HomeMy WebLinkAboutMiscellaneous - 38 DAVIS STREET 4/30/2018BAY STATE ADJUSTMENT SERVICE
1t110A11/1 a
• Wn"" 10jum P.O. BOX 338
nluna of ANDOVER, MASSACHUSETTS 01810-0338
FAX N 508-474-0336
Andover: 475.8111 Lowell: 458.2542
Haverhill: 374.9282 Lynn: 598.5050
TOWN/9211 FIRE DEPARTMENT
(�!U_ILDING COMMISSIONER or
INSPEEMOR-OF - BUILDINGS
TOWN OF NORTH ANDOVER )
BOARD ---OF MEALnL_�
BOARD OF SELECTMEN'
( TOWN 6f-----N-0R'"
F NORTH ANDOVER
( TOWN HALL
NORTH ANDOVER, MA
RE: INSURED: ALLAN W, & MARIE A FURNEAUX
PROPERTY ADDRESS: 3R DAVIST N ANDOVER, MA
POLICY N0, s HP 0 4116 5 7 COMPANY: MERRIMACK MUTUAL
LOSS OF: WATER DATE: AUGUST 30, 1991
FILE OR CLAIM NO.: 1-1945-W
Claim has been made involving loss, damage or destruction of the above
captioned -property, which may either exceed $1,000.00 or cause Massachusetts
General Law, Chapter 143, Section 6 to be applicable. If any notice under
Massachusetts General Law, Chapter 139, Section 3B is appropriate, please
direct it to the attention of the writer and include a reference to a
captioned insured, location, policy number, date of loss and claim or file
number.
WALTER M RO NACHUR GENERAL ADJUSTER
Title
On this date, I caused copies of this notice to be sent to the persons named
above, at the addresses indica>ed above, by first class mail.
l
Signature
Insurance Adjustment Service Inc.
531 King Street • Unit 2, Second Floor
Littleton, MA 01460
978-952-6966 • Fax 978-952-2459
Email: iashtfleton@netlplus.com
Date:_ J-/�-�
Board of Health: ro., / A;_ 4"j p_c
Building Inspector:
Fire Department:
Re: Insured: �Vi"h�li
Location: 38. .5j -
Claim
j -
Claim Number:
Policy Number:
Our File Number:
Cause of Loss: L.ir_ 1..
Date of Loss: 12 - i �- v
Dear Sir/Madam:
M
A claim has been made involving loss, damage or destruction of the above
captioned property which may either exceed $1,000 or cause Massachusetts
General Laws, Chapter 143, Section 6 to be applied.
If any notice under Massachusetts General Laws, Chapter 139, Section 3B is
appropriate, please direct that information to my attention and include a
reference to the captioned insured, location, date of loss and file number.
Thank you for your cooperation.
Very truly yours,
Scott O'Neil
Adjuster
Ext. 129