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HomeMy WebLinkAboutInsurance Notice of Claim - Correspondence - 80 MILLPOND 2/8/2019 1100 Crown Colony Drive P.O. Box 699195 A R B E L L A Quincy,MA 02264-9 i 95 617.328.2800 INSURANCE GROUP arbella.com February 8, 2019 k 1 NORTH ANDOVER BUILDING COMMISSIONER 120 MAIN STREET, FIRST FLOOR NORTH ANDOVER, MA 01845 Claim Number: 033999885 Policy Number: 05086400006 Company Name: Arbella Indemnity Insurance Company Date of Loss: 01/14/2019 Insured: JOHN KAMAL Property Location: 80 MILLPOND,NORTH ANDOVER, MA To Whom It May Concern: A claim has been made involving loss, damage, or destruction of the above captioned property, which may either exceed $1,000 or cause Massachusetts General Laws, Chapter 143, Section 6,to be applicable. If any notice under Massachusetts General Law, Chapter 139, Section 313 is appropriate, please direct it to the attention of the writer. Please include a reference to the captioned insured, location, date of loss and claim number. Thank you for your assistance. Sincerely, Cynthia Holden-Amur Claim Service Specialist Property Claim Office 800-272-3552 ext.7549 Fax 617-773-4760 CC:NORTH ANDOVER HEALTH DEPARTMENT 1600 OSGOOD STREET, BLDG 20, SUITE 2035 NORTH ANDOVER, MA 01845 CC:NORTH ANDOVER FIRE DEPARTMENT 795 CHICKERING ROAD NORTH ANDOVER, MA 01845 93-utterivorthi. & O'TooCe, Inc. ADJUSTERS/APPRAISERS FOR INSURANCE COMPANIES ONLY P.O.BOX 8294 SALEM,MA 01971-8294 'rEL. (978)741-5731 FAX (978)740-9109 claims ebutterworthotoolexorn 01/28/2019 FORM OF NOTICE OF CASUALTY LOSS TO BUILDING UNDER MASS. GEN. LAWS, CH. 139, SEC. 3B TO: Building Inspector & North Andover Fire Department & Health Inspector 120 Main Street 795 Chickering Road 120 Main Street North Andover, MA 01845 North Andover, MA 01845 North Andover, MA 01845 RE: Insured: Jami Marshall Address: 178 Old Cart Way North Andover, MA 01845 Policy No.: 3017541 Loss of: 01/25/2019 Water/ Burst Pipe File or Claim No.: 091-0081 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. Brad Doherty Adjuster f1'fClflhGl'Of '.. National Association of Independent Insurance Adjusters INDEPENDENT CLAIMS SERVICE, INC . Service - Integrity • Experience Notice of Casualty Loss to Building Under Massachusetts General Laws, Chapter 139, Section 3B February 8, 2019 North Andover, MA Building Inspector 120 Main Street North Andover, MA 01845 North Andover, MA Board of Health 120 Main Street North Andover, MA 01845 North Andover, MA Fire Department 124 Main Street North Andover, MA 01845 INSURED: James.Heckman ADDRESS: 14 Robinson Ct,North Andover , MA 01845 LOCATION OF LOSS: 14 Robinson Ct,North Andover , MA 01845 COMPANY: Narragansett Bay Insurance POLICY#: 10331343 CLAIM#: 19-80534 DATE OF LOSS: 09/13/2018 TYPE OF LOSS: Water Dear Sir or Madam: Independent Claims Service is the insurance adjusting firm hired by the above referenced client to handle the captioned loss on behalf of their insured. A claim has been inade involving loss, damage, or destruction of the above-captioned property which may either exceed `61,000.00 or cause Massachusetts General Laws, Chapter 143, Section 6 to be applicable. If notice under Massachusetts General Laws, Chapter 139, Section 3B is appropriate, please bring it to our attention, and include a reference of the captioned insured: Location,policy number, and/or date of loss. Sincerely, j INDEPENDENT CLAIMS SERVICE, INC. i 22 Water Street Westborough,MA 01 581 508.366.8535 FAX 508.366,0917 www.icsclaims.com AMERICAN CLAIMS SERVICE MULTI-LINE ADJUSTERS Letter 143 February 6, 2019 Town of Barth Andover Building Department 120 Main Street North Andover, MA 01845 Attention: Building Inspector Board of Health and/or Board of Selectman Insured: Naffah Location: 3 Pembrook Road North Andover, MA 01845 Policy: PMO 0100 53 77 73 Loss Date: February 3, 20192/3/19 Loss Type: Pipe burst ACS File: 190038 Dear Sir/Madam, 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, loss date and file. On this date, February 6, 2019, 1 caused copies of this notice to be sent to the persons named above at the addresses indicated above by first class mail Unless a response is received within the next ten days we will not be obligated to pay any portion of this claim to you. Respectfully submitted, Claims Representative 7 KIM ALL LANE BUILDING C LYNNFIELD, MA 01940 PHONE 781-245-916 FAX 781-245-1077 qlairns&c ygrizori.net I 1100 Crown Colony Drive P.O. Box 699195 A R B E L L A Quincy, MA 02269-9195 .328,2800 61�.32s.28oa INSURANCE GROUP arbella.com February 22, 2019 3 NORTH ANDOVER BUILDING COMMISSIONER 120 MAIN STREET, FIRST FLOOR NORTH ANDOVER, MA 01845 Claim Number: 034003576 Policy Number: 51619400004 Company Name: Arbella Mutual Insurance Company Date of Loss: 02/21/2019 Insured: ELAINE KIRBY Property Location: 911 JOHNSON ST,NORTH ANDOVER, MA To Whom It May Concern: A claim has been made involving loss, damage, or destruction of the above captioned property, which may either exceed $1,000 or cause Massachusetts General Laws, Chapter 143, Section 6,to be applicable. If any notice under Massachusetts General Law, Chapter 139, Section 3B is appropriate, please direct it to the attention of the writer. Please include a reference to the captioned insured, location, date of loss and claim number. Thank you for your assistance. Sincerely, Cynthia Holden-Amoy Claim Service Specialist Property Claim Office 800-272-3552 ext.7549 Fax 617-773-4760 CC: NORTH ANDOVER HEALTH DEPARTMENT 1600 OSGOOD STREET, BLDG 20, SUITE 2035 NORTH ANDOVER, MA 01845 CC: NORTH ANDOVER FIRE DEPARTMENT 795 CHICKERING ROAD NORTH ANDOVER, MA 01845 The Commerce Insurance Company'" MAPFRE Citation Insurance Company1m 11 Gore Road,Webster,Massachusetts 01570 INSURANCE' 508.949.1500 jwwwmapfteinsurance.com February 20, 2019 BUILDING COMMISSIONER or Board of Health or INSPECTOR OF BUILDINGS Board of Selectmen TOWN/CITY HALL Town/City Hall N ANDOVER MA 01845 RE: Our Insured: JULIE SHOMOS I THEODORE SHOMOS Property Address: 40 FERNVIEW AVENUE UNIT 7 Policy#: BDTMTD Date of Loss: 02/17/2019 File#: RJNW72-PCWAW5 Claim has been made involving loss, damage, or destruction of the above captioned property which may exceed $1,000, 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 my attention. Please reference the above captioned insured, location, policy number, date of loss, and file number on any correspondence. KAYLA COSTA Telephone: (508)949-1500 Ext: 15217 Claim Representative 1, Property Toll Free. 1-800-221-1605, Ext: 15217 On this date, I cause copies of this notice to be sent to the persons indicated above, at the address above, by first class mail. February 20, 2019 CIC 254 (Rev.4/95) MAIL KCI Form of Notice of Casualty Loss to Building Under MASS. GEN. LAWS, Ch. 139, Sec. 3B To: Building Commissioner or Inspector of Buildings 1 120 Main Street North Andover, MA 01845 RE: Insured: Mary &Vincent Devito Property Address: 71 Empire Drive Company: Bay State Insurance Company Policy/Claim Number: HP3015467, HP3015467 Date/Cause of Loss: 2/2/2019, Water/Pipe Burst Our File Number: 36782-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 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. Ryan Werner, Ext. 116 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 Signal, ign re nd Date ANDERSON ADJUSTMENT CO., INC. 50 Nashua Road, Suite 303 PO Box 1098 Londonderry, NH 03053 Cc: Health Department North Andover Fire Department 120 Main Street 795 Chickering Road North Andover, MA 01845 North Andover, MA 01845 i Safety Insurance AUTO •HOME • BUSINESS P.O. Box 55098 Boston MA 02205 617-951-0600 November 27, 2018 Building Commissioner or Inspector of Buildings Fire Department or Arson Squad Board of Health or Board of Selectman City Hall NORTH ANDOVER, MA 01845 Insured: JULIE C JENSEN Property Address: 14 EDGELAWN AVE UNIT#7, NORTH ANDOVER MA Policy Number: HMA0468259 Claim Number: BOS00088380 Date of Loss: 11/24/2018 Notice of Loss Under M.G.L. e. 139 3B This communication shall serve as written notice pursuant to M.G.L. c. 139, § 3B that [Safety Insurance Company] ("Safety") has received a claim involving loss, damage or destruction to a building or other structure at the above-referenced address which may either: (1) meet or exceed $1,000; or (2) cause the condition or the building or other structure to render M.G.L. c. 143, § 6 applicable. In accordance with M.G.L. c. 139, § 3B, if the city or town intends to initiate proceedings designed to perfect a lien under Section 3B, M.G.L. c. 143, § 9 or M.G.L. c. 111, § 127B, please notify Safety of the same by certified mail. Kindly forward such notice to my attention, at the address indicated above, and include with such notice a reference to the above-described insured, property address, policy number and claim number. If you have any questions regarding this notice, please feel free to contact me directly at 617-951-0600 EXT 3549, Sincerely, Pat O'Sullivan Claim Examiner ® The Commerce Insurance Company-Im MAPFRE" Citation Insurance Company1m 11 Gore Road,Webster,Massachusetts 01570 INSURANCE 508.949.1500 jwww.mapfreinsurance.com November 27, 2018 BUILDING COMMISSIONER or Board of Health or INSPECTOR OF BUILDINGS Board of Selectmen TOWNICITY HALL Town/City Hall NORTH ANDOVER MA 01845 RE: Our Insured: TINA I ROSSETTI Property Address: 14 EDGELAWN AVE UNIT 8 Policy#: HHP773 Date of Loss: 11/24/2018 File#: RAJY12-NXKCN3 Claim has been made involving loss, damage, or destruction of the above captioned property which may exceed $1,000, 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 my attention. Please reference the above captioned insured, location, policy number, date of loss, and file number on any correspondence. KRISTENDOW Telephone: (508)949-1500 Ext: 15768 CLAIM REP, CAT RESPONSE Toll Free: 1-800-221-1605, Ext: 15768 On this date, I cause copies of this notice to be sent to the persons indicated above, at the address above, by first class mail. November 27, 2018 CIC 254 (Rev.4/95) MAIL 782 W W .Safety Insurance AUTO+ HOME +BUSINESS P.O. Box 55098 Boston MA 02205 617-951-0600 December 03, 2018 Building Commissioner or Inspector of Buildings Fire Department or Arson Squad Board of Health or Board of Selectman City Hall NORTH ANDOVER, MA 01845 Insured: WILFRIED WELSCH and RAQUEL T WELSCH Property Address: 49 EQUESTRIAN DRIVE, NORTH ANDOVER MA Policy Number: HMA0262065 Claim Number: BOS00088486 Date of Loss: 9/28/2018 Notice of Loss Under M.G.L. c. 1 39 3B This communication shall serve as written notice pursuant to M.G.L. c. 139, § 3B that[Safety Insurance Company] ("Safety") has received a claim involving loss, damage or destruction to a building or other structure at the above-referenced address which may either: (1) meet or exceed $1,000; or(2) cause the condition or the building or other structure to render M.G.L. c. 143, §6 applicable. In accordance with M.G.L. c. 139, § 3B, if the city or town intends to initiate proceedings designed to perfect a lien under Section 3B, M.G.L. c. 143, § 9 or M.G.L. c. 111, § 127B, please notify Safety of the same by certified mail. Kindly forward such notice to my attention, at the address indicated above, and include with such notice a reference to the above-described insured, property address, policy number and claim number. If you have any questions regarding this notice, please feel free to contact me directly at 617-951-0600 EXT 2010. Sincerely; Robert Krupa Claim Examiner i Samuel F. McCormack Co. Inc. Insurance Adjusters and Appraisers Samuel F.RtConnauk Co.,k, AeJnSTERS ANO APPRAISERS August 21, 2018 Town of North Andover Building Inspector 120 Main St. North Andover ,MA 01845 RE ASSURED: Michael J. &Carol A. Leary LOSS LOCATION: 57 Essex St, N. Andover, MA 01845 POLICY NO: 2344107 TYPE OF LOSS: Mold ©ATE OF LOSS: 08/16/2018 OUR FILE NO: 18-04608 To Whom It May Concern: 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 this writer and include a reference to the above- captioned insured, location, policy number, date of loss and claim or file number. Thank you for your anticipated cooperation. Very truly yours, Michael J. White Adjuster mw@mccormackadjuster.com cc: Board of Health 42 Holbrook Avenue,Braintree,MA 021841-800-972-5399(781)843-1222 Fax(781)849-8191 125 Waterhouse Road Bourne,MA 02532(508)403-2600 Fax(508)403-2602 tvtivrv.rrrccot,tnackadjtrster•.corrr Form of Notice of Casualty Loss to Building Under MASS. GEN. LAWS, Ch. 139, Sec. 3B i i To: Building Commissioner or I Inspector of Buildings 1 120 Main Street North Andover, MA 01845 i RE: Insured: Linda Appleby-Armstrong Property Address: 2 Fernview Avenue, Apt. 9 Company: Merrimack Mutual Fire Insurance Company Policy/Claim Number: HP3063879, HP3063879 Date/Cause of Loss: 11/3/2018, Water/Leak from Unit Above Our File Number: 36531-D 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. Daniel Paul, Ext. 117 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. 50 Nashua Road, Suite 303 PO Box 1098 Londonderry, NH 03053 Cc: Health Department North Andover Fire Department 120 Main Street 795 Chickering Road North Andover, MA 01845 North Andover, MA 01845 Claim # Advantage Claim Services Adjuster Assigned: Glenn Guarente 522 Chickering Road Suite B North Andover MA 01845 Form of Notice of Casualty Loss to Building Under Mass. Gen. Laws, Ch. 139, Sec. 3B To: BUILDING INSPECTOR Town of North Andover 120 Main St. North Andover MA 01845 Re: Insured: Kristen Kazanji.an Property address: 6 Fernview Ave. Apt. 8 North Andover, MA 01845 Policy #: 3177414 Loss of: 2018/11/08 File or Claim No. AD 2314 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. Glenn Guarente Title: Adjuster On this date, I caused copies of this notice to be sent to the persons named at the addresses indicated above by first class mail. 11-1.5-2018 Signature and date 1100 Crown Colony Drive P.O. Box 699195 A R B E L L A Quincy,MA 02269-9195 617.328.2800 INSURANCE GROUP arbella.corn December 20, 2018 NORTH ANDOVER BUILDING COMMISSIONER 120 MAIN STREET, FIRST FLOOR NORTH ANDOVER, MA 01845 Claim Number: 033987366 Policy Number: 42429400005 Company Name: Arbella Mutual Insurance Company Date of Loss: 12/18/2018 Insured: PRADEEP KUMAR Property Location: 23 FERN VIEW AVE UNIT 4,NORTH ANDOVER, MA To Whom It May Concern: A claim has been made involving loss, damage, or destruction of the above captioned property, which may either exceed $1,000 or cause Massachusetts General Laws, Chapter 143, Section 6, to be applicable. If any notice under Massachusetts General Law, Chapter 139, Section 3B is appropriate, please direct it to the attention of the writer. Please include a reference to the captioned insured, location, date of loss and claim number. Thank you for your assistance. Sincerely, Cynthia Holden-Amoy Claim Service Specialist Property Claim Office 800-272-3552 ext.7549 Fax 617-773-4760 CC: NORTH ANDOVER HEALTH DEPARTMENT 1600 OSGOOD STREET, BLDG 20, SUITE 2035 NORTH ANDOVER, MA 01845 CC: NORTH ANDOVER FIRE DEPARTMENT 795 CHICKERING ROAD NORTH ANDOVER, MA 01845 Form of Notice of Casualty Loss to Building Under MASS. GEN. LAWS, Ch. 139, Sec. 3B To: Building Commissioner or Inspector of Buildings 120 Main Street North Andover, MA 01845 RE: Insured: Andrew Bisceglia Property Address: 37 Fernview Avenue, #7 Company: Commerce Insurance Company Policy/Claim Number: BGXKTT, PYPY27 Date/Cause of Loss: 11/5/2018, Water Damage to Ceiling(s) Our File Number: 36516-M 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. Mike Peterson, Ext. 115 On this date, I caused copies of this Notice to be sent t 4ersons named above at the addresses indicated above by First Class Mail. Signature and Date ANDERSON ADJUSTMENT CO., INC. 50 Nashua Road, Suite 303 PO Box 1098 Londonderry, NH 03053 Cc: Health Department North Andover Fire Department 120 Main Street 795 Chickering Road North Andover, MA 01845 North Andover, MA 01845 ® The Commerce Insurance Company"' MAPFRE Citation Insurance Company"' 11 Gore Road,Webster,Massachusetts 01570 INSURANCE" 508.949.1500jwww.mapfreinsurance.corn November 07, 2018 BUILDING COMMISSIONER or Board of Health or INSPECTOR OF BUILDINGS Board of Selectmen TOWN/CITY HALL Town/City Hall NORTH ANDOVER MA 01845 RE: Our Insured: ANDREW BISCEGLIA Property Address: 37 FERNVIEW AVE#7 Policy#: BGXKTT Date of Loss: 11/05/2018 Filet PYPY27-NWPJNI Claim has been made involving loss, damage, or destruction of the above captioned property which may exceed $1,000, 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 my attention. Please reference the above captioned insured, location, policy number, date of loss, and file number on any correspondence. ELENA BOURASSA Telephone: (508)949-1500 Ext: 15916 Claim Representative I, Property Toll Free: 1-800-221-1605, Ext: 15916 On this date, I cause copies of this notice to be sent to the persons indicated above, at the address above, by first class mail. November 07, 2018 CIC 254 (Rev. 4195) MAIL FB 1 TRAVELERS J� 209 The Phoenix Insurance Company P.O. Box 430 Buffalo, NY 14240-0430 08/31/2018 Building Inspector of North Andover 120 Main Street North Andover MA 01845 Insured: Frederick-M-Augus Williams Claim Number: STF1612 Policy Number: OGA717-980153291-636 -1 Date of Loss: 08/19/2018 Loss Location: 66 Fernview Ave Apt 9 North Andover MA To: Board of Selectmen Building Commissioner Inspector of Buildings Board of Health A claim has been made involving loss, damage or destruction of the above captioned property which may either exceed $1,000 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 my attention and include a reference to our insured, the policy number, the claim/file number, the date of loss, and the location. If you have any questions, please feel free to contact me at (508)946-6609 or email me at ABARDASZ@travelers.com. Sincerely, Ashley Bardasz Claim Professional (508)946-6609 Ext. 946-6609 Fax: (877)786-5584 Email: ABARDASZ@travelers.com 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 Date s p F P0062 F3162C1S18244000209 00001 N