HomeMy WebLinkAboutInsurance Notice of Claim - Correspondence - 178 ANDOVER STREET 8/15/2019 Form of Notice of casualty Loss to Building
Under MASS. GEN. LAWS, Ch., 139, Sec. 3B
To: Building Department
120 Main Street
North Andover, ILIA 01845
E: Insured: Mary Chase
Property Address: 178 Andover Street
Company: Merrimack Mutual Fire Insurance Company
Policy/Claim Number: HPo 3 4 3, HP0632443
Date/cause of Loss: 3 4 1 g, Water/Appliance
Our File Number: 3 3 9-D
Claim has been rude 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 3S 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.
Darrel Paul, Ext. 11
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.
5j
Signature and Date
ANDERSON ADJUSTMENT co., INC.
50 Nashua Road, Suite 303
Po Box 1098
Londonderry, NH 03053
Cc- North Andover Health Department
120 Main Street
North Andover, MA 013
North Andover Fire Department
795 Chicering Road
North Andover, MA 01845