HomeMy WebLinkAboutInsurance Notice of Claim - Correspondence - 178 OLD CART WAY 1/28/2019 t
J/f�[
Butterworth, O'Toole., In.c.
ADJUSTERSIAPPRAISERS
FOR INSURANCE COMPANIES ONLY
P.O.BOX 8294
SALEM,MA 01971-8294
TEL. (978)741-5731
FAX (978)740-9109
clairnsgbutterworthotoole.com
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 Chicicering 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 1 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 Dohel
Adjuster
Hernher of
National Association of Independent Insurance Adjusters