HomeMy WebLinkAboutMiscellaneous - 19 TYLER ROAD 4/30/2018 (2)i-
�LENDSEY
MORDIN
CLAIM SERVICES, INC
Form of Notice of Casualty Loss to Building
Under Mass. Gen. Laws, Ch. 139, Sec. 31B
TO: Building
Commissioner or
Board of Health or
Inspector
of Buildings
Board of Selectmen
Town
Hall
) or
(
Town Hall
North Andover MA
)
(
North Andover_ MA
RE: Insured:
Kevin -& Cynthia McGowan
Property address: 19 Tyler Road
North Andover MA
Policy No. HP1325712
Loss of June 13, 1992
File or Claim No. LW16116
Claim has been made involving or destruction of the above captioned
Property, which may either exceed $1,000.00 or cause Mass. Gen. Chapter
143, Section 153, Section 6 to be applicable. If any notice under Mass.
Gen. Laws, Ch. 139 Sec. 38. 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.
dedu��ible.
Insurance Adjuster
Title
On this date, I caused copies of this notice to be sent to the persons
named above at the address indicated above first class mail.
OLL A 9
Signature and date
_T_
65 MERRIMACK STREET, LAWRENCE, MASSACHUSETTS 01843
FAX NO: 508-687-7246.
( 508 ) 686 - 4163
A Member of the Morden and HeWg Group Inc. 11*