HomeMy WebLinkAboutMiscellaneous - 15 IRONWOOD ROAD 4/30/2018 (3) / IRONWOOD ROAD
290/9/1.04.0-0143-0000.0
Form of Notice of Casualty Loss to Building
Under MASS. GEN. LAWS, Ch. 139, Sec. 3B
TO: BUILDING COMMISSIONER OR
INSPECTOR OF BUILDINGS
Town Hall of North Andover
North Andover, MA 01845
TO: BOARD OF HEALTH OR
BOARD OF SELECTMEN
Town Hall of North Andover
North Andover, MA 01845
RE: Insured: Charles& Mary Lietz
PropertyAddress: 451ronwood_Road-,
North Andover,MA
Policy Number: H09126345
Date/Cause of Loss:4/13/93 Storm Damage
File or Claim No: 95206-K
CLAIM HAS BEEN MADE INVOLVING LOSS DAMAGE OR DESTRUCTION OF THE ABOVE-CAP
� , ONED 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. 313 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.
I
Kevin McCarthy,General 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.
M'"
Signature and Date
- HALLMARK CLAIM SERVICES -