HomeMy WebLinkAboutMiscellaneous - 93 PLEASANT STREET 4/30/2018 (2)14
0
m
0 co
>
C/)
--I
M
MU
R
Mn
_f
Fma
PATRICK J. 0011OVAll ASSOCIATES, I"C.
"CLAI" MID LOSS AWUSTME"TS"
P.O. Box 110
"Skefield, "A 01980
(617) 245-5540
rOtU4 OF 11OTtCE OF CASUALTY LOSS TO PUMD11,10
U"DVR "AS@. CE". LAWS. clip. 139, SEC. 313
Too. Building commissioner or
lngppc�or of Buildthgo
City or Tou" Hall
I. -
Al All> - vc-- re e2l X- V 6,
RE! insureat JON -)O clq J��PW 6---*"
J
Property Addres"t q -3-5J- A,1
P - A A,1)) w� AL 01- y -
Policy Number! /'q' �2
Logs Type! / e C -
Date of Loss: / -5�(
our File Number!
35-J
Claim hnq bp@n made Involving loss, damage or destruction of the above -
captioned property, uhich may either emceed S11000 or cause mass. aen. Laws,
Chapter 143, Section 9, to be applicable. if any notice under "as@. Gen.
Lmws, chapter 139, Section 3y3 is appropriate, please direct It to the
attention of the writer and Include a reference to the captioned Insured,
location, policy numb@r, dSte of loss and file "umber.
/ 1,e- � ;��
Adjuster
Donovan Associates, Inc.
Wakefield, MA
oil thAw dewbe, I 08Uw*d copieg of this notice to be sent to the persons named
above at the addroaffew Indleated above by first class mail.
/a " )'F -F (-�
PATRICK J. DONOVAN ASSOCIATES, INC.
"CLAIM AND LOSS ADJUSTMENTS"
P. 0. Box 110
Wakefield, MA 01880
(617) 245-5540 9, �1'
FORM OF NOTICE OF CASUALTY LOSS TO
UNDER MASS. GEN. LAWS. CHP. 139,
TO: Building Commissioner or
Inspector of Buildings
City or Town Hall
J./O 0) 8 Lq -5
RE: Insured: To Q .011,
Property Address
CC- 1�flr -t-
ct, S-
P
Policy Number: VC) 73-� 1�2
Loss Type: \A/gpl&
Date of Loss:.
Our File Number:
", �xwlvl;
id so�
BUILDING-- \90
SEC. '39
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 LIkj�,C, SLZx�
Donovan Associates, Inc.
I MA
On this date, I caused copies of this notice to be sent to the persons named
above at the addresses indicated above bv first class mail
617