HomeMy WebLinkAboutMiscellaneous - Exception (143)I
MASSACHUSETTS PROPERTY INSURANCE UNDERWRITING ASSOCIATION
Two Center Plaza
Boston, Massachusetts 02108-1904
(617)723-3800 Ma Only (800)392-6108, FAX (800)851-8424
NORTH ANDOVER HEALTH DEPT.
NORTH ANDOVER TOWN HALL
NORTH ANDOVER MA 01845
Form of Notice of Casualty Loss to Building
Under Mass, Gen. Laws, Ch. 139, Sec.3B
RECEIVED
DEC 2 9 2008
TOWN OF N(`- ,%iVUJUER
HEALTH HRTMENT
Re: Insured:
HAMID ZOHDI
Property Address:
48 FERNVIEW AVE UNIT 10, NORTH ANDOVER, MA 01845
Policy Number:
1000880
Type Loss:
Freezing
Date of Loss:
12/12/2008
Claim Number:
258436
Claim has been made involving loss, damage or destruction of the above captioned propert, which may either
exceed $1000.00 or cause Massachusetts General Laws, Chapter 143 section 6 to be applicable. If any
notice under Massachusetts General Laws, Chapter 139, Section 313 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.
MPIUA Claims Division
CMA00021
12/17/2008
BUTTERWORTH & O'TOOLE, INC.
P.O. BOX 8294
SALEM, MA 01971-8294
ADJUSTERS/APPRAISERS
FOR INSURANCE COMPANIES ONLY
TELEPHONE (978) 741-5731 - ; FAX (978) 740-9109
September 09, 2003
r
FORM OF NOTICE OF CASUALTY LOSS TO BUILDING
UNDER MASS. GEN. LAWS, CH. 139, SEC. 3B
TO: Building Commissioner or Board of Health or
Inspector of Buildings Board of Selectmen
City/Town Hall
ADDRESSES
North Andover, MA 01845
RE: Insured: Irving Hilman
i""��i°�✓1�1�
Address: 48 Fla= Y Road
City/Town Hall
North Andover, MA 01845
#9 ✓
North Andover, MA 01845
Policy No.: H012237276
Loss of: 09/02/03
File or Claim No.: 031-1830
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,
Ch. 139, Sec. 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.
If no reply is received from your office within ten days, we will assume
you have no liens of any type against this property and we will recommend to the
insuring company that this claim is paid.
Vicki Gardner
Adjuster
BUTTERWORTH & 01TOOLE, INC.
P.O. BOX 8294
SALEM, MA 01971-8294
ADJUSTERS/APPRAISERS
FOR INSURANCE COMPANIES ONLY
TELEPHONE (978) 741-5731 FAX (978) 740-9109
v� of
June 07, 2004 pF t-A00A
OF ,
FORM OF NOTICE OF CASUALTY LOSS TO BUILDING
UNDER MASS. GEN. LAWS, CH. 139, SEC. 3B
TO: Building Commissioner or Board of Health or
Inspector of Buildings Board of Selectmen
Citv/Town Hall
ADDRESSES
North Andover, MA 01845
RE: Insured: Irving Hilman
Address: 48 Fernview Road #9
Citv/Town Hall
North Andover, MA 01845
North Andover, MA 01845
Policy No.: H012237276
Loss of: 06/02/04
File or Claim No.: 040-1072
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,
Ch. 139, Sec. 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.
If no reply is received from your office within ten days, we will assume
you have no liens of any type against this property and we will recommend to the
insuring company that this claim is paid.
Paul Dionne
Adjuster
TELEPHONE (978) 741-5731
June 07, 2004
BUTTERWORTH & 01TOOLE, INC.
P.O. BOX 8294
SALEM, MA 01971-8294
ADJUSTERS/APPRAISERS
FOR INSURANCE COMPANIES ONLY
FAX (978) 740-9109
FORM OF NOTICE OF CASUALTY LOSS TO BUILDING
UNDER MASS. GEN. LAWS, CH. 139, SEC. 3B
TO: Building Commissioner or
Inspector of Buildings
City/Town Hall
ADDRESSES
15
4
Board of Health or
Board of Selectmen
City/Town Hall
North Andover, MA 01845 North Andover, MA 01845
RE: Insured: Irving Hilman -
Address: 48 Fernview Road #9
North Andover, MA 01845
Policy No.: H012237276
Loss of: 06/02/04
File or Claim No.: 040-1072
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,
Ch. 139, Sec. 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.
If no reply is received from your office within ten days, we will assume
you have no liens of any type against this property and we will recommend to the
insuring company that this claim is paid.
Paul Dionne
Adjuster