HomeMy WebLinkAboutMiscellaneous - 257 WINTER STREET 4/30/2018 (3)Form of Notice of Casualty Loss to Building 4: '
Under Mass. Gen. Laws, Ch. 139, Sec. 313
To: Building Commissioner or Board of Health or
Inspector of Buildings Board of Selectmen
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addresses
ie)lnsured:—
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Property address: % &Af7-6=k—
Policy NO. 6, IIZ Z
Loss of Cl &7&,5 / lg 19.1
File or Claim No. __��� Ss I-lClk2IC.9NC �JD�
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, Ch. 139 Sec. 313 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.
On this date, I caused copies of this notice
indicated above by first class mail.
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CLAIMS SERVICE OF
NEW ENGLAND, INC.
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Title:
to sent to the pers ns named above at the addresses
Sig atureyyannd dat g_ NW g
tis t+,1Et RRIMACK S $ a
SUITE 15
LAWRENCE, MA 0.1343
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