HomeMy WebLinkAboutMiscellaneous - 24 SALTONSTALL ROAD 4/30/2018 (2)"EW ENGLAND
I I CLAIMS SERVICE INC.
ReplyTo ❑
P.O. BOX 345
MANSFIELD, MA 02048
TEL. (508) 337-8058
FAX (508) 339-5835
Reply To Q
100 CONIFER HILL DRIVE, SUITE 308
DANVERS, MA 01923
TEL,. (978) 777-9900
FAX (978) 774-9296
f=orm of Notice of Casualty Loss to Building
. Under Mass Gen Laws Ch. 139, Sec. 3D
TO: Building Commissioner or
inspector of Buildings
addresses
Al
A'
RE: INSURED
PROPERTY ADDRESS a'
Reply To ❑
P.O. BOX 578
SHREWSBURY, MA 01545_
TEL..(508)B42-39.95 �
SEC 1 g 200 �:
Board of Health or
Board of Selectmen
POLICY NO.:D
LOSS OF:
FILE OR CLAIM NO.: �
064
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 3D
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.
TIT E
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 ANDD TEIZ03