HomeMy WebLinkAboutMiscellaneous - 25 VILLAGE GREEN DRIVE 4/30/2018Safety Insurance
Form of Notice of Casualty Loss to Building
Under MASS. GEN. LAWS, Ch. 139, Sec. 3B
To: Building Commissioner or
Inspector of Buildings
City Hall
NORTH ANDOVER, MA 01845
RE: Insured
Property Address:
Policy Number:
Claim Number:
Date of Loss:
Company:
Board of Health or
Board of Selectman
City Hall
NORTH ANDOVER, MA 01845
DAVID A HOLDEN
25 VILLAGE GREEN DR, NORTH ANDOVER, MA
HMA 0362688
BOS00047152
1/11/2015
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.
Bryan Savosik Claim Examiner
Safety Insurance Company
Homeowners Claims Unit
P. 0. Box 55098
Boston, MA 02205-5098
Phone: (617) 951-0600 EXT 2070
Fax: (617) 535-5841
Email: BryanSavosik@Safetylnsurance.com
1/14/2015