HomeMy WebLinkAboutInsurance Letter - Correspondence - 40 HITCHING POST ROAD 12/29/2023 i
All-state vehicle and Property Insurance Company
WAIIState-DALLAS
PO BOX 660636 TX 75266
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TOWN OF NORTH ANDOVER, MASSACHUSETTS
120 MAIN ST
NORTH ANDOVER MA 018452420
December 29,2023
INSURED: KENNETH DEROCHE PHONE NUMBER: 603-340-0981
DATE OF LOSS: December 01,2023 FAX NUMBER: 866-447-4293
CLAIM NUMBER: 0739499894 DMM OFFICE HOURS:
PROPERTY ADDRESS: 40 HITCHING POST RD,NORTH
ANDOVER,MA
POLICY NO.: 000984437736
Form of Notice of Casualty Loss to Building
Under Mass.0 ell.Laws.01 139.Sce,3B
TO:
Building Commissioner or Board of Health or
Inspector of Buildings Board of Selectmen
CITY/TOWN HALL: North Andover Town Hall
ADDRESS: 120 Main Street
CITY/'TOWN/ZIP CODE: North Andover, MA 01845
Claim has been made involving loss,damage or destruction of the above-captioned property which may either exceed
$1,000.00 or cause Mass, Ceti. Laws,Chanter 143 Section 6 to be applicable, If any notice under• Mass. Gen.
Laws, Chanter 139,Section 313 is appropriate,please direct it to the attention of the undersigned and include a
reference to the captioned insured, location, policy number,date of loss and claim number.
On this date, I caused copies of this notice to be sent to the persons named above at the addresses indicated above by
first class retail.
SIGNATURE AND DATE
MICHAEL MURPHY
December 29,2023
Copy : KENNETH W DEROCHE HANA S DESROCHE
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