HomeMy WebLinkAboutMiscellaneous - 21 ROCK ROAD 4/30/2018 (2)Form o Notice of Casualty Loss to Building
Unde Mass. Gen. Laws, Ch. 139, Sec. 31B
TO: Building Commsioner or
Inspector of/Buildings
Board of Health or
Board of Selectmen
Tow Hall ) or ( Town Hall
N rth Andover MA } ( North Andover MA
RE: Insu ed: William E. & Nancy D. Lever
Property address: "'�-2-1 Rock Road
North Andover MA
Policy No.
202070751
Loss of September 26. 1992
File or Claim No. LW16366
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. 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 or file number.
deductible.
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.
,l
Sign,U ure and date
65 MERRIMACK STREET, LAWRENCE, MASSACHUSETTS 01843
FAX N0: 508-687-7246.
( 508 ) 6S6 -- 4 163
C 0(N'P%7
/fBuildings
m of Notice of Casualty Loss to Building
der Mass. Gen. Laws, Ch. 139, Sec. 3B
TO: Building Cioner or Board of Health or
Inspector Board of Selectmen
Towd Hall ) or { Town Hall
7- ) {
North Andover MA ) ( 'North Andover MA
RE: Insured: William E. & Nancy D. Lever
Property address:
Policy No.
Loss of
21 Rock Road
North Andover MA
202070751
September 26, 1992
File or Claim No. LW16366
0
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. 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 or file number.
deductible.
Insurance Adiuster
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.
S' ature and date
65 MERRIMACK STREET, LAWRENCE, MASSACHUSETTS 01843
FAX N0: 508-687-7246.
(508) 686 - 4163
A Member of the Morden and HeWg Group Inc.