HomeMy WebLinkAboutMiscellaneous - 265 APPLETON STREET 4/30/2018 (2)IX
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NEW ENGLAND CLAIMS SERVICE,
365 Broadway
Lynnfield, MA 01940
7orm of Notice of Casualty Loss t(
Under Mass - Gen. Laws,- ch., 139.
Building Ccin"nissioner oi:
Inspector c -C BuiJA_i.jjg,,
70 L -o kk '" &I _L_
addresses
Board of Health or
Daa.ud of Sc-.JeCtjn17_11,) eLE
(:z , Sh L4
INSURED: r 1C,
9VI -b
PROPERTY ikDD-IRIESS: C.'j-
kh-
POLICY NO.:
L OSS OF:. 19
FILE'OR C L NO.
j
Claim has been made involving loss, damage or destruction of the
above -captioned property which may either exceed Sl 000-00 or cause Mass.
Gen. Laws Chapter id3,1 Section 6 to be applicable.' If any notice under
Mass. Gen. Laws, Cnapter 139 Section 3D is approp
.�Driate, please direct it
to the attention o4l the writer and include a refere'nce to the captioned
insured, location, Policy number, date Of loss..and claim or file number.
TIT ',E �_LAIH_% kbTUSTErr _
On this date, I caused copies of this notice to be sent to the
persons named abcve at the addresses indicated above by first class mail.
SIGNATURE A14D DATE
L L - CtAtej�r