HomeMy WebLinkAboutInsurance Notice of Claim - Correspondence - 149 PLEASANT STREET 9/13/2018 Form of Notice of Casualty Loss to Building
Under MASS. GEN,, LAWS, Ch. 139, Sec., 3B,
To,# Building Commissioner or
Inspector of Buildings
120, Main Street
North Andover, MA 01845
RE# Insured.- J.Y. Rea,lty Trust
Property Address,,- '1419-151 Pleasiant Street
Company: Providence Mutual Fire Insurance Company
Policy/Claim Number, BOP006255,91, 18-5591
Date,/Cause of Loss: 9/1,3120,18, Gas Explosion
Our File Number.- 36325-W
Claim has been ma dle involving loss, damage or destruction ofthe above captioned property,
which may either exceed $1,000.00 or cause MASS ACHUSETTS GENERAL, LAWS,,, CHAPTER
143, SECTION 61, to be applicable., If any notice under MASSACHUSETTS GENER AL LAWS,1
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, date of loss and claim or
file number.
Wade Anderson, Ext. 112
On this date, I caused copies 'this Notice to be sent to the persons named above at the
addresses Indicated above by First Class Mall.
��16nature and Date
ANDERSON ADJUSTMENT CO.,, INC.
50 Na,,shua Road, Suite 303
PO Box 1098
Londonderry, NH 030513
cc,.' Health Department North Andover it Department
120 Main Street 795 Chick ering Road
North Andover, MA 01845 North Andover, MA 01845