA 01845
.Insured: DENIS J DRAGONAS
Property Address: 109 BRENTWOOD CIRCLE, NORTH ANDOVER MA
Policy Number: HMA0259634
Claim Number: BOS00079143
Date of Loss: 11/9/2017
Notice of Loss Under M.G.L. c. 139,§3B
This communication shall serve as written notice pursuant to M.G.L. c. 139, § 3B that [Safety
Insurance Company] ("Safety") has received a claim involving loss, damage or destruction to a
building or other structure at the above-referenced address which may either: (1) meet or exceed
$1,000; or(2) cause the condition or the building or other structure to render M.G.L. c. 143, § 6
applicable.
In accordance with M.G.L. c. 139, § 3B, if the city or town intends to initiate proceedings designed
to perfect a lien under Section 3B, M.G.L. c. 143, § 9 or M.G.L. c. 111, § 127B, please notify
Safety of the same by certified mail. Kindly forward such notice to my attention, at the address
indicated above, and include with such notice a reference to the above-described insured, property
address, policy number and claim number.
If you have any questions regarding this notice, please feel free to contact me directly at
617-951-0600, extension 5015.
Sincerely,
Jessica Tuccelli
Claim Examiner
� Safety Insurance
AUTO•HOME •BUSINESS
P.O. Box 55098
Boston MA 02205
617-951-0600
November 10, 2017
Building Commissioner or Inspector of Buildings
Fire Department or Arson Squad
Board of Health or Board of Selectman
City Hall
NORTH ANDOVER, MA 01845
Insured: DENIS J DRAGONAS _
Property Address: 109 BRENTWOOD CIRCLE, NORTH ANDOVER MA
Policy Number: HMA0259634
Claim Number: BOS00079137
Date of Loss: 10/30/2017
Notice of Loss Under M.G.L. c. 139,§3B
This communication shall serve as written notice pursuant to M.G.L. c. 139, § 3B that [Safety
Insurance Company] ("Safety") has received a claim involving loss, damage or destruction to a
building or other structure at the above-referenced address which may either: (1) meet or exceed
$1,000; or(2) cause the condition or the building or other structure to render M.G.L. c. 143, § 6
applicable.
In accordance with M.G.L. c. 139 3B, if the city or town intends to initiate proceedings designed
to perfect a lien under Section 313, M.G.L. c. 143, § 9 or M.G.L. c. 111, § 127B, please notify
Safety of the same by certified mail. Kindly forward such notice to my attention, at the address
indicated above, and include with such notice a reference to the above-described insured, property
address, policy number and claim number.
If you have any questions regarding this notice, please feel free to contact me directly at
617-951-0600, extension 5015. .
Sincerely,.;
Pete Najarian
Claim Examiner
/i
PO Box 55098
Boston,MA 02205-5098
617-951-0600
Form of Notice of Casualty Loss to Building
Under MASS. GEN. LAWS, Ch. 139, Sec. 3B
To: Building Commissioner or Board of Health or
Inspector of Buildings Board of Selectman
City Hall City Hall
NORTH ANDOVER, MA 01845 NORTH ANDOVER, MA 01845
RE: Insured: DENIS J DRAGONAS `
Property Address: 109 BRENTWOOD CIRCLE,NORTH ANDOVER, MA
Policy Number: HMA 0259634
Claim Number: BOS00049603
Date of Loss: 2/18/2015
Company: Safety Indemnity Insurance Company
Claim has been made involving loss, damage or destruction of the above-captioned property,
whichmay 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 3B is appropriate,please
direct it to the attention of the writer and include a reference to the captioned insured, location,
policy number, date of loss and claim number.
Mike Grauwiler Clain!Examiner 2/19/2015
Safety Insurance Company
Homeowners Claims Unit
P. O. Box 55098
Boston, MA 02205-5098
Phone: (617) 951-0600 EXT 2049
Fax: (617) 535-5855
Email: MikeGrauwiler@Safetylnsurance.com