HomeMy WebLinkAboutInsurance Corespondence - Correspondence - 40 SURREY DRIVE 12/3/2019 Form of Notice, of Casualty Loss to Building
Under MASS. GEN. it 139, Sec, 3B
To.* Building Commissioner or
Inspector of Buildings
1,20 Main Street
North Andover, MA 01845
RE*- I nsui red,: Evon� Darius Trustee for Walsh Davos I RT c/o Kara
Rem Is
Property Address.* 40 Surrey Drive
Company: Vermont Mutual Insurance Company
Policy/Clairn Number: DF13107806, D0002257
Date/Cause of L,oss,im 11/23/2019,, Water Heater Leak
Our Fi'lle NumIber,-.' 37606-R
Claim has been made involving loss, damage or destruction of" the, above captioned property,
which may either exceed' $,l 000.00 or cause MASSACHUSETTS GENERAL LAWS, CHAPTER
143 SECTION 6, to, be apipilicabl�e. If any notice, under MASSACHUSETTS GENERAL, LAWS
CHAPTER 139, SECTION 3B is appropriat'e, please direct it to the Matte ntionI of the writer and
include a reference to the capti'loned insured, location, policy nurnber, date of loss and claim or
file number.
are Werner, Ext. 116
On this date) I caused' copies of this Notice to be sent to the arsons named above at the
addresses indicated abovIe by First Class Mail.
Sign at r and Date
ANDERSON A I ENT CO., INCIV
5,0 Nashua Road, Suilite 303
PO x 1098
Londonderry', NH 03053
Cc 1# Health Department North Andover Fire Department
120 MainStreet, 795 Chickering Road
North Andover, II A 01845 North Andover,, MA 0118,45