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193 GREENE STREET
Z a045�0000.0
GAB BUSINESS SERVICES,INC.
CATASTROPHE OFFICE
85 Central Street, Ste 201
Waltham, MA 02154
TEL: 617-891-0671
FAR: 617-893-9952
To: Building Commissioner/Inspector of Buildings
Board of Health/Board of Selectmen
NOTICE OF CASUALTY LOSS TO BUILDING
UNDER MASSACHUSETTS GENERAL LAWS, CHAPTER 139, SECTION 3B
Claim has been made involving loss, damage or destruction
of the property captioned below, which may either exceed
$1, 000. 00 or cause Massachusetts General Laws, Chapter
143, Section 6 to be applicable. If any notice under
Massachusetts General Laws, Chapter 139, Section #B 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 the GAB file
number.
Insured: HYDER . , GLADYS
Property Address: 193 GREEN ST
N. ANDOVER, MA 01845
Policy No: HB1323733
Date of Loss: 08-19-91
GAB File No: 10860 - 01381
Frank Edwards
Supervisor
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.
Signature and date