HomeMy WebLinkAboutInsurance Notice of Claim - Correspondence - 65 HILLSIDE ROAD 7/29/2019 .........
Form of notice of Casualty Loss to i l d i
Under MASS. GEN. LAWNS, Ch, 139, Sec. 3
To: Building Commissioner or
Inspector of Buildings
120 Main Street
North Andover, MIA 01845
RE: Insured: Mark Fischer & Kathy Ann Konecsni
Property Address: 65 Hillside Road
Company: Merrimack Mutual Fire Insurance Company
Policy/Claim Number: HP199 23 , HP199 232
Date/Cause of Loss: /29/2019, Water/Plumbing Leak
Our File Number: 3 283-D
Claim has been made involving loss, damage r destruction of the above arpti n d property,
which may either exceed 1 x999.99 or cause MASSACHUSETTS GENERAL LAWS, CHAPTER
143, SECTION 6, to be applicable. If any notice under MASSACHUSETTS GENERAL LAWS,
CHAPTER 139, SECTION 313 is appropriate, please direct it to the attention of the writer and
Include a reference to the captioned insured, location, policy number, dame of loss and claim or
file number.
Daniel Paul, Ext. 117
n 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.
f i
Signature and Date
AN SON ADJUSTMENT Co., INC.
50 Nashua Road, suite 33
PO Box 1098
Londonderry, NH 033
Cc: Health Department North Andover Fire Department
29 Main Street 795 Chikering Road
North Andover, MA 01845North Andover, MA 0 1845