HomeMy WebLinkAboutMiscellaneous - 4 LINCOLN STREET 4/30/2018 4 LINCOLN STREET
210/070.024.0000.0
Safety Insurance
--_' -- -- - PO Box 55098
Boston,MA 02205
Form of Notice of Casualty Loss to Building
Under MASS. GEN. LAWS, Ch. 139, Sec. 3B
To: Building Commissioner or Board of Health or
Inspector of Buildings Board of Selectman
City Hall City Hall
N ANDOVER, MA 01845 N ANDOVER, MA 01845
RE: Insured: _ -JOHN LYONS-and KATHLEEN LYONS ,
Property Address: 4 LINCOLN ST, N ANDOVER, MA
Policy Number: HMA 0225578
Claim Number: BOS00067712
Date of Loss: 2/15/2016
Company: Safety Indemnity Insurance Company
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 3B is appropriate,please
direct it to the attention of the writer and include a reference to the captioned insured, location,
policy number, date of loss and claim number.
Joshua Terenzoni Claim Examiner 2/17/2016
Safety Insurance Company
Homeowners Claims Unit
P. O. Box 55098
Boston, MA 02205-5098
Phone: (617) 951-0600 EXT 3287
Fax: (617) 531-6648
Email: JoshuaTerenzoni@Safetylnsurance.com