HomeMy WebLinkAboutInsurance Correspondence - Correspondence - 9/10/2019 {
Butterworth. & 0'9'ooCe,, .T-nc.
FOR INSURANCE COMP IE ONLY
P.O.BOX 8294
ALEM,MA 01971-8294
TF L. 97 7 1-57 1
FAX 97 7 -9 1 09
laiiris@butterwort otoo1 .corn
09 10 2019
FORM of NOTICE of CASUALTY LOSS To BUILDING
UNDER MASS, GEN. LAWS, CH, 139, SEC. 3
To,
Building Inspector & North Andover Fire & Health Inspector
Department
120 Main Street 795 Chickering Roach 120 Main Street
North Andover, MA. 0 1845 Norte.Andover,, MA, 0 18 45 North.Andover, MA, o 1845
E: Insured: Justin Pawlowski
Address: 2 Harvest Drive, Unit 1 I I
North Andover, MA. o 1845
Policy No.: 3161849
Loss of; o o2 2 l 8 Water See
File or Claim No.: 95-0 3
Claim has been made involving loss,dania a or destruction f the boar captioned property, which may either exceed
1,00 .00 or cause Mass. Gen. Laws,Chapter 1,43.,Section 6 to be applicable. If any notice under Mass. Gen. Law
Ch. 139,See.3B 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 fire number.
If no reply is received from your office within ten days,we will assume you have no liens of any type against this
property and we will recommend to the insuring company that this claim is paid.
Vicki Gardner
4i3517'IKr,
-.-.----- -w
Ifember of
National Association of Independent Insurance Adjuster