HomeMy WebLinkAboutInsurance Notice of Claim - Correspondence - 1815 GREAT POND ROAD 5/20/2019 Fora of Notice of Casualty Loss to Building
Under MASS. GEN. LAWS, Ch. 39, sec. 3
T : Building Department
120 Main street
North Andover, MA 01845
FEE: Insured: Maryellen D lToff
Property Address: 1815 Great Pond Read
Company: Merrimack k Mutual Fire Insurance Company
Policy/Claim Number: HP2540350, HP2540350
Date/Cause of Less: /2219, eater/Underground Pipe Failure
Our File Number- 372 7-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 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. 11
n this date, I caused copies of this Notice to be seat to the persons named above at the
'addresses indicated above by First Class Mail.
2j
S6nature and Date
ANDERSON ADJUSTMENT CO., INC.
50 Nashua Roach, sprite 303
PO Box 1098
Londonderry, NH 03053
Co: North Andover Health Department
120 Main Street
North Andover, MA 01845
North Andover Fire Department
795 Chiokering Road
North Andover, MA 01845
