HomeMy WebLinkAboutInsurance Notice of Claim - Correspondence - 26 ANNIS STREET 8/27/2019 Form of Noticeof Casualty Loss to Building
Under MASS, GEN. LAWS, Ch. 139, sec. 313
To: Building Commissioner or
Inspector of Buildings
120 Main Street
Forth Andover, MBA 01845
RE: Insured: Paul & Jeanne Gallagher
Property Address: 26 Ann'rs Street
Company& Merrimack Mutual Fire Insurance Company
Policy/Claim Number: HP1 1 6r HP1701694
Date/Cause of Loss: 221 , Biohazard Clean-lip
Our File Number: 37351-C
Claim has been made involving loss, damage or destruction of the above captioned property,
which may either exceed $1,000-00 or cause MASSACH SETTS GENERAL LAWS, CHAPTER
143, SECTION 6, to be applicable. If any notice under MIASSACHUSETTS GENERAL LAWS,
CHAPTER 139, SECTION 3E 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, Et. 117
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.
t
Signature and Date
ANDERSON ADJUSTMENT Co., INC,
o Nashua Road, suite 303
o Box 109
Londonderry, NH 03053
cc: Health Department forth Andover Fire Department
120 Main Street 795 Chid ering Road
North Andover, MIA 01845 North Andover, MIA 0 1845