HomeMy WebLinkAboutMiscellaneous - 9 MORTON STREET 4/30/2018NEW ENGLAND CLAIMS SERVICE, INC.
Reply To ❑ Reply To ❑
100 CONIFER HILL DRIVE, SUITE 308. P. O. BOX 578
•' DANVERS, MA -01923 SHREWSBURY, MA 01545
TEL. (508) 777-9900 TEL. (508) 842-3995
'FAX (508) 774-9296 FAX (508) 842-7510
Form of Notice of Casualty Loss to Building
Under Mass. Gen. Laws Ch. 139 Sec. 31)
TO: Building Commissioner or
Inspector of Buildings
�t-
addresses
RE: INSURED
Board of Health or
Board of Selectmen
PROPERTY ADDRESS p rbc
POLICY NO.:
LOSS OF: 12 19�
FILE OR CLAIM NO.:. -)4ci-)
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 3D
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 or file number.
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 mail.
3�is�5�
SIGNATU E AND DATE
CC: Fire Dept.