HomeMy WebLinkAboutMiscellaneous - 120 LACONIA CIRCLE 4/30/2018 (26) SUBURBAN ADJUSTMENT
226 LOWELL STREET, SUITE B5 WILMINGTON,MA 01887 978-988-5959
FAX 978-657-8969
Form of Notice of Casual Loss to Building
g
Under Mass. General Laws Ch. 139, Sec. 3B
TO: Building Commissioner or Board of Health or Fire Department or
Inspector of Buildings Board of Selectmen Arson Squad
North Andover,MA 01845-3368 North Andover,MA 01845-3368 City or Town Hall
RE: Insured: Karen Crawford
Property Address 120 Laconia Circle
Policy No.: H012-30-46-13 FM
APR 12 2010
TOWN OF NORTH ANDOVER
Loss of: 3/13/2010 L.HEALTH DEPARTMENT
File or Claim No.: 10175-K
Claim has been made involving loss,damage or destruction to 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,Ch. 139 Sec.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 or file
number.
David Kalil
Property Adjuster
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.
4/1/2010
Signature and Date