HomeMy WebLinkAboutInsurance Notice of Claim - Homeowner License Exemption - 24 FARNUM STREET 4/17/2019 LaMarche Associates
5 North Road, P.O. Box 250
Chelmsford, MA 01824
800-349-1525
Fax: 978-256-8590
April 17, 2019
Building Commissioner/Inspector of Buildings
North Andover, MA 01845-5605
Board of Health/Board of Selectmen
North Andover, MA 01845-5605
NOTICE OF CASUALTY LOSS TO BUILDING
UNDER MASSACHUSETTS GENERAL LAWS CHAPTER 139 SECTION 3B
Claim has been made involving loss, damage or destruction of the property captioned
below, 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, cause of loss and
LA file number,
Insured: Sandra & Warren Sideri
Loss Location: 24 Farnum Street
North Andover, MA 01845-5605
Policy Number: HO12218220
Date of Loss: 04/15/2019
Cause of Loss: Physical Damage
LA File Number: MA-2-36392
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.
John Anderson
Adjuster
"Marche Associates,Inc.-000-349-1525
Page 1 of I