HomeMy WebLinkAboutInsurance Notice of Claim - Correspondence - 53 QUAIL RUN ROAD 1/6/2018 Form of Notice of Casualty Loss to Building
Under MASS. GEN. LAWS, Ch. 139, Sec. 3B
To: Building Department
Building 20, Suite 2035
1600 Osgood Street
North Andover, MA 01845
RE: Insured: Matthew & Erica lorio
Property Address: 53 Quail Run Road
Company: Bay State Insurance Company
Policy/Claim Number- HP3137677, HP3137677
Date/Cause of Loss: 1/6/2018, Water/Plumbing Leak
Our File Number: 35425-M
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.
Mike Peterson, Ext. 115
On this date, I caused copies of this Notice to be sent t AT6,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
Building 20, Suite 2035 795 Chickering Road
1600 Osgood Street North Andover, MA 01845
North Andover, MA 01845