HomeMy WebLinkAboutMiscellaneous - 14 MILLPOND 4/30/2018 14 MILLPOND
210/095.A-0014-0000.0
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Form of Notice of Casualty Loss to Building
Under MASS. GEN. LAWS, Ch. 139, Sec. 3B
To: Building Commissioner or
Inspector of Buildings
City Hall
North Andover, MA 01845
To: Board of Health or
Board of Selectmen
City Hall
North Andover, MA 01845
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RE: Insured: Robert& Pamela Shedd �
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Property Address: 14 Millpond.
Policy Number: HP2187652
Cause/Date of Loss: Water Damage Loss of 12/17/03
File or Claim Number: 03-2899PM
Claim has been made involving loss, damage or destruction of the above captioned property, which
may either exceed $1,000.00 or cause MASSACHUSETTS GENERAL LAWS, CHAPTER 143,
SECTION 6, to be applicable. If any notice under MASSACHUSETTS GENERAL 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 or file
number.
Phillip D. McRae
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.
Signature Date IV
HALLMARK L
� .. C AIM SERVICES,INC.
100 Main Street, Reading, MA 01867
Phone#(781)944-9701 Fax#(781)944-9896