HomeMy WebLinkAboutMiscellaneous - 193 ANDOVER STREET 4/30/2018 (2) / 193 ANDOVER ST '
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Mul iple Line Adjusters & Surveyv'rs Established 1926
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k ADDRESS REPLY TO:
r GORDON BOYD & CO. INC.
11 LAWRENCE ST.
LAWRENCEi office
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Form of Notice.of Casualty Loss to Building / rl
-Under Mass, Gen. Law;, Ch.. 139, Sec. 38
To: Building Commissioner ory, —• Board of Health or ✓ i
Inspector of Buildings Board of Selectmen
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addresses
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Re: Insured:!1 I so kJ �E"t 1 �r�}S __. _
Property address.-
Policy
ddress Policy No.� 79 4 :g ( I
Less of f �C� ( r —--02 l v 19 y i
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File or Claim No._ L" T�tL
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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. R
If any notice under Mass Gen, Laws, Ch.f139 Sec. 38its appropriate please direct it to the attention
of the writer and include a reference to the captioned insured; location, policy number, date of loss s
and claim or file number:
Title: -- --
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On this date, I caused copies of this notice to be sent ..o the persons named above at the addresses
indicated above by first class mail.
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Signature,+n, d ''
MASSACHUSETTS CONNECTICUT NEW HAMPSHIRE VERMONT MAINE RHODE ISLAND
Boston Gloucester Bridgeport Claremont Brattleboro Augusta Pawtucket N.rwNa
CLAIMS SERVICE OF Barnstable Lawrence New London Gorham Burlington Lewiston ♦ssOt1AT*N
Nof.(IpM
aewe_ NCLwno,INC. Brockton Pittsfield No.Haven Manchester S.Portland
Fall River Salem Waterbury Portsmouth •oA ,ts
Falmouth Springfield W.Hartford /
Worcester
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