HomeMy WebLinkAboutInsurance Correspondence - Correspondence - 30 EAST WATER STREET 9/19/2019 Form of Notice of Casualty Loss to Building
Under MASS, GEN, LAWS, Ch. 139, sec. 3
To: Building Department
120 Main Street
N orth Andover, MA 0 184
FEE: Insured: Dean & Mona Thornhill
Property Address: 28-30 E. eater Street
Company: Bay State Insurance Company
Policy/Claim Number- HP0 0 429, HP0806429
Date/Cause of Loss: 9 19 2 19, Rot Damage
Our File Number: 37411- v
Claim has been made 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 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 foss and claim or
file number.
Wade Anderson, Ext. 112
n this date, I caused copies of this Notice to be sent the persons named above at the
addresses indicated above by First Class Mail.
y
/ 1 9
Signature and Date
Al D l SON ADJUSTMENT Co., INC.
60 NashuaToad, Suite 30
Po Box 108
Londonderry, NH 003
Forth Andover Health Department
120 Main Street
North Andover, MA 0184
Borth Andover Fire Department
795 Checkering Road
North Andover, MA 0184