HomeMy WebLinkAboutInsurance Notice of Claim - Correspondence - 98 PLEASANT STREET 9/13/2018 Form of Notice of Casualty Loss to Building
Under MASS. GEN. LAWS, Chi. 139, Sec., 3B
To': Building Commissioner or
Inspector of Buildings
120 Main Street
North Andover, MA 01845
REI: Insured- Reuben Asicencio
Property Address-,
Company: Providence Mutual Fire Insurance Company
Pollcy/Claim Number- HP01 919809, 18-5651
Date/Cause of Loss: 8',,Gash o:feat,o,r,H,ot,,VV, ter
Our File Number-. 36349-W
Claim has, been made involving loss,, damage or destruction of the above captioned property,
wI ich, 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 writier and
include a reference to the captioned insured, location, policy number, date of loss and claim or
file number.,
Wadle Anderson Ext. 112
On this date, I caused copies of this Notice to be sent to the persons namedabove at the
addresses indicated above by First Class Mall.
Signature and Date
ANDERSON ADJUSTMENT CO., INC.
50 Nashua Road, Suite 303
PO Box 1098
Londonderry, NH 03,053
C c Health, Department North Andover Fire Department
120 Main Street '795 Chickering Road
North Andolver, MA 01845 North Andover,, MA 01845