HomeMy WebLinkAboutInsurance Notice fo Claim - Decision - 1264 SALEM STREET 3/7/2018 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: Kyle Rys & Carrie Rainen
Property Address: 1264 Salem Street
Company: Bay State Insurance Company
Policy/Claim Number: HP3153984, HP3153984
Date/Cause of Loss: 3/7/2018, Windstorm/Tree on Dwelling
Our File Number: 35670-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.
s
Signature and Date
ANDERSON ADJUSTMENT CO., INC.
50 Nashua Road, Suite 303
PO Box 1098
Londonderry, NH 03063
Cc: Health Department North Andover Fire Department
120 Main Street 795 Chickering Road
North Andover, MA 01845 North Andover, MA 01845