HomeMy WebLinkAboutMiscellaneous - 22 ANNIS STREET 4/30/2018 (2) % 22 ANNIS STREET
210/014.0-0044-0000.0
f.
PO 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
NORTH ANDOVER, MA 01845 NORTH ANDOVER, MA 01845
RE: Insured: JAMES V HETHERINGTON and KAREN L HETHERINGTON
Property Address: 22 ANNIS STREET,NORTH ANDOVER, MA
Policy Number: HMA 0069432
Claim Number: BOS00055699
Date of Loss: 2/28/2015
Company: Safety 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 3/16/2015
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