HomeMy WebLinkAboutMiscellaneous - 39-41 Milton Street 39 - 41 Milton Street
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Lumbermens Mutual Casualty Company Com an • American Motorists Insurance Company
American Manufacturers Mutual Insurance Company • American Protection Insurance Company
150 Newport Avenue, North Quincy, MA 02171 6171328-2000
1/13/86 X11,
Building Commissioner
Town Hall
No. Andover$ r7a.. 01845
Building Commissioner or Board of Health or
Inspector of Buildings Board of Selectman
Town Hall
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No. Andover,
CLAIM NUMBER: 601 KU 168809 X
POLICY NUMBER: 3RD 200928 00
LOSS DATE: 1/8/86
INSURED: Francis D1TLICCIG__�12•. __ - �- — ____ - - -- ----
PROPERTY ADDRESS : ( 39! 41 Kilton._s_•_ No•-.Andover#. Ms.- r
Claim has been made involving loss, damage or destruction of
the above-captioned property, which may either exceed $1, 000 ,
or cause Mass. Gen. Laws Chapter 143 Section 6 to be applica-
ble.
P Lica
PP
ble. If an notice under Mass. Gen. Laws Ch. 139 Sec.ec. 3B
is appropriate, please direct it to the attention of the
writer and include a reference to the captioned insured, loca-
tion, policy number, date of loss and claim or file number.
Claim Representative
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.
ames C a non
gnature and ate/ '
NEDC #104
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