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HomeMy WebLinkAboutMiscellaneous - 175 SANDRA LANE 4/30/2018Safety Insurance W 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 Board of Health or Board of Selectman City Hall NORTH ANDOVER, MA 01845 RE: Insured: BRENDAN GUNN and LAURA MESSIER Property Address: 175 SANDRA LANE, NORTH ANDOVER, MA Policy Number: HMA 0383892 Claim Number: BOS00046722 Date of Loss: 12/12/2014 Company: Safety Indemnity Insurance Company Claim has been made involving loss, damage or destruction of the above -captioned property, which may,cithet 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. Lisa Monette Claim Examiner 12/16/2014 Safety Insurance Company Homeowners Claims Unit P. O. Box 55098 Boston, MA 02205-5098 Phone: (857) 233 -8618. - Fax: (617) 535-5833 ' Email: lisamonefte@safetyinsurance.com PO Box 55098 Boston, MA 02205-5098 617-951-0600 of 1980 , 8 201s years 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: BRENDAN GUNN and'LAURA MESSIER Property Address: 175 SANDRA LANE, NORTH ANDOVER, MA Policy Number: HMA 0383892 Claim Number: BOS00053657 Date of Loss: 3/5/2015 Company: Safety Indemnity Insurance Company Claim has been made involving loss, damage or destruction of 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, 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. Stephen Desrosiers Claim Examiner 3/6/2015 Safety Insurance Company Homeowners Claims Unit P. O. Box 55098 Boston, MA 02205-5698 Phone: (617) 951-0600 EXT 3546 ..Fax: (617) 531-6658 Email:'Step4e'nDesrosiers@Safetyl.nsuran,ce.com Location No. Date NOIlTq TOWN OF NORTH ANDOVER O • 1 Osr Certificate of Occupancy $ +; # Building/Frame Permit Fee $ f �� Foundation Permit Fee $ s�CHusE Other Permit Fee $ 0.,.1 Sewer Connection Fee $ ;� Water:Connection Fee $ TOTAL Building Inspector f Div. Public Works Location —r ✓"i 49 A. - No. �`� _ � Date tr g!7/ TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee Other.Permit Fee $ / b U p= $ J ��j Sewer Connection Fee? $ ) 1 ( brr)' Water Connection Fee $ � l9l VY TOTAL $ Building Inspector / / Div. 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