HomeMy WebLinkAboutMiscellaneous - 92 SANDRA LANE 4/30/2018 (2)I
Form of Notice of Casualty Loss to Building
Under MASS. GEN. LAWS, Ch. 139, Sec. 3B
To: Building Commissioner or
Inspector of Buildings
City Hall
No. Andover, MA 01845
RE: Insured: Mary Cranston
Property Address: 92 Sandra Lane, No. Andover, MA 01845
Policy Number: HP2243904
Date/Cause of Loss: 7/1/2004, Stone Wall Damage
File or Claim Number: 13796-R
Claim has been made involving loss, damage or destruction of the above captioned property,
which may either exceed $1,000.00 or cause MASSACHUSETTS GENERAL LAWS, CHAPTER
143, SECTION 6, to be applicable. If any notice under MASSACHUSETTS GENERAL 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 claim or
file number.
Rene Archambault
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.
Signature and Date
ANDERSON ADJUSTMENT CO., INC.
54 Stiles Road, C-106
Salem, NH 03079