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HomeMy WebLinkAboutMiscellaneous - 80 PEMBROOK ROAD 4/30/2018 (4)N O �. N W ENGLAND CLA=MS SEcavT_C E, INC. 363 Broadway Linn d, MA 01940 Fcr:n of Notice of Casualty Loss tc Building Under Mass. Gen. Laws. Ch. 139 sec. 30 s -p : Building Ccmmissianer or Inspectar of Buildings RC2=d Qf '=n3rt t^ CC:'"t Bcard of RE c INSURE:3 PROPERTY ADDRESS : ) r=ju X4 Ar dl�yS Flo, a vet OJd1yE" PoLTev No. e 4 p 0� d .Ib LOSS OF-. FILE OR CLAIM NO..: (J Claim has been made involving loss, damage a= destructiec c= t: -:e zbeve-captioned vroperty which may either e:�ceed .�1, 000.00 or cause Mas_ G-e_n. laws, Chanter 143: Sect_cr_ 6 to be ape? _cable . If any re t_ce urde= Mass. Ger_. Laws; Chanter 139, Section 3D is appropriate, please d__ect iz to the attentiva of the writer and include a re=e-ence to the ca_oticred i,J ; rr+c- nsured, location, polio nc.:::�er, date of Lass ani claim o_ 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 Trail. C z F S=GNATU?r AND d7 f �