HomeMy WebLinkAboutInsurance Notice of Claim - Correspondence - 4 HARVEST DRIVE 226 5/5/2018 J3 utterivortf. & O'�tooCe, Inc.
ADJUSTERSIAPPRAISERS
FOR INSURANCE COMPANIES ONLY
PA,BOX 8294
SALEM,MA 01971-8294
TEL. (978)741-5731
FAX (978)740-9I09
claims@butterworthotoole.com
12/05/2018
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: Evan Rosenblatt
Address: 4 Harvest Drive Unit 226
North Andover, MA 01845
Policy No.: 3086379
Loss of- 05/05/2018 Water/Burst Pipe
File or Claim No.: 85-1698
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
Member of
National Association of Independent Insurance Adjusters