HomeMy WebLinkAboutInsurance Notice of Claim - Correspondence - 199 OLD CART WAY 5/11/2018 Form of Notice of Casualty Loss to Building
Under MASS. GEN. LAWS, Ch. 139, Sec. 3B
To: Building Department
120 Main Street
North Andover, MA 01845
V
RE: Insured: Paul & Mary Daley
Property Address: 199 Old Cart Way
Company: Bay State Insurance Company
Policy/Claim Number: HP3053001, HP3053001
Date/Cause of toss: 3/2/2018, Windstorm/Fallen Trees
Our File Number: 35844-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: North Andover Health Department North Andover Fire Department
120 Main Street 795 Chickering Road
North Andover, MA 01845 North Andover, MA 01845