HomeMy WebLinkAboutInsurance Corespondence - Correspondence - 67 ROCKY BROOK ROAD 10/13/2021 A(,J,,v al"i t a q e C.1.a.J.,m IS Ie r-vi c e A-d,3i,.ister Assigned: Glenr"i Guarente
200 Sta,ttor'l St'" . Su."'Lite 233
North MA 01845
Fc")r,I'�m of Nol.-.1ice, oIf Casua-1 ty 1,joss to BiiJ-1d,"'j-r'),g
Under Mass, Ge-m. 1-jaws, Ci'i., 1,39, Sec. '3,B
To BUILDING DEPAR" :'
TOWN OF NORTH" ANDOVER
120 MAIN ST
NORTH ANDOVER MA, 01845
r Re - J'ay liu,apaya Insu'i ed.,
Pr o j,')I r t,y-I 1J,d"1"'E!S)'S 67 Rocky Brolok Rd.,
North Ar-idoverl MIA 01.845
Lo S S 0 f"': 202 1/1.0/13
or ClailTt No. AD 2785
o v e I.1 airrn has been nIe "Irivolvj,T-iig I oss, ciamaige or
capti oneld, property,, whic!"'), May ei.'ther exceed $1, 0010.00 o1ii- cw..iise
not-ice ti nder Ma s a,ws,—Ch,*, 1,13 9--Sappir(,.-)Pr,.i.a,te Please
the wri'ter and 1'ri(-'�I-ude a refer,',ence to tl-ie
dd"-r-�'e 11:"" 1.t 'L o t 1"i.e a t 1-e T",i�,t o�n o f
c,,aptI'i-("")f'Aed,', isi.'Itred, 1,I)o-1 c"',y riurnbe'ri-1 dic"i"te of loss and cil-airin ori,
e rl,L,11T1,1D e r
3,1 el i ice G'�. a r e n,I:-e
T 1.t 1 e A d A.i�I e,r"
0 n is a e ,P
I'lailned at the addresses ini,dicated above by mai''1.
25-2 0 2 1
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Slignaturie an(Ji date