HomeMy WebLinkAboutInsurance Notice of Claim - Correspondence - 478 WAVERLY ROAD 3/7/2018 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
RE: Insured: Benjamin Campbell
Property Address: 478 Waverly Road
Company: Merrimack Mutual Fire Insurance Company
Policy/Claim Number: HP1333826, HP1333826
Date/Cause of Loss: 3/7/2018, Windstorm/Tree on Dwelling
Our File Number: 35626-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.
2,3/, �
Sig ure and Date
ANDERSON ADJUSTMENT CO., INC.
50 Nashua Road, Suite 303
PO Box 1098
Londonderry, NH 03063
Cc: North Andover Health Department North Andover Fire Department
120 Main Street 795 Chickering Road
North Andover, MA 01845 North Andover, MA 01845