HomeMy WebLinkAboutMiscellaneous - 36 CAMDEN STREET 4/30/2018NEW ENGLAND CLAIMS SERVICE, INC.
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P.O. BOX 345
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100 CONIFER IIILL DRIVE, SUITE 308
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P.O. BOX 578
MANSFIELD, MA 02048
TEL. (508) 337-8058
DAN VERS, MA 01923
SHREWSBURY, MA 01545
FAX (508) 339-5835
:-TEL. (978) 777-9900
FAX.(978) 774-9296
TEL. (508) 842-3995
FAX (508) 842-7510
Form of Notice of Casualty Loss to Building
Under Mass. Gen. Lawes Ch. 139, Sec. 3D
TO: Building Commissioner or Board of Health or
Inspector of Buildings Board of Selectmen
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addresses—__._ --
RE: INSURED1['sj
PROPERTY ADDRESS
POLICY NO..
LOSS OF:
FILE OR CLAIM NO.:..�._
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 3D
is appropriate, please direct it to tide attention of the writer and include a reference to the
captioned insured, location, policy number, (late of loss and claire or file number.
AI res- /1..x'1 07:_^, 2
TffLET ��
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.. - Z_'
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SIG NATUR AND DATE
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cc: Fire Dept.