HomeMy WebLinkAboutMiscellaneous - Exception (78)Insurance Adjustment Service Inc.
435 Fjgg Street - Second Floor
Littleton, MA 01460
978-952-6966 - Fax 978-952-2459
Email: iashttleton@netlplus.com
Date: )-?-0?
Board of Health:_ A), d,-,
Building Inspector: 71
Fire Department:
Re: Insured: k,,,he
Location: it p,,lr, G ------ At
NOR H
Claim Number: BOARD OF HEAUM
Policy Number:
Our File Number: Fr -11 -,.jY 7 M
Cause of Loss: W",,
Date of Loss: 12 -Is -121
-121
Dear Sir/Madam:
A claim has been made involving loss, damage or destruction of the above
captioned property which may either exceed $1,000 or cause Massachusetts
General Laws, Chapter 143, Section 6 to be applied.
If any notice under Massachusetts General Laws, Chapter 139, Section 3B is
appropriate, please direct that information to my attention and include a
reference to the captioned insured, location, date of loss and file number.
Thank you for your cooperation.
Very truI rs,
Scott O'Neil
Adjuster
Ext. 129
I'() 131Q 338
1 aesnes a 11 � ��'<'n 1• _ AlUXI TIO
Al' 11.11 ✓Efi. 1�1� , , � III I,,[I I� Oi! il) n:;;3g �ssotuT��
I ll'SKMRI111 NDI%;Nq NT
\ al;�+• I M It !,(7s? •174 t1:3:3(; "o n i
Andover: 471; 81 I l Dwell: 458-2542 -
Haverhill : 371-f)2H,' Lynn: 598-5050
-GE-17Y F111E D11WARTMENT
_BUIL?DI:NG COMMISSIONEH_,-c>r' BOA -RD --- OFHEALTH or
INSP:EC:TOR OF BUILDINGS OARI) OF SELECTMEW�
TOWN OF NORTH ANDOVEFt__�_ (-----TOWN OF Nogni ANnnyF.$
TOWN 1:iALL ___.._.._`]'QWN HATJ,
NORTH �ANDOV R,_ 1�AORTH ANDQVFR r MA
RE: INSURED: -I RANK_
PROPERTY ADDRT:'rS : 11 1'ANA ST .
POLICY NO.: F1J' 12 5 4 51-5_.___._______C014 PANY : MERRIMACK MUTUAL
LOSS OF:— FI12_F'1)A7'r; 9 / 2 7 / 9 2
FILE OR CLAIM PrlO .: _._..__ 2. -1.15 O =F
Claim has been made i,r).volv_i.ng loss, d,amagn or destruction of the
above: captioned proper1:.y, wl)i.ch may ei-11-her exceed $1,000.00 or
cause! Massachusetts _Gon.eral Law, _Chapter_ 143, Section 6 to be
applicable. If any notice under Massachusetts General Law,
Chapter 139, Section 313 is appr..opr_i_ate, please direct it to the
attention of thewr.i.i_er. and include a. .reference to a captioned
insured, location, i:lo.l i_cy number, date of loss and claim of file.
number. .
MARC J. LeBLANC, ADJUSTER
Title
On this date, I caused copies of this notice to be sent to the
persons named above?, at- 1:.he addresses indicated above, by first
class mail.
Signati.
OCT - 2