67 SCHOOL ST UNIT 1 THENORFOLICrDEDHAMGROUN
FNorfojlkUa Dedham MutualFire Insurance Co. Dorchester Mutual Insurance Co. Fitchburg Mutual Insurance Co.
ne 7, 2023
FORM OF NOTICE OF CASUALTY LOSS TO BUILDING
UNDER MASS. GEN. LAWS, CH. 139, SEC. 3B
Building Commissioner, or Inspector of Buildings
c/o City or Town Hall
93 Washington St.
Salem, MA 01970
Board of Health or Board of Selectmen
c/o City or Town Hall
93 Washington St.
Salem, MA 01970
Fire Department or Arson Squad
c/o City or Town Hall
93 Washington St.
Salem, MA 01970
RE: Our File No.: P2312879
Insured: Adelaide Rhodes
Address: 67 School Street, Unit#1, Salem, MA
Policy No.: H2179621A
Loss Date: 04/27/2023
Loss Type: Building or Other Structure Damage
A 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, Ch. 143, Sec. 6 to be
applicable. If any notice under Mass. Gen. Laws, Ch. 139, Sec. 3B is appropriate, please direct
it to my attention and include a reference to the captioned insured, location, policy number, loss
date and claim or file number.
If no reply is received from your office within ten days, we will assume you have no liens of any
type against this property, and the claim will be paid in our customary manner.
Sincerely,
Laurie A Fernandes _
Senior Property Claims Examiner
1-800-688-1825 Ext. 1238
222 Ames Street, Dedham MA 02026 . g ,�•
1.800.688-1825 NDGroup.com Norfolk& Dedham Mutual Fire Insurance Co.
Dorchester Mutual insurance Co.
Fitchburg Mutual Insurance Co.