HomeMy WebLinkAboutMiscellaneous - 355 CHESTNUT STREET 4/30/2018SUBURBAN ADJUSTMENT I T'
JUL? 1 23 ' I
226 LOWELL STREET, SUITE B5 WILMINGTON, MA 01887 978-988-5959
FAX 978-657-8969
Form of Notice of Casualty Loss to Building Under
Massachusetts General Laws, Chapter 139, Section 3B
TO: Building Commissioner or Board of Health or Fire Department or
Inspector of Buildings Board of Selectmen Arson Squad
Town Hall
North Andover, Ma. 01845
RE: Insured: William & Deborah Wise
Town Hall
Town Hall
North Andover, Ma. 01845 North Andover, Ma. 01845
Property Address: 355 Chestnut St. North Andover, MA. 01845
Policy No.: 267 88 99 03 Co. File or Claim No.: 03298-M
Date of Loss: 06-13-2003
Claim has been made involving loss, damage, or destruction to the above captioned property, which may
either exceed $1,000.00 or cause Massachusetts General Laws, Chapter 143, Section 6, to be applicable.
If any notice under Massachusetts General Laws, Chapter 139, Section 313, is appropriate, please direct
it to the attention of the writer and include reference to the captioned insured, location, policy number,
date of loss, and claim or file number.
Mark A. Epstein
Signature
Property Adjuster
Title
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.
07-16-2003
Signature and Date