HomeMy WebLinkAboutMiscellaneous - 26 MILTON STREET 4/30/2018Form. of Nlotice of Casualty Loss -co S-3uH,ding
Under Maass. Gen. Laws, C6. IZ39, Sec. 2B
I I I
To: 'Buiiding Commissioner 'H
or Board of eaiih or
inspector of Buildings Board of Selectmen
joaddresses
Re. insured: A4/-/. t 6
Property address:— "0
-,q
Policy No.
Loss of. I:& � c; _-2/
File or Claim No,
Uairrl has been made invoivinq loss, damage or destruction of the above captioned property, which
may eit'her exceed $1,000.00 or cause Mass. Ge -.n. Lavis, (;Aa Saar 743, Section G -to be -applicable.
if any notice under hfilass Gen. Lavvs, Ch. 139 Sec. 3B is apprc;priate please aired it to t-,he,,-.t'ter,'jtloll
of the writer and include a reference to the captioned insured, location, policy number, dat6 of loss
and claim or -file number.
a
e:
On this date, I caused copies of this notice to be sent to the persons narnpp�-f� above at the addresses
indicated above by first class
mail.
Signature and date
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