HomeMy WebLinkAboutInsurance Notice of Claim - Correspondence - 83 CAMPBELL ROAD 5/2/2018 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: Thomas & Lucie Fallon
Property Address: 83 Campbell Road
Company: Merrimack Mutual Fire Insurance Company
Policy/Claim Number: HP3083624, HP3083624
Date/Cause of Loss: 512/2018, Tree on Wires
Our File Number: 35874-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 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.
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.
Signavr and Date
ANDERSON ADJUS MENT CO., INC.
7
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