HomeMy WebLinkAboutMiscellaneous - 148 MAIN STREET 4/30/2018 (15) IV I'tX Oct, - 6- 431I �
BUILDING FILE
® MAPFRE The Commerce Insurance Company1m
Citation Insurance Companyw
Commerce "
Gore Road,Webster,Massachusetts 01570
INSURANCE-
508.949.15001 www.commerceinsurance.com
January 06, 2014
BUILDING COMMISSIONER or Board of Health or
INSPECTOR OF BUILDINGS Board of Selectmen
TOWN/CITY HALL Town/City Hall
NORTH ANDOVER MA 01845
RE: Our Insured: DONNA POLCAR!
Property Address: 148 MAIN STREET UNIT B431
Policy#: BCQXRT
Date of Loss: 01/03/2014
File#: HRVK42-CHRHN6
Claim has been made involving loss, damage, or destruction of the above captioned
property which may exceed $1,000, 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 my attention. Please reference the above captioned insured, location,
policy number, date of loss, and file number on any correspondence.
MEGAN FINACOM Telephone: (508)949-1500 Ext: 15847
CLAIM REP I,PROPERTY Toll Free: 1-800-221-1605,Ext: 15847
On this date, I cause copies of this notice to be sent to the persons indicated above, at the
address above, by first class mail.
January 06, 2014
CIC 254 (Rev.4/95) MAEL 786
Form of Notice of Casualty Loss to Building
Under MASS. GEN. LAWS, Ch. 139, Sec. 3B
To: Building Commissioner or
Inspector of Buildings
1600 Osgood Street
North Andover, MA 01845
RE: Insured: Donna Polcari
Property Address: 148 Main Street, Unit B431
Policy Number: BCQXRT
Date/Cause of Loss: 1/3/2014, Water Damage
File or Claim Number: 28845-R
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.
Ryan Werner
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.
Signat "e and Date
ANDERSON ADJUSTMENT CO., INC.
50 Nashua Road, Suite 303
PO Box 1098
Londonderry, NH 03053