HomeMy WebLinkAboutMiscellaneous - 61 VILLAGE GREEN DRIVE 4/30/2018� 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
NORTH ANDOVER, MA 01845 NORTH ANDOVER, MA 01845
RE: Insured: MELISSA DUGGAN
Property Address: 61 VILLAGE GREEN, NORTH ANDOVER, MA
Policy Number: HMA 0363511
Claim Number: BOS00066057
Date of Loss: 11/20/2015
Company: Safety 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 313 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.
Dan Lourinia Claim Examiner
Safety Insurance Company
Homeowners Claims Unit
P. O. Box 55098
Boston, MA 02205-5098
Phone: (617) 951-0600 EXT 3167
Fax: (617) 531-6691
Email: DanLourinia@Safetylnsurance.com
11/23/2015