HomeMy WebLinkAboutMiscellaneous - 67 COTUIT STREET 4/30/2018 (2) 67 COTUIT STREET U-1
210/0230000.0
PATRICK J. DONOVAN ASSOCIATES, INC.
"CLAIM AND LOSS ADJUSTMENTS"
P. 0. Box 110
Wakefield, MA 01880
(617) 245-5540
FILE �rk�• �
FORM OF NOTICE OF CASUALTY LOSS TOfBU,ILD
UNDER MASS. GEN. LAWS. CHP. 139�w9)�C.
TO: Building Commissioner or
Inspector of Buildings `
City or Town Hall `r
A 14 Db U
RE: Insured: �°-� �2
Property Address:
7` �1
Policy Number: `� / �l 3 3 G/
Loss Type: r
Date of Loss:
Our File Number:
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 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 file number.
Adjuster,
Donovan Associates, Inc.
Wakefield, MA
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.
Address 7 GaT.o cT" —j Title of File
Page of
Date f=ile Open:
Date file closed:--
Date
losed: _
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Doc Document/Action Title Date of Refer to other Purpose of i�ocume�nt ! _
action Document/ document
/ ct�on and notes
Num. Action
De artment
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Board ofi Appeals — Board of Health Planniin- Board ;
9. Conservatiion commission - Bt�il.din� Departrne
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