HomeMy WebLinkAboutMiscellaneous - 76 MARTIN AVENUE 4/30/2018LINDSEY
MORDEN
CLAIM SERVICES, INC
Form Notice of Casualty Loss to Building
Un r Mass. Gen. Laws, Ch. 139, Sec. 3B
TO: Building Co/Buildings
oner or Board of Health or
Inspector o Board of Selectmen
Hall ) or ( Town Hall
(
Andover MA ) ( North Andover MA
RE: Insured:
Property address:
Policy No.
Loss of
Scott MacArthur
76 Martin Avenue
North Andover MA
202092075
November 20, 1992
File or Claim No. LW16452
Claim has been made involving or destruction of the above captioned
property, which may either exceed $1,000.00 or cause Mass. Gen. Chapter
1431 Section 153, Section 6 to be applicable. If any notice under Mass.
Gen. Laws, Ch. 139 Sec. 3B. is appropriate please direct it to the
attention of tiic C+liiter and include a reference to the captioned insured.,
location, policy number, date of loss and claim or file number.
deductible.
Insurance Ad-iuster
Title
On this date, I caused copies of this notice to be sent to the persons
named above at the address indicated above first class mail..
S'gnatur an date v% H cv�
65 MERRIMACK STREET, LAWRENCE, MASSACHUSETTS 01843
FAX N0: 508-687-7246
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