HomeMy WebLinkAboutMiscellaneous - 180 JOHNNY CAKE STREET 4/30/2018PO Box 55098
Boston, MA 02205-5098
617-951-0600
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
N ANDOVER, MA 01845 N ANDOVER, MA 01845
RE: Insured:
JOHN SCHUTZ and CAROL, SCHUTZ
Property Address:
180 JOHNNYCAKE ST, N ANDOVER, MA
Policy Number:
HMA 0263951
Claim Number:
BOS00058181
Date of Loss:
2/21/2015
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.
Eric Gill Claim Examiner 4/3/2015
Safety Insurance Company
Homeowners Claims Unit
P. O. Box 55098
Boston, MA 02205-5098
Phone: (617) 951-0600 EXT 3321
Fax: (617) 531-5774
Email: EricGill@Safetylnsurance.com