HomeMy WebLinkAboutInsurance Notice of Claim - Correspondence - 123 MARBLEHEAD STREET 9/13/2018 Phone. 978-632-2660 Fox: 978-632.2662
JACVIES A. "TR1J]DEA[1
Adjustment Service Inc.
P. O.Box 7
Gardner,MA 01.440
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Notice of Casualty Toss of building
Under Massachusetts General Laws, Chapter 139, Section 3B
November 8, 2018
....................
gilding Inspector
120 Main Street
North Andover, MA 01845
Board of Health
120 Main Street
North Andover, MA 01845
Fire Department
Dept. of Records
795 Chickering Road
North Andover,MA 01845
Insured: David Dipasquale
Loss Location: 123-125 Marblehead Street,North Andover,MA 01845
Insurance Company: Preferred Mutual Insurance Co.
Policy No.: PHO01.00865163
Date of Loss: September 13,2018
File Number: 18-17038
Claim Number: 18125144
Type of Loss: Property Damage
Claim has been made involving loss, damage, or destruction of the above captioned property, which may either
exceed l,0(10.00 or cause"Mass. Gen. Laws,Chapter 143, Section 6"to be applicable. If any notice under"Mass.
Gen. Laws, Chapter 139, Section 313" is appropriate, please direct it to the writer and include a reference to the
captioned insured, location,policy number, date of loss, and file or claim number.
Claim has been made involving loss, damage or destruction of the above-captioned property, which may
exceed $5000. If any notice under Massachusetts General Laws, Chanter 175. Section 97A 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 number.
On this date, I cause copies of this notice to be sent to the person(s) named above at the address indicated by first
class mail.
Sincerely,
Robert P.Blais
Claims Adjuster
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