HomeMy WebLinkAboutInsurance Claim - Miscellaneous - 125 BLUE RIDGE ROAD 9/19/2022 Claim # CLM11919
Advantage Claim Services Adjuster Assigned: Thomas Siebert
200 Sutton St. Suite 233
North Andover MA 01845
Form of Notice of Casualty Loss to Building
Under Mass. Gen. Laws, Ch. 139, Sec. 3B
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To: BOARD OF HEALTH
TOWN OF NORTH ANDOVER SE J 9 Vll
120 MAIN ST Q
NORTH ANDOVER MA 01845 ,IN M4 N�R
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Re: Insured: Frank McFall
Property address: 125 Blue Ridge Rd.
North Andover, MA 01845
Policy #: 12187653
Loss of: 2022/09/12
File or Claim No. AD 2911
Claim has been made involving loss, damage or destruction of the above
captioned property, which may either exceed $1,000.00 or cause
Mass._Gen._Laws,_Chapter_143,_Section_6 to be applicable. If any
notice under Mass_Gen_Laws,_Ch._139_Sec._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
file number.
Thomas Siebert
Title: Adjuster
On this date, I caused copies of this notice to be sent to the persons
named at the addresses indicated above by first class mail.
9-15-2022
Signature and date
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